Did you know that Medicare is the largest insurer of health insurance that provides services during the last year of life? For example, 8 out of 10 of the 2.6 million people who passed in 2014 were people on Medicare.[1] Medicare is health insurance for U.S. citizens 65 years and older or others who qualify earlier due to Social Security disability benefits. With this many seniors passing yearly, you might question if Medicare covers end-of-life care. This article will touch more on Medicare and if it covers end-of-life care.

What is end-of-life care?

End-of-life care is designed to support an individual and provide medical care during the last days or years of one’s life. Whether an illness or injury is sudden or prolonged over time, you can receive end-of-life care. End-of-life care can range from mental and emotional needs to medical care.

The two most common end-of-life care types are palliative and hospice care. Palliative care is recommended for those with severe illnesses like cancer or dementia. Palliative care is helpful soon after you are diagnosed with a disease or illness. It can help improve your overall quality of life, such as understanding your medical treatments and symptom management and help you get more comfortable.

At some point, though, an illness or disease might triumph. In this case, most people opt for hospice regarding end-of-life care. Hospice is designed to provide comfort and care and promote a better quality of life during the last six months of your life. Hospice can occur in your home or a facility, such as a hospital or nursing home.

But how does Medicare cover hospice and end-of-life care?

Does Medicare cover hospice?

Original Medicare does cover hospice care when you have six months or less to live. However, you will need to work with a hospice team that accepts Medicare as health insurance for hospice to be covered. There are also some requirements you must meet for Medicare to cover hospice:

• Your primary physician and hospice provider can confirm you are terminally ill
• You accept palliative care instead of care to cure your illness
• You sign a statement opting for hospice instead of other treatment for your illness

Hospice is covered by Medicare Part A. If you have Part A, you will not have any out-of-pocket costs for your hospice care. However, there is a chance you could pay 5% of the Medicare-approved amount for inpatient respite care. You may be charged for room and board if you receive hospice care in a facility such as a nursing home. To ensure your hospice care will be covered, you will want to work with a Medicare-approved hospice program.

If you receive outpatient medication, you may have a copay of up to $5 for your symptom and pain management prescriptions. But, if Medicare denies coverage for your outpatient medications, you will want to contact your Part D drug plan to see if your drug plan will cover the cost.

How to know if you’re eligible for hospice

Eligibility for hospice care is straightforward when it comes to Medicare insurance. If you are enrolled in Medicare Part A and have a certification from your doctor that you have six months or less to live, you will qualify for hospice.

Final point

Although no one wants to consider inquiring about hospice care before they need it, you and your loved ones should become familiar with the program and how it’s covered in the case of an emergency. For more information on how Medicare covers end-of-life care, visit Medicare.gov.

[1] https://www.kff.org/medicare/fact-sheet/10-faqs-medicares-role-in-end-of-life-care/