Post Update: Friday, August 27, 2021
Many of us struggle with the decision to begin hospice care. Our natural hesitance to recognize the impending end of life is one of the reasons for that. However, many other factors can make us hesitate. One of those is finance-related. Who pays for hospice care?
That’s a natural worry for people today. The rising cost of medical care, the desire not to leave our heirs saddled with medical debt related to our end of life, and other factors can give us pause. The good news is that paying for hospice is often not a problem for most people. In this post, we’ll explore who pays for hospice care and what you and your family should know.
When you ask who pays for hospice care, there will be one of four potential answers. For many patients, private insurance is responsible for covering these costs. The vast majority of health insurance plans today include hospice coverage. However, to be sure that this is the case, double-check your coverage before enrolling in hospice care. If you are unsure about your coverage, contact your health insurance provider and ask.
Note that private insurance coverage may not be complete. The insurer will only pay for services, medications, and treatments they deem necessary, so it’s wise to discuss the situation with an insurance company representative. Otherwise, you could find yourself facing out-of-pocket costs.
For many Americans, Medicare or Medicaid may also pay for hospice care. If you qualify under Medicare Part A, your plan will cover costs related to hospice care. If you’re covered under Medicare, there will be no out of pocket costs related to hospice care. Not sure if you qualify for Medicare Part A or Medicaid coverage? A reputable hospice care provider can work with you to verify coverage and then enroll you to make things as simple as possible.
Those covered by Medicare will find that the Hospice Plan includes the following:
- Counseling and care for family members for up to a year after the loss of a covered loved one
- Physical therapy and occupational therapy for palliative care purposes
- Speech therapy and dietary counseling for palliative care purposes
- Lab testing
- Diagnostic testing for palliative care
- All prescribed medications
- All over the counter medications
- All required equipment and devices relevant to the terminal illness
- Inpatient treatment necessary for pain/discomfort
What about Medicaid?
Medicaid offers similar benefits to Medicare. However, as this program is administered by each state, the coverage varies from location to location. You can work with your Medicare office to learn more about what’s covered in your state, or you can contact a hospice care provider who can walk you through not just applying for Medicare, but understanding what aspects of care will be covered.
Who Pays for Hospice Care If Insurance Isn’t an Option?
If you lack private insurance coverage and you do not qualify for Medicare or Medicaid, there are options to help making paying for hospice care simpler and easier. First, understand that hospice care is far more affordable than hospital treatment. It’s even less expensive than traditional in-home care.
Most hospice care providers offer access to financing plans that can help pay for the costs of care. Several charities and nonprofit organizations can help to offset the costs, and self-pay financing options can make it easier to spread the costs of hospice care over time.
What Options Can Make Hospice More Affordable?
For those without Medicaid coverage, whether that’s limited coverage through private insurance or self-pay, there are ways to make hospice care yet more affordable. Some of the options include the following:
- Ask the hospice care provider if they have tiered pricing for services
- Learn if there are packaged or bundled treatments and services that offer discounts
- Check if the hospice care company offers discounted service for patients without Medicaid
Perhaps the most important step is this: If you do not currently have Medicaid, work with the hospice care provider to find out if you qualify and then enroll. The US federal government covers 100% of hospice costs under Part A, and the majority of terminally ill patients ultimately qualify for coverage.
This could be your situation – you simply don’t know it yet. Work with your hospice care provider to determine if you qualify for Medicaid hospice coverage, and then enroll in the program. This is the only way to ensure that there are no out of pocket costs to cover and that medical debt is not passed along to your heirs.
Financial Stability and Help
Ultimately, there are several answers to the question of who pays for hospice care. For most patients, Medicare or Medicaid will be the best option, but private insurance and even self-pay financing options can work.