How to Pay for Hospice Care

Covering the cost of hospice care can seem like a daunting task. Fortunately, there are many government-run programs in the United States that offer help, including Medicare, Medicaid, and veterans programs.

Various Programs Available

Medicare

Enacted in 1966, Medicare is currently the United States’ largest national health insurance program. It provides comprehensive benefits for individuals over age 65, plus younger individuals with certain disabilities.

Medicare pays for about 85% of hospice care costs, covering everything from necessary medications and medical equipment to visits from nurses, counselors, occupational therapists, and bereavement counseling for families. However, it does not cover room and board and emergency fees, which are usually paid out-of-pocket.

Medicare provides for two 90-day benefit periods, then an unlimited number of 60-day benefit periods. At the start of each period, a doctor must certify that the patient has less than six months to live.

Medicaid

Medicaid was created alongside Medicare as a national health insurance program for adults of all ages with limited income. It is jointly funded by state and federal governments and managed by the states. Therefore, the benefits prescribed by Medicaid vary widely from state to state.

California’s version of Medicaid is called Medi-Cal. Check your eligibility here. The income limit for Medi-Cal is $16,105 for an individual and $21,708 for married couples. About 20% of all Medicare beneficiaries are dual-eligible for both Medicare and Medicaid. In this case, Medicaid can cover certain costs that Medicare doesn’t cover, such as long-term care.

Veterans Programs

There are two main government-run health insurance programs for veterans and their dependents:

• TRICARE is sponsored by the US Department of Defense. It provides health benefits, including hospice care, for active or retired military personnel and their dependents.
• CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs) is sponsored by the Veterans Administration. It provides health benefits for beneficiaries of certain deceased or disabled veterans.

At La Bella Vita Hospice, we’ll help you determine which of these programs, if any, you or your loved one is eligible for. If none of these programs apply to you, we’ll work with you to develop a financing plan.