Q: Does Health Insurance Cover Hospice Care?
Asked by Rebecca H. on August 13, 2018
Hospice care gives comprehensive end-of-life support to those who have 6 months or less to live. Hospice providers focus on making you comfortable during a terminal illness.
Hospice is generally thought of as an inpatient service – whether in a dedicated facility or part of a hospital – although in-home hospice care is common. Hospice providers may help you, your family, and your caregiver.
Private Health Insurance: Most health insurance plans – including Obamacare and employer plans – will cover hospice care nearly in full. Your hospice stay will likely come with a dedicated caregiver, any medical equipment you need, and emotional support. When in hospice, your plan can pay for non-medical benefits like food or music therapy.
Your health insurance may want a doctor to verify that your condition is terminal before agreeing to pay for hospice. Your health insurance may ask you to stop receiving curative treatments for your medical condition.
Medicare and Hospices: Medicare accounts for most U.S. hospice spending. Your mandatory Medicare Part A covers most hospice costs.
All Medicare Supplement plans cover your copayments for hospice pain and symptom management prescriptions; and will also take care of your 5 percent copayment for inpatient respite care, which gives time off for you and your primary caregiver if you’re faced with a life-limiting disease.
Since Medicare Part A covers hospices, optional Medicare Advantage plans (which replace your Original Medicare) take care of hospices as well.
Short-Term Health Insurance: These plans rarely interact with hospice care, since temporary insurance plans may not accept new members with chronic or terminal illnesses. It’s possible that you could qualify for hospice care while on short-term insurance if you’re in a serious accident.
All short-term plans are different. While some plans might not cover hospice care, other plans will treat it like any other benefit. Once you qualify for hospice, a short-term plan could pay for your hospice care in full if you’ve met your deductible and out-of-pocket maximum.
Medicaid: In most states, Medicaid will cover hospice care almost in full. Medicaid’s hospice benefits are similar to Medicare.
TRICARE and VA : Veterans’ programs pay for hospice care in the United States and its territories.
Other Insurance Products: Many independent insurance agents sell long-term care insurance, a type of benefit that pays for assisted living needs. Some life insurance plans also include a living benefit rider, which gives you an advance life insurance payment.