The Medicare hospice benefit is one of the most complete benefits in American health care. It is also one families understand the least at the very moment they need it. Here is the plain version of what it covers, what it costs and who qualifies.
What the benefit covers
Once hospice is elected, Medicare covers the care related to the terminal illness, with little to no cost to the family. That includes the care team of nurses, aides, a physician, a social worker and a chaplain; the medications that keep the patient comfortable; the equipment and supplies the illness calls for; and counseling and bereavement support for the family. It is care built to surround a person, not only to treat a symptom.
The four levels of care
The benefit flexes with need across four levels. Routine care at home covers most days. Continuous care brings intensive nursing through a crisis. General inpatient care handles symptoms that are hard to manage at home. Respite care gives family caregivers a planned rest. A strong hospice can move between these levels as the situation asks.
What it costs
For care covered under the benefit, families pay little or nothing. A small copayment may apply to some medications or to respite care. Your own plan can carry specifics worth confirming. Medicare answers questions directly at 1.800.633.4227 or medicare.gov. We are glad to walk you through it.
Who qualifies
A physician certifies that the illness, left to run its usual course, carries a life expectancy of six months or less. Many people live longer. The benefit continues as long as they remain eligible, reviewed at set points along the way. Choosing hospice means care turns toward comfort rather than cure for that illness. A family can step away from the benefit at any time and return to other treatment if they wish.