Who pays for Hospice?

When facing the serious illness and death of a loved one, medical expenses are one more looming stressor for families.

One reason people hesitate to call hospice is misinformation and understanding about who pays for hospice services and how those expenses are paid. Another huge medical bill is not an option.

But the fact is, both Medicaid and Medicare cover hospice services, as does the Veteran’s Health Administration and most private insurers.

No family should suffer unnecessarily because they think they cannot afford hospice. Here’s a summary of how Hospice is paid.

Who covers hospice costs?

Hospice is covered by Medicare and by Medicaid in New York State, by the Veterans Administration and most private health insurance policies. To be sure of your coverage, hospice will check with your health insurance provider and inform you of any charges. (Please note: Medicare does not cover the room and board charge associated with the Joe Raso Hospice Residence.)

What benefits cover hospice?

The Medicare Hospice Benefit is the most common payor for hospice services in most states. People are eligible for Medicaid when their income and assets are low. Medicaid benefits are very similar to the Medicare Hospice Benefits.

Are there hospice benefits for veterans?

The Veteran’s Health Administration covers hospice care. It provides benefits that are very similar to the Medicare Hospice Benefits.

What about private insurance for hospice care?

Many private insurance companies provide some coverage options for hospice care. Check with your insurer to learn more about your hospice coverage and qualifications. Private insurers may have different eligibility requirements.

I don’t have insurance, and I don’t think I’m eligible for hospice benefit programs. What should I do?

For individuals who do not have insurance and can’t afford hospice services, a hospice may provide care either free or on a sliding scale. This financial assistance is provided through donations, gifts, grants or other community sources. United Hospice can help you determine if you are eligible for free or reduced cost care.

If Medicare or any other health insurance will not cover the patient, will hospice still provide care?

First hospice assists the families in finding out whether the patient is eligible for any additional coverage they don’t know about. A financial assessment can determine any benefits for which you qualify and any fees that may have to be paid out of pocket. In any case, Hospice care is provided regardless of the family’s ability to pay.

How do I know if I qualify for hospice benefits?

A patient’s eligibility for hospice benefits may vary depending on who is covering the cost of care. Most hospice care in the U.S. is covered by the Medicare Hospice Benefit, which requires:
•    Patients have been diagnosed with a terminal illness
•    Be 65 years or older
•    Doctor and a hospice medical director certify that the patient has less than six months to live

Many other hospice benefit programs follow these same guidelines set by Medicare.

If you have any questions about hospice services or how you or a loved one are able to pay for hospice, please call United Hospice and we will be happy to help you assess your needs and options. Contact us at 845.634.4974.

Sources: unitedhospiceinc.org, americanhospice.org