Medicare Hospice Coverage

Medicare is the leading health care insurance provider in the United States for seniors. It is a federally funded program which centers its purpose in providing basic health insurance to seniors with age 65 and above. Medicare coverage is based on three main factors: the federal and state laws, the national coverage decisions made by Medicare about whether something is covered and local coverage decision made by companies in each state that process claims for Medicare. Often, these companies decide whether something is medically necessary and should be covered in their area. Medicare covers 100% of Hospice Patients Care and End Of Life. With HealthNow, you do not have to worry about any bills that may arise from Hospice Coverage.

The two main plan coverage of Medicare are the Original Medicare which has Part A and B and a Medicare Advantage Plan (Part C). In order to receive hospice care, you must meet the following conditions: a certification from a hospice doctor or your regular doctor that you are terminally ill with less than six months to live, you must accept that your illness has no cure and wants to receive palliative care for comfort only and a signed statement that you opt to receive a hospice care instead of Medicare-covered benefits to treat your terminal illness and other related conditions.

The HealthNow Hospice Care Program can include services such as doctor services, nursing care, medical equipment and supplies, prescription drugs for symptoms control or pain relief, hospice aide and homemaker services, physical therapy and occupational therapy, speech-language pathology services, dietary counselling and grief and loss counselling for you and your family. It will also include a short-term inpatient care for pain and symptom management and a short-term respite care. For the respite care, your hospice care provider will arrange it for you. You can get inpatient respite care if your usual caregiver needs rest. You can for five days each time you get respite care, you can get it more than once and it can be provided on an occasional basis. Finally, as recommended by your hospice team, you may get any other Medicare-covered services needed to manage your pain and other symptoms that are related to your terminal illness and other related conditions.

Depending on your plan coverage, Medicare can also cover medically necessary services and preventive services. Medically necessary services are services or supplies needed to diagnose or treat medical condition that meet accepted standards of medical practice. Preventive care is health care to prevent illnesses or detect it at an early stage when treatment is most likely to work best. You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.  Other than these, Medicare may also cover things like clinical research, ambulance services and durable medical equipment (DME). They also include services for your mental health whether you are inpatient, outpatient or in partial hospitalization. They can also include limited outpatient prescription drugs.

Now that you know what are the services Medicare offers and covers for your HealthNow Hospice Care, it is also important to know what services Medicare does not cover. Medicare will not cover treatment intended to cure your terminal illness, prescription drugs to cure your illness, care from any hospice provider that wasn’t set up by the hospice medical team, room and board and care you get as a hospital outpatient, hospital inpatient and ambulance transportation once your hospice care starts. It is always best to talk to your hospice team before you decide to get any of these services to avoid paying for any unnecessary cost.