What Does Medicare Cover?

Medicare Hospice Benefits

Hospice services are covered 100% under the Medicare Hospice Benefit. The Hospice Medicare Benefit is provided under Medicare Part A.  To receive the Hospice Medicare Benefit under Medicare Part A, the patient has to elect the Hospice Benefit and waive the traditional Medicare Part A Hospital Benefit. Medicare will continue to make payment for Physician service if attending physician is not a hospice employee. Medicare will also continue to cover services or conditions unrelated to the the life limiting illness.

Coverage

Coverage under the Medicare Hospice benefit is broken into benefit periods:

  • Benefit period ONE - 90 days
  • Benefit period TWO - 90 days
  • Additional Unlimited 60 day periods

The Medicare Hospice benefit can be revoked at any time by completing a revocation statement received from the Hospice office. Traditional Medicare Part A Hospital coverage is reinstated at that time. If the Medicare Hospice Benefit is revoked in the middle of a benefit period the patient loses the remaining days in the benefit period. For example: if a patient revokes the Medicare Hospice Benefit after the first 10 days, the patient gives up the remaining 80 days in the first benefit period. The patient would then have the second period and unlimited 60 day periods.

The Hospice Medicare Benefit pays 100% for:

  • Medications related to the life limiting illness
  • Durable Medical Equipment (hospital beds, walkers, commodes, oxygen equipment, etc.) related to the life limiting illness
  • Hospice Nurse - intermittent visits
  • 24 hour on-call nurse and accessibility of interdisciplinary team members
  • Hospice Aide for bathing
  • Homemaker for light housekeeping
  • Social Worker - intermittent visits
  • Physical, Speech and Occupational Therapist Consultation
  • Hospice Chaplain
  • Dietitian for nutritional consultation
  • Volunteers for respite, companionship, etc.
  • Inpatient Respite - up to 5 days of inpatient care provided in an authorized HoriSun Hospice Inpatient facility
  • Bereavement Services
  • Continuous Care - provided in the patient's home on a 24 hour basis for the specific purpose of controlling acute medical symptoms. The goal of the care is to provide support to the patient/family in order to maintain the patient at home.
  • Inpatient care for symptom control related to the life limiting illness. Symptoms are not controlled and need a highly skilled approach to regain a level of comfort for the patient. Inpatient care is provided in contracted facilities only.
  • The Hospice Medicare Benefit does not include a 24 hour caregiver.