Medicare Hospice Benefit

Medicare will reimburse the cost of hospice care under your Medicare Hospital Insurance. When all requirements are met Medicare will cover the following:

If you are receiving care under the Medicare Hospice Benefit, Medicare requires that no more than 30 days prior to the beginning of the third benefit period (180 days) and prior to each subsequent benefit period, a hospice physician or nurse practitioner must conduct a face-to-face visit with your to determine continued eligibility for hospice care. If you refuse to allow the face-to-face visit, you will no longer be eligible to receive hospice care under the Medicare Hospice Benefit

Services Covered Under the Medicare Hospice Benefit

  • Physician services
  • Nursing care
  • Medical appliances and supplies
  • Medications for symptom management and pain relief of the terminal illness and related conditions (must be pre-approved by hospice)
  • Short-term inpatient care for pain and symptom control
  • Hospice aide/homemaker
  • Spiritual counseling
  • Bereavement counseling
  • Physical therapy, occupational therapy, speech therapy
  • Medical social services
  • Dietary counseling
  • Volunteer services
  • Short-term respite care

Services Not Covered Under the Medicare Hospice Benefit

  • Treatment for the terminal illness which is not for palliative symptom management and is not within the hospice plan of care
  • Care provided by another hospice that was not arranged by the patient's hospice
  • Ambulance transportation not included in the plan of care
  • Medications that are not related to the terminal illness
  • Visits to the emergency department without the prior approval or arrangements by hospice
  • Inpatient care at noncontracted facilities
  • Sitter services/hired caregivers
  • Admission to the hospital without the prior approval or arrangements by hospice
  • Lab studies, medical testing and/ or any treatments not indicated
  • Visits to any physician not identified as your hospice attending physician

If you are receiving care under the Medicare Hospice Benefit, Medicare requires that no more than 30 days prior to the beginning of the third benefit period (180 days) and prior to each subsequent benefit period, a hospice physician or nurse practitioner must conduct a face-to-face visit with your to determine continued eligibility for hospice care. If you refuse to allow the face-to-face visit, you will no longer be eligible to receive hospice care under the Medicare Hospice Benefit