Medicare and Continuing Care
(Watch the video to learn how Medicare covers hospice and respite care. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
What is Hospice Care?
Hospice care is a special way of caring for people who are terminally ill (dying) and helping their families cope. Hospice care includes treatment to relieve symptoms and keep the individual comfortable. The goal is to provide end-of-life care, not to cure the illness. Medical care, nursing care, social services, drugs for the terminal and related conditions, durable medical equipment, and other types of items and services can be a part of hospice care.
Most hospice patients get hospice care in the comfort of their home and with their families. Depending on the patient's condition, hospice care also may be given in a Medicare-approved hospice facility, hospital, or nursing home.
What Medicare Covers
Medicare's hospice benefit provides for support and comfort to patients who are dying, including services not usually paid for by Medicare. Hospice volunteers are available to do household chores, provide companionship, allow the caregiver time off to do tasks outside of the house, and offer support to the patient and family. Medicare also pays for inpatient respite care (short term care for hospice patients) so that the usual caregiver can rest.
Who is Eligible?
To be eligible for hospice care, the patient must have Medicare Part A (hospital insurance) and
- the doctor and hospice medical director must certify that the patient is terminally ill and has probably six months or less to live
- the patient must sign a statement choosing hospice care instead of routine Medicare-covered benefits for their terminal illness
- the patient must receive care from a Medicare-approved hospice program.
Medicare hospice benefits do not include treatment to cure terminal illness. If the patient's health improves or the illness goes into remission, he or she always has the right to stop getting hospice care and go back to the regular Medicare health plan. A hospice patient will continue to have Medicare benefits to help pay for treatment of conditions unrelated to the terminal illness.
Your costs in Original Medicare
- $0 for hospice
- You may need to pay a copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you're at home. In the rare case your drug isn’t covered by the hospice benefit, your hospice provider should contact your Medicare drug plan to see if it's covered under Part D.
- You may need to pay 5% of the Medicare-approved amount for inpatient respite care.
- Medicare doesn't cover room and board when you get hospice care in your home or another facility where you live (like a nursing home).
Questions to Consider
(Watch the video to learn about hospice and other end-of-life care options. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
Here are questions you may wish to consider when selecting hospice care providers.
- Does the hospice provider train caregivers to care for the patient at home?
- How will the patient's doctor work with the doctor in the hospice program?
- What is the patient-to-staff ratio?
- Does the hospice staff meet regularly with the patient and family to discuss care?
- How does the hospice staff respond to after-hour emergencies?
- What measures are in place to ensure hospice care quality?
- What services do hospice volunteers offer? Are they trained?
- Is the hospice program certified and licensed by the state or federal government?
Finding a Hospice Program
To find a hospice program, call 1-800-Medicare (1-800-633-4227) or your State Hospice Organization in the blue pages of your telephone book. (TTY users should call 1-877-486-2048.) You may also call your Regional Home Health Intermediary (RHHI) for more information about Medicare hospice benefits. An RHHI is a private company that contracts with Medicare to pay bills and check on the quality of hospice and home health care. Medicare requires the hospice agency and hospice team you choose to provide care.
To get local telephone numbers for your RHHI or State Hospice Organization, call 1-800-Medicare (1-800-633-4227). TTY users should call 1-877-486-2048.