Paying for Palliative Care
Palliative care is used to provide comfort, relieve pain, and alleviate other symptoms for patients both in and out of hospice. It is often used to treat ailments such as nausea, depression, weakness, and anxiety (to name just a few). This type of holistic care is an essential part of many care plans for ongoing conditions or terminal illnesses. If you or a loved one have been prescribed palliative care, you may be wondering, who pays for that?
The answer? Well, that depends. Let’s discuss palliative care and how to pay.
Medicare
Medicare provides comprehensive coverage for doctor-recommended palliative care that forms part of your hospice care plan. Under the Medicare hospice benefit, a wide range of services are covered. This could include physical therapy, aimed at managing pain or improving mobility and strength. The goal here is not to cure, but to ensure the patient’s comfort and improve their quality of life.
Medication is another significant aspect of palliative care covered by Medicare. This includes drugs used to alleviate symptoms, manage pain, or treat secondary conditions related to the primary illness. However, it’s important to note that prescription drugs may require a small copayment. This cost-sharing measure is typical in many insurance plans, including Medicare.
Other services such as dietary counseling, speech and occupational therapy, and medical equipment (like wheelchairs or walkers) may also be included in the hospice care plan and covered by Medicare. Counseling services for the patient and their family are typically covered as well.
It’s important to note that Medicare coverage for hospice care requires certification from a physician that the patient is terminally ill and has a life expectancy of six months or less, should the illness run its normal course.
Medicaid
Medicaid, a joint federal and state program that helps cover medical costs for some people with limited income and resources, will cover the cost of palliative care as part of a hospice care plan. To qualify for this coverage, the patient must already be a recipient of Medicaid benefits.
For Medicaid to pay, the patient must be certified as terminally ill by a medical professional (just as with Medicare). This certification must be updated periodically to continue receiving covered hospice care.
The specific eligibility criteria and coverage for hospice care under Medicaid can vary significantly from state to state. This might include varying income limits, asset limits, or medical necessity requirements. Therefore, it’s highly recommended for patients and their families to thoroughly research their state’s specific guidelines and regulations. To find out more about the hospice care coverage in your area, visiting Medicaid.gov is a good starting point.
Private Insurance
Most private insurance companies will cover palliative care. It’s best to check with your policy to know for sure. Some assistance might require copays.
Long-Term Care Insurance
Long-term care insurance is meant to fill the gaps in between what private healthcare insurance doesn’t cover. If you or a loved one have a private policy that won’t cover palliative care, then check with your LTC insurance provider! Learn more about Long-Term Care Insurance here.
Do You Need More Help?
Need more help? Then start with these great resources:
Senior Resource Glossary of Hospice Terms
Click here to find home care near you.
Want to learn more about hospice? Then start here.
Need Something Else?
Senior Resource exists to provide aging adults, retirees, and caregivers with applicable, and educational content. We address topics like senior housing, nursing care, and aging in place.
Popular Articles About Hospice Care
Originally published January 31, 2024
Author(s):
