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Who Pays For Hospice?

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Money in WalletAll hospices are reimbursed in the same way, so they do not compete on cost. It is the quality of service and spectrum of choices that differentiate one hospice from another.

Hospice care is paid for in a variety of ways. These are the most common types of coverage:

Medicare
If a person is terminally ill and is a Medicare beneficiary using a Medicare-certified hospice provider, 100 percent of hospice services are covered. In 2010, 83.8 percent of hospice patients were covered by the Medicare hospice benefit. Hospice payments are separate from Medicare payments for other illnesses, diseases or care the patient may be receiving.

MediCal
In California, MediCal covers hospice. Nearly all states and the District of Columbia offer 100 percent hospice coverage under Medicaid. In general, Medicaid hospice benefits parallel the Medicare benefit, although there may be some variations in certain states. The hospice you choose will know California state regulations.

Private Insurance
Most insurance plans issued by employers and many managed care plans offer a hospice benefit. In most cases, the coverage is similar to the Medicare benefit, although there may be some variations. Review your coverage details or ask your insurance representative.

TRICARE
TRICARE is the health benefit program for military personnel and retirees. Hospice is a fully covered benefit under TRICARE. Only Medicare-certified hospices can provide for the TRICARE hospice benefit, so it is important for patients and their families to choose a qualified hospice agency.

Private Pay
If insurance coverage is unavailable or insufficient, patients and their families can discuss private pay and payment plans. The hospice you choose can outline your payment options.

Charitable Care
Hospices have a financial specialist on staff to answer questions about financial assistance and any community resources that may be available. There is no need to defer hospice care due to financial concerns.

Provided by VITAS Innovative Hospice Care® of the San Francisco Bay Area. For more information call 1.800.337.2058 or go to VitasBayArea.com.

Posted: February 2013

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