By Dr. Allen Naygauzen, a board-certified internal medicine physician in Philadelphia specializing in palliative care, hospice medicine, and house-call services.
Who pays for hospice care? For patients who qualify, Medicare has a hospice benefit, and for patients receiving it, most services related to the terminal illness are covered by Medicare. Medicaid programs and many private insurance plans also provide hospice benefits. And it is completely appropriate to ask how hospice will be paid for at any point, before your family makes any decisions.
What’s in this guide
- Does Medicare Cover Hospice Care?
- It’s Not Just a Nursing Visit: What the Hospice Benefit Includes
- Do Families Pay Anything Out of Pocket?
- What Happens to Other Medications and Treatments?
- No Medicare? Medicaid and Private Insurance Also Cover Hospice
- Not Sure What Your Plan Covers? Ask the Hospice
- There’s No Wrong Time to Ask How Hospice Will Be Paid For
- The One Thing to Remember About Paying for Hospice
- Frequently Asked Questions
- Talk to Humanitas Hospice
Does Medicare Cover Hospice Care?
Yes. For patients who qualify, Medicare has a hospice benefit, and it was designed specifically to support patients and families when the focus of care shifts toward comfort and quality of life.
Hospice is a defined Medicare benefit. The benefit can cover the hospice team, including:
- Nurses
- Physicians
- Aides
- Social workers
- Chaplain support
It can also cover medications, medical equipment, and supplies related to the terminal illness.
It’s Not Just a Nursing Visit: What the Hospice Benefit Includes
Families are often surprised by how much support hospice can provide, because it is not just a nursing visit.
Hospice isn’t simply someone coming to the house to check on you. It is an entire system of support, built around keeping the patient comfortable and helping the family care for them. You can read how that works day to day on our hospice care at home page.
Depending on the patient’s needs, hospice can provide:
- Medications related to comfort
- Medical equipment, such as a hospital bed or oxygen supplies
- Aides
- Social work support
- Spiritual support
- Access to clinical help around the clock
The full list of hospice services Humanitas offers is on its own page.
Do Families Pay Anything Out of Pocket?
For patients receiving the Medicare hospice benefit, most services related to the terminal illness are covered by Medicare.
There can be limited circumstances where a patient has some financial responsibility. Things that aren’t related to the hospice diagnosis may continue to be handled through the patient’s regular Medicare coverage or other insurance. The specifics can vary.
So this is one area where the Humanitas team reviews the patient’s coverage with the family before care begins.
What Happens to Other Medications and Treatments?
Starting hospice does not mean suddenly stopping all of someone’s medications.
The team reviews the entire medication list and asks a very practical question: is this medication still helping this particular patient?
Medications that continue to provide meaningful benefit may absolutely continue. Others may no longer make sense, either because their benefits are primarily years down the road, or because their burdens and side effects now outweigh their benefits.
Those decisions should be individualized and discussed with the patient and family. Hospice is about changing the goal of treatment, not abandoning treatment. If that shift in goals is the part your family is wrestling with, our guide to hospice vs. palliative care covers it in more depth.
No Medicare? Medicaid and Private Insurance Also Cover Hospice
Medicare isn’t the only way hospice can be covered.
Medicaid programs and many private insurance plans also provide hospice benefits, although the exact coverage and requirements can differ depending on the plan. That means the answer to who pays for hospice care can differ from one family’s plan to the next. Not having Medicare is not, by itself, a reason to assume hospice isn’t available.
Not Sure What Your Plan Covers? Ask the Hospice Provider
When a family isn’t sure what their plan covers, the recommended step is to call the hospice provider and ask.
Families shouldn’t have to become insurance experts at one of the most difficult times in their life. The Humanitas team can review the patient’s insurance, verify the hospice benefit, and explain what is covered before the family makes any decisions.
Asking the question doesn’t commit you to hospice. It simply gives you the information you need to make an informed decision.
There’s No Wrong Time to Ask How Hospice Will Be Paid For
It is completely appropriate to ask about cost at any point.
Families are dealing with medical decisions, emotional stress, caregiver responsibilities, and often financial concerns, all at the same time. They deserve a clear explanation of what insurance covers and what, if anything, they may be responsible for. Those questions should never make someone feel uncomfortable or embarrassed. They are part of planning someone’s care.
If cost is making you hesitate
Uncertainty about cost should not prevent at least having a conversation. If your loved one may qualify for hospice, a call lets the hospice determine what coverage is available. For many Medicare beneficiaries, the hospice services related to their terminal illness are covered through the Medicare hospice benefit. That conversation lets you understand both the medical options and the financial side of the decision.
The One Thing to Remember About Paying for Hospice
Fear about cost shouldn’t prevent a family from asking for help.
Hospice is a defined Medicare benefit, and Medicaid and many private insurance plans also provide hospice coverage. If you are caring for someone with a serious illness and wondering whether hospice might help, the next step is to call and ask. Humanitas also has a referral form online. The team can determine eligibility, explain the coverage, and help you understand your options.
The conversation itself doesn’t obligate you to anything. And sometimes, understanding what’s available can make an incredibly difficult situation a little easier.
Frequently Asked Questions
Does Medicare cover hospice care?
Yes, for patients who qualify. Medicare has a hospice benefit designed specifically to support patients and families when the focus of care shifts toward comfort and quality of life. The benefit can cover the hospice team, including nurses, physicians, aides, social workers, and chaplain support, as well as medications, medical equipment, and supplies related to the terminal illness.
Is hospice free?
For patients receiving the Medicare hospice benefit, most services related to the terminal illness are covered by Medicare. There can be limited circumstances where a patient has some financial responsibility, and things not related to the hospice diagnosis may continue to be handled through the patient’s regular Medicare coverage or other insurance. The specifics can vary, so the team reviews coverage with the family before care begins.
Who pays for hospice care if someone doesn’t have Medicare?
Medicare isn’t the only way hospice can be covered. Medicaid programs and many private insurance plans also provide hospice benefits, although the exact coverage and requirements can differ depending on the plan. Not having Medicare is not, by itself, a reason to assume hospice isn’t available.
Do you have to stop all medications on hospice?
No. Starting hospice does not mean suddenly stopping all of someone’s medications. The team reviews the entire medication list and asks whether each medication is still helping this particular patient. Medications that continue to provide meaningful benefit may absolutely continue. Others may no longer make sense because their benefits are years down the road, or because their burdens and side effects now outweigh their benefits.
Does hospice provide equipment like a hospital bed or oxygen?
Depending on the patient’s needs, hospice can provide medical equipment such as a hospital bed or oxygen supplies, along with medications related to comfort, aides, social work support, spiritual support, and access to clinical help around the clock. The Medicare hospice benefit can cover medications, medical equipment, and supplies related to the terminal illness.
Does asking about hospice coverage commit you to anything?
No. Asking the question doesn’t commit you to hospice. It simply gives you the information you need to make an informed decision. The team can review the patient’s insurance, verify the hospice benefit, and explain what is covered before the family makes any decisions. The conversation itself doesn’t obligate you to anything.
Talk to Humanitas Hospice
If you are trying to work out how hospice would be paid for in your family’s situation, you can contact the Humanitas Hospice team or call (215) 302-9955. The team can review your loved one’s insurance, verify the hospice benefit, and explain what is covered before you make any decisions. Asking doesn’t obligate you to anything.
Related Reading
- Hospice care questions families ask most
- Is it time for hospice? A short set of questions
- How Humanitas approaches hospice care
About the Author
Dr. Allen Naygauzen is a board-certified internal medicine physician in Philadelphia. His practice focuses on palliative care, hospice medicine, and house-call services.
This article is general information about paying for hospice care, not insurance, financial, or medical advice about any individual patient. Coverage and requirements can differ depending on each patient’s plan. Questions about a specific situation are best answered by reviewing that patient’s own coverage with the hospice.
