First, we want you to be aware that the regulations for Medicare are always changing, and details vary significantly based on the patient’s specific Medicare plan. We always recommend that you stay on top of the latest developments by visiting the official Medicare website to evaluate what will and will not be covered.
However, we want to provide some basic information to help you maximize your Medicare benefits in paying for hospice care.
Does Medicare Cover Hospice?
Yes, Medicare will cover hospice, if you meet qualifications to receive the benefits. These include:
- Your physicians must determine and certify that you have a serious illness with a life expectancy of six months or less
- You have decided NOT to receive treatment to cure your illness
- You accept comfort-related care instead of curative care
- You sign a statement that indicates you’re choosing hospice care instead of other Medicare-covered treatments for your illness
The Medicare hospice benefit covers:
- All items and services needed for pain and symptom management
- Medical, nursing and social services
- Medications needed in relation to your hospice diagnosis
- Durable medical equipment (DME) for pain relief and symptom management (i.e. bed, bedside commode, oxygen, wheelchair, etc.)
- Aide services
- Other covered services you need to manage pain and symptoms, as well as spiritual and grief counseling for you and your family
How Long Will Medicare Pay for Hospice?
Hospice care is for patients who have a life expectancy of six months or less given the current progression of their illness. Typically, Medicare’s initial hospice benefit is broken down into two 90-day benefit periods. If hospice care is still needed after six months, patients can be re-certified for an unlimited number of 60-day benefits.
If you are unsatisfied with the care you are receiving, you can change your hospice provider once during each benefit period.
You can read more about the extensive details of how long Medicare will pay for hospice care in this comprehensive guide. Your hospice provider can also help you understand what is covered by Medicare and any costs that may be involved for specific services.
Does Medicare pay for hospice in a skilled nursing facility?
Yes, it will. However, it’s important to remember that Medicare does not cover room and board associated with living full-time in a skilled nursing facility or nursing home.
Medicare may offer some benefits if your health care team determines you need a short-term inpatient stay to manage pain and symptoms. Lower Cape Fear Lifecare has three hospice care centers designed to specifically meet patients’ and families’ needs. These home-like care centers are available exclusively for our patients, and LCFL is the only area hospice provider to operate these types of facilities.
Medicare’s Hospice Benefit also provides for respite care to give caregivers a much-needed break. Medicare covers most of the cost of respite care. It is available on an occasional basis for a period lasting no more than five days in a row. Lower Cape Fear LifeCare provides respite care for our families at our hospice care centers.
Review your Medicare plan to find out more information about what copays are involved or talk with your hospice provider.
How Can I Maximize My Medicare Benefits?
There are several things you must know to help you maximize your Medicare benefits. These include:
Understanding key differences between the different types of Medicare plans
There are a lot of details that you should not overlook when evaluating your Medicare plans. Again, we refer you to the official Medicare government website for the most recent information.
Free counseling and personalized help with navigating the complexities of Medicare is also available through your State Health Insurance Assistance Program (SHIP). You can find a SHIP counseling location using their online locator.
Review the scope of services that are covered
We encourage you to evaluate your plan to be sure you are taking advantage of all the benefits you are eligible for.
Discover if doctor or provider accepts the Medicare-approved amount as full payment
You can find useful information about finding providers through the search tool at the Medicare website.
Be sure to carefully review Medicare statements
We know it can be overwhelming to receive so many Medicare documents, but it’s vital to review them carefully to be sure you’re getting the benefits for which you qualify.
Lower Cape Fear LifeCare Never Refuses Care Based on Ability to Pay
As a non-profit hospice, we understand the difference that proper care can make in the lives of our patients and their families. That’s why Lower Cape Fear LifeCare never refuses anyone care, regardless of their ability to pay. Why? Because we believe that everyone in our community deserves comprehensive, high-quality hospice care that offers people dignity and respect.
Each year, thousands of families across Southeastern North Carolina and Northeastern South Carolina trust us to provide their hospice care. According to a national caregiver survey, 93% of family caregivers say they would be willing to recommend Lower Cape Fear LifeCare.
Making a referral is easy. You can refer friends, family members, or even yourself.
Need more information? Contact us for more information.