I was recently asked the question from one of my clients here in Long Beach, California. Does Medicare Cover Hospice? What he was really asking is, will I incur any cost associated with hospice care for my spouse.
Interestingly enough Hospice coverage is provided through your Original Medicare Part A coverage and as long as you have the Plan A, Plan G, Plan N, or Plan F they will pick up 100% of all cost.
Without having a Medigap plan in place you would be responsible for any and all copays and coinsurance for all services provided for your hospice care.
This client made it clear to me that he was not willing to give up the fight for his spouses life. He instructed the Doctor to do whatever it takes to keep her alive. This is important as you also have to agree to Hospice and are not required to accept the Doctors advise.
If you are covered by a Medicare Advantage plan it will be important that you review your plan in full. You may have co-pays, coinsurance, and a max out of pocket limit up to a maximum allowable amount of $7,550 for the 2021 plan year.
While hospice should be covered by your Medicare Advantage plan, unfortunately we are unable to better define your cost as there are to many variations of cost depending on which plan you signed up for.
We always recommend that you contact your insurance company to inquire about how your coverage should work. As your Medicare Insurance Agent we can help explain your benefits based on the Medicare Advantage plan that you selected.
In order for you or your family member to qualify for hospice care, Medicare will require a Doctor to certify that you are at the end of your life. The official term used is “Terminally ill” which means you have a life expectancy of 6 months or less.
Even though your Doctor is certifying that you or your family member only has 6 months to live, there is no time limit that you can be on hospice. This means that if you or your family member lives past the 6 month period, the Doctor would need to recertify the need for Hospice care.
According the Medicare.gov this re-certification process must be a face-to-face certification. Once your Doctor has recertified your need for Hospice your care will continue.
As mentioned above both your Doctor and yourself have to agree to Hospice care. If either of you will not put it in writing that this is the option you both choose then the fight for your life will continue.
Integrity Now Insurance Brokers is here to help you will all of your Medicare needs. If you are new to Medicare or just have a few questions about your Medicare coverage we would encourage you to reach out to us. We specialize in everything Medicare throughout California.
We are centrally located in Long Beach, California, however, we service clients throughout the entire state. There are many Medicare plan options to choose from, and we make it our mission to help you find the best Medicare plan for your individual needs. Feel free to give us a call and we will do our best to serve you.
Integrity Now Insurance Brokers, Inc.
(562) 606-1030 x1