Compassion and Coverage: How Medicare Helps During Hospice and Palliative Care
Each November, we recognize National Hospice & Palliative Care Month, a time to honor the dedicated professionals who provide comfort, dignity, and support to individuals and families facing serious or terminal illness. It’s also an important opportunity to raise awareness about the role Medicare plays in ensuring that compassionate care is both accessible and affordable during life’s most delicate moments.
Understanding Hospice and Palliative Care
While the terms hospice and palliative care are sometimes used interchangeably, they serve different needs:
Hospice care is designed for individuals with a life expectancy of six months or less when curative treatment is no longer the focus. The goal is to maximize comfort, manage pain, and support both the patient and their loved ones.
Palliative care, on the other hand, can begin at any stage of a serious illness. It works alongside curative treatments to relieve symptoms, improve quality of life, and offer emotional and spiritual support.
Both approaches center on one thing - compassion.
How Medicare Supports Hospice Care
Medicare has long recognized the importance of hospice care. Under Medicare Part A, beneficiaries are entitled to comprehensive hospice coverage when they meet certain criteria:
A doctor certifies that the individual has a life expectancy of six months or less.
The person chooses to receive comfort care instead of curative treatment.
The care is provided by a Medicare-approved hospice organization.
Once enrolled, Medicare covers nearly all hospice-related services, including:
Care provided at home, in a hospice facility, or in a nursing home
Doctor and nursing services
Medical equipment and supplies
Pain management and symptom control medications
Counseling and grief support for both the patient and family
In most cases, beneficiaries have little to no out-of-pocket costs, aside from small copayments for medications or inpatient respite care.
Hospice Coverage with Medicare Advantage (Part C)
Even if you’re enrolled in a Medicare Advantage (MA) plan, hospice benefits are still provided and paid for by Original Medicare, not your Medicare Advantage plan. This is a key distinction many beneficiaries don’t realize.
Here’s how it works:
When you elect hospice care, Original Medicare steps in to cover all hospice-related services.
Your Medicare Advantage plan continues to cover any care unrelated to the terminal illness or hospice diagnosis, such as routine dental or vision services, prescription drugs not related to hospice, or emergency care.
You remain enrolled in your MA plan during hospice care, and your plan may still offer supplemental benefits or coordination support.
This arrangement ensures continuity of care and access to hospice providers, regardless of which type of Medicare plan you have.
What About Palliative Care Coverage?
Unlike hospice, palliative care does not have a distinct benefit under Medicare. However, many of its services are covered under Medicare Part B, including:
Doctor visits and consultations with palliative specialists
Outpatient therapies
Certain medications
Mental health and social work support
Some Medicare Advantage plans may offer enhanced palliative or chronic care management benefits, so it’s important to review your plan details or talk with your broker to understand what’s included.
Common Misunderstandings
Many people delay considering hospice or palliative care because they believe it means “giving up.” In truth, these programs are about living well for as long as possible, focusing on comfort, connection, and dignity. Hospice care can even be discontinued if a person’s condition improves or if they decide to pursue curative treatment again.
Bringing It All Together: Compassion and Coverage
Whether you have Original Medicare or a Medicare Advantage plan, you have access to compassionate care options that prioritize comfort, dignity, and support. Understanding how coverage works can make these difficult times a little easier to navigate.
As a Medicare broker, I’m here to help you explore your options and ensure you’re getting the care - and the coverage - you deserve.
This National Hospice & Palliative Care Month, take time to talk with your loved ones about your wishes and your Medicare plan. When care matters most, both compassion and coverage make all the difference.
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