Medicare Hospice Benefit
Hospice is covered under the Medicare Part A (hospital insurance) benefit. For the vast majority of our clients, there is no out-of-pocket expense for hospice services under the Medicare and Medicaid Hospice Benefit. Most private insurance plans have coverage for hospice services and payment for services varies according to the provisions of the individual policy. Typically, however, all services, treatments, prescription drugs, supplies and equipment, which are related to the hospice diagnosis, are fully covered. When your care is covered by the Medicare hospice benefit, you may also be covered through your Part A benefit for any services unrelated to your hospice care.
Minnesota Hospice provides care regardless of ability to pay and will work with the client and family to resolve financial concerns.
For clients and their families who elect hospice, Minnesota Hospice will:
- Verify coverage with all reimbursement entities and submit all required claims, paperwork, and updates on your behalf.
- Physician-directed services
- Nursing, social work, spiritual care and home health aide
- Medical equipment and supplies
- Short-term inpatient care
- 24/7 on-call availability
Personal Care Assistance
To lessen the burden on the family, our Home Health Aides help with daily living activities, including but not limited to:
- Bathing and hygiene
- Light housekeeping
Emotional and Spiritual Support
Clients and families will receive emotional, psychological and spiritual support from experienced professionals.
- Medical social services
- Spiritual services
- Bereavement services
- Trained volunteers
- Respite care
Minnesota Hospice understands how important communication is during this time and we recognize that many of our clients face communication challenges due to hearing, speech or visual impairment. We also recognize some individuals communicate in a language other than English. If necessary, Minnesota Hospice will arrange interpreter services. There is no additional cost to the client for this service. For those who experience hearing or speech difficulties, an interpreter can be available. An arrangement may also be made to use a TTY/TDD service.
The following services are not covered under the hospice Medicare benefit:
- Treatment intended to cure your serious, life-limiting illness. As a hospice client, you always have the right to stop hospice care at any time and get the Medicare coverage you had before you chose hospice care.
- Prescription drugs to cure your illness rather than for symptom management or pain relief.
- Care from more than one hospice provider at the same time. All care that you receive for your hospice diagnosis must be given by one hospice agency of your choice. You cannot get the same type of hospice care from two agencies at the same time.
- Room and board are not covered by Medicare if you receive hospice care in a skilled nursing facility, assisted living facility or hospice residential facility.
- Care in an emergency room, a hospital facility or ambulance transportation, unless it is either arranged by your hospice agency or is unrelated to your hospice diagnosis.
Hospice Care With a Medicare Advantage Plan
All Medicare-covered hospice services are covered under the regular Medicare Part A benefit, even if you are in a Medicare Advantage Plan (like HMO or PPO) or other Medicare Health Plan. However, your Part A benefit will continue to cover you for any extra services not covered by the regular Medicare Part A benefit, such as dental and vision benefits. If you choose to stay in your Medicare Advantage Plan while getting hospice care, you must continue to pay your plan’s monthly premium.
Care For a Condition Other Than Your Hospice Diagnosis
You should continue to use the regular Medicare Part B Benefits to get care for any health problems not related to your hospice diagnosis. The hospice team will determine whether any other medical care you need is related or not related to your hospice diagnosis. You must pay any deductible and coinsurance amounts for all Medicare B covered services. You must also continue to pay Medicare premiums, if necessary.
For more information about the Medicare Plan, Medicare Advantage Plans, Medigap and other Medicare Health Plans, look in your copy of the “Medicare and You” handbook mailed to every Medicare household in the fall. If you do not have the “Medicare and You” handbook, you can visit the Medicare website. You may also get a free copy by calling 1-800-MEDICARE.
For more information about the Hospice Medicare Benefit, you can visit the National Hospice and Palliative Care Association (NHPCO) Hospice Association of America Medicare Website at www.NHPCO.com or call 1-800-MEDICARE.