Who Pays for Hospice?

Medicare

Hospice patients, in most cases, are Medicare eligible. Being a Medicare benefit, 100% of the cost of hospice care is covered under Medicare. There is no deductible needed for hospice, although a small co-payment may be required for some medications that are not covered, as well as payment for respite care may be required or not covered by Medicare. 

Medicaid 

Payment for hospice services is made to the hospice provider based on the Medicaid hospice rates are released yearly by the Center for Medicare and Medicaid Services. Payments for hospice is made at a predetermined rate for each day the patients is under hospice care, which also depends on the intensity of care the patient receives and is generally determined on a case by case basis. For more information on Medicaid as it pertains to hospice, visit medicaid.gov. 

Private Insurance

Most private insurances, such as coverage provided by an employer, usually has hospice care covered under most plans, though in most cases a prior authorization must be obtained in order to proceed with care.  Check with your health insurance provider for more information on if hospice is covered under your plan.

Medication Information

In hospice, all medications related to the diagnosis of the patient are covered 100%. Other medications may require a co-pay to the patients pharmacy, which varies from medication to medication. Sanitary equipment is also covered by hospice.

Durable Medical Equipment

Durable medical equipment is covered 100% for hospice patients. This is included, but not limited to hospital beds, oxygen equipment, wheelchairs, oxygen tanks, etc.