Medicare Hospice Benefit Facts:
The Medicare Hospice Benefit consists of two 90-day benefit periods and an unlimited number of 60-day benefit periods (patient must
continue to meet eligibility criteria). When the patient elects hospice, they waive all rights to Medicare payments for the duration of their
hospice election for the following services:
■ Care provided by hospice other than the one designated by the patient (unless under arrangement)
■ Services related to the treatment of the terminal condition for which hospice was elected (or a related condition)
What the Medicare Hospice Benefit Won’t Cover
When you choose hospice care, you’ve decided that you no longer want care to cure your terminal illness and related conditions, and/or
your doctor has determined that efforts to cure your illness aren’t working. Medicare won’t cover any of these once you choose hospice
■ Treatment intended to cure your terminal illness and/or related conditions. Talk with your doctor if you’re thinking about getting
treatment to cure your illness. You always have the right to stop hospice care at any time.
■ Prescription drugs (except for symptom control or pain relief).
■ Care from any provider that wasn’t set up by the hospice medical team. You must get hospice care from the hospice provider you
chose. All care that you get for your terminal illness and related conditions must be given by or arranged by the hospice team. You
can’t get the same type of hospice care from a different provider, unless you change your hospice provider. However, you can still
see your regular doctor if you’ve chosen him or her to be the attending medical professional who helps supervise your hospice
■ Room and board. Medicare doesn’t cover room and board. However, if the hospice team determines that you need short-term
inpatient or respite care services that they arrange, Medicare will cover your stay in the facility. You may have to pay a small
co-payment for the respite stay.
■ Care you get as a hospital outpatient (like in an emergency room), or ambulance transportation, unless it’s either arranged by the
hospice team by your hospice team or is unrelated to your terminal illness and related conditions. Note: Contact your hospice
team before you get any of these services, or you might have to pay the entire cost.