Hospice is one of the most generously covered benefits in American health care. Here's who pays, and what you might owe.
How Medicare and Medicaid pay for hospice
Medicare Part A is the largest payer of hospice care, covering it fully for patients certified terminally ill with about 6 months or less to live. There's no deductible and no cost beyond up to $5 per symptom-relief prescription and 5% for respite care. Medicaid offers a hospice benefit in every state with terms that closely mirror Medicare's, often with little or no patient cost. For people who are dually eligible for both Medicare and Medicaid, the two programs coordinate so out-of-pocket costs are minimal. Room and board in a facility is the main expense neither hospice benefit covers.
Veterans, private insurance, and the uninsured
Veterans can receive hospice through the VA as part of their standard medical benefits, often at no cost. Most private and employer health plans, as well as Medicare Advantage members (whose hospice is paid by original Medicare), also cover hospice care. For the uninsured or underinsured, many nonprofit hospices provide charity or sliding-scale care funded by donations and grants, so financial hardship rarely prevents access. A Medigap plan can cover Medicare's small hospice charges and help with unrelated medical costs. To learn exactly who pays for your situation, call 1-800-MEDIGAP.