Understanding Medicare Hospice Billing

Many individuals shy away from the idea of hospice care, fearing undue expense. However, the truth is that hospice care is fully covered under Medicare (Part A). Here at Wings of Hope, we’ve seen far too many families struggle to sustain hospice care alone, not knowing that helping hands are available under their usual insurance coverage.

Here are some of the most common questions that we hear about hospice coverage and Medicare.

Who Qualifies for Hospice Coverage?

If you have Medicare Part A (which is designated hospital insurance) then you can also get hospice coverage if all of the following is true for you:

  • Your hospice doctor confirms your status as terminally ill. If the disease runs its expected course, hospice care is in effect when the life expectancy is 6 months or less. Of course, if life continues beyond this time, you can still get continued coverage, as long as you have the form re-signed by your hospice doctor.
  • Rather than continuing to treat the disease, you’re opting only for palliative care (another word for comfort care, or quality-of-life care.)

What Is and Isn’t Covered by Medicare?

Nearly everything that you’ll need for home hospice care is covered by Medicare. This includes:

  • Necessary medical equipment, such as hospital beds, bedside commodes, etc.
  • Medication necessary for palliative care (including pain medication, sleep aides, etc.)
  • Doctor care
  • Nursing care
  • Mental health care and counseling for both you and your family
  • Physical therapy services
  • Medical supplies, such as bandages, etc.
  • Short-term inpatient care
  • Short-term respite care

There are a few things that are not covered under Medicare that you may also need for treatment. This could include…

  • Room and board for residential hospice care
  • Treatment for your disease, or anything beyond palliative care
  • Medical services arranged outside your hospice provider

Even when something isn’t covered by Medicare, we work closely with clients to ensure that we’re able to give the best care, regardless of financial constraints. Communicating with us about your plans can help you get the best coverage.

How Does Billing Work?

You and your family shouldn’t have to cover any of the normal cost of hospice care. Your chosen hospice care provider bills Medicare directly. Beyond continuing to pay your premiums for Medicare A and B, you should be able to entirely pass over the concerns of payment so that you can focus on what matters most.

You can learn more from this official Medicare booklet, or give us a call to discuss treatment and payment details for your specific case. (602) 971-0304

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