The Truth About Hospice Care – Myth No. 4:
Hospice Care is more expensive
Studies have shown hospice care to be less expensive than conventional care during the last six months of life. Less high-cost technology is used, and family, friends and volunteers provide an estimated 90 percent of the day-to-day patient care at home.
Additionally, patients eligible for Medicare of Medicaid generally pay fewer out-of-pocket expenses related to their hospice care. Many private insurers also cover some or most hospice-related expenses.
According to Medicare.gov, people who meet all of the following conditions are eligible to receive hospice care benefits if:
- The person is eligible for Medicare Part A (Hospital Insurance),
- The person’s doctor certifies he or she is terminally ill and expected to have six months or less to live (recertification is required every six months),
- The person accepts palliative care (for comfort) instead of care to cure his or her illness,
- The person signs a statement choosing hospice care instead of routine Medicare-covered benefits for his or her illness.
Medicare Hospice Benefit
According to Medicare.gov, hospice benefits can include:
- Doctor services
- Nursing care
- Medical equipment (like wheelchairs or walkers)
- Medical supplies (like bandages and catheters)
- Drugs for symptom control or pain relief (may need to pay a small co-payment)
- Hospice aide and homemaker services
- Physical and occupational therapy; speech-language pathology services*
- Social worker services
- Dietary counseling
- Grief and loss counseling for the hospice patient and their family
- Short-term inpatient care (for pain and symptom management)
- Short-term respite care
- Any other Medicare-covered services needed to manage pain and other symptoms related to the terminal illness, as recommended by the hospice team
*Costs of these services would fall under a per diem reimbursement. A hospice program may agree to a physical therapy or speech consult only, not a series or therapy sessions.
What Medicare Does Not Cover When Hospice Care Is Chosen:
- Treatment intended to cure a terminal illness.
- Prescription drugs to cure illness (rather than for symptom control or pain relief)
- Care from any hospice provider that wasn’t set up by the hospice medical team.
- Room and board. Medicare doesn’t cover room and board if hospice care is proved in the home, in a nursing home, or in a hospice inpatient facility.)
- Care in an emergency room, inpatient facility care, or ambulance transportation, unless it’s either arranged by a hospice team or is unrelated to a terminal illness.