Medicare offers a benefit for those nearing the end of life. This benefit is called hospice care. This benefit is optional though, so you must choose to receive this care. For you to qualify for hospice, a doctor must certify that you have six months or less to live.
Hospice care does not try to cure your illness. Instead, hospice focuses on keeping you comfortable and improving your quality of life in your final weeks or months. Hospice care caters to your physical, emotional, and spiritual needs. Hospice care also helps your family cope with your illness.
The hospice benefit covers several services that Medicare typically does not cover otherwise. These include respite care, which gives your caregivers some physical relief. It covers nurses, if you have a medical emergency. It also provides grief counseling for your loved ones. Choosing hospice care is a big decision. Please give it careful thought.
How does hospice care work?
Most hospice patients get care at home. But you may get some hospice care in a hospice inpatient facility, hospital, or nursing home.
It is important to know that Medicare does not pay for both room and board and hospice care under the hospice benefit. If you get hospice care while at a skilled nursing facility, Medicare will pay either for the hospice care, or the stay, but not for both.
Example: If Medicare does pay for your nursing home stay, you would need to find another way to pay for the hospice care. If you pay for your nursing home in another way, such as private self-pay or Medicaid, Medicare will cover your hospice care.
There is one exception. Medicare will cover both room and board and hospice care when you need respite care, which we explain below.
Does my own doctor give me hospice care?
Your regular doctor can be part of the team of people who help and support you when you choose hospice care. You will have a specially trained medical and support team to help you and your family. This can include:
- Social workers
- Skilled therapists
- Hospice aides
You and your family also can reach a hospice nurse or doctor any time of day or night.
Will I die sooner in hospice care?
Hospice care does not shorten your life. But it is not designed to prolong your life either. It is meant to give you and your family comfort and support as you live out your life with a terminal illness.
What is respite care?
It is temporary care that lets the family member or friend who cares for your take time off to rest.
You can stay in a setting Medicare approves for up to 5 days each time you get respite care. This may include a hospice inpatient facility, hospital, or nursing home, And you can get respite care as many times as you need it.
Learn more about respite care and find other caregiver resources on the Medicare.gov website.
If I am in hospice for cancer and have a heart attack, can I be treated?
Yes. Medicare will pay for services it normally covers if you have a health problem unrelated to your terminal illness. You pay any deductible and coinsurance you would normally pay for such services.
When you choose hospice care, you only waive your rights to Medicare benefits that would cover treatment of your terminal illness.