Parts of Medicare and Hospice Coverage
Medicare is broken down into different parts: A, B, C, D, and Medigap. To qualify for the hospice-care benefit from Medicare, you need Medicare Part A, which covers hospital insurance and all other conditions. Medicare typically pays your hospice provider for your hospice care and there’s no deductible, but you’ll pay the remaining cost of monthly Medicare Part A or Medicare Part B premiums.
Medicare Part A covers most medically necessary hospital, skilled nursing facility, home health, and hospice care treatments, and also provides caregivers with respite. Under Medicare Part A, you’ll need to meet specific conditions certified by a hospice doctor and regular doctor.
- Your hospice doctor and regular doctor must certify that you are terminally ill and expected to live six months or fewer.
- You agree to accept palliative or comfort care instead of curing your illness.
- You sign a statement accepting hospice care instead of other Medicare treatments for terminal illness.
Medicare Part B provides outpatient and medical coverage, which includes certain doctors’ services, outpatient care, medical supplies, x-rays, mental health care and some home health, and other preventative services.
Medicare Part C is the Medicare Advantage part of Medicare, which lets private health insurance companies offer the same Medicare benefits as original Medicare. If you have Medicare Advantage and decide on hospice care, you can still receive hospice coverage through Medicare A. Medicare C may also help cover the cost of treatments unrelated to hospice care or terminal illness. Hospice is not covered under Medicare Part C.
Medicare Part D covers outpatient prescription-drug insurance and is provided only through private insurance companies with government contracts. This coverage will also help you pay for prescriptions not related to your terminal illness.
Medigap, also known as Medicare Supplement Insurance, fills certain gaps in Original Medicare. Hospice care is, for the most part, covered by Part A and Original Medicare, but Medigap fills in for additional health costs such as copayments, deductibles, and coinsurance. To learn more, read my article What Is Medigap?