What You Need to Know About Your Medicare Hospice Benefit

Your Medicare hospice benefit has a lot to offer, and it’s never too early to get informed. Chronic, life-limiting illness can strike even when we least expect it. Knowing ahead of time what the benefit covers and how it can be utilized will help you make more informed decisions about planning for end-of-life care for yourself or for a loved one. Continue reading to learn more. 

A Little Bit About Us

  • Hospice of Huntington helps people with terminal illnesses live comfortably. We’ve been in the business of caring for more than 40 years.
  • Our focus is on comfort, not on curing an illness.
  • Our specially trained, interdisciplinary team of professionals provides care for your physical, emotional, social and spiritual needs.
  • Hospice care is provided wherever the patient calls home, be that a private residence, nursing home or assisted living facility.
  • The Emogene Dolin Jones Hospice House is our beautiful inpatient hospice facility built in 2006.
  • We accept patients and families of all backgrounds, regardless of ability to pay for services not covered under their hospice benefit.

What Your Hospice Benefit Covers

The Medicare hospice benefit gives terminally ill patients an option for high-quality, end-of-life care. It covers a wide variety of services recommended to keep you and your family as comfortable as possible. Your benefit pays for services like:

  • In-home hospice physician and nurse visits
  • Prescription drugs needed to manage symptoms and keep you comfortable
  • Medical equipment, like a wheelchair or hospital bed in the home
  • Medical supplies, like bandages and catheters
  • Hospice home health aides for day-to-day assistance in the home
  • Speech, physical and occupational therapy
  • Dietary counseling
  • Grief counseling for you and your loved ones
  • Social worker services to help you and your family get your affairs in order
  • Short-term inpatient care at the Emogene Dolin Jones Hospice House when illness symptoms become too severe to manage at home
  • Short-term respite care at the Emogene Dolin Jones Hospice House when caregivers need a break
  • Anything else the Hospice team feels necessary to manage your pain and other symptoms of your terminal illness and related conditions

Your hospice benefit does not cover curative treatments, the cost of long-term room and board or ER services not arranged by your hospice provider. What’s important to know – even when your hospice benefit starts, you can still receive care for conditions not related to your terminal illness covered under your regular Medicare health plan.

Qualifying for the Medicare Hospice Benefit

To start using your hospice benefit, you will need to meet the following conditions:

  • You must have Medicare Part A (Hospital Insurance).
  • Your primary care provider (if you have one) and the hospice provider must certify that you are terminally ill with a life expectancy of six months or less.
  • You must accept palliative care for comfort instead of care to cure your illness.
  • You must sign a statement choosing hospice care instead of other Medicare-covered benefits to treat/cure your terminal illness and related conditions.

Once you qualify, you can get hospice care for two 90-day benefit periods followed by an unlimited number of 60-day benefit periods. At the start of each benefit period, the hospice provider must re-certify your condition with a life expectancy of fewer than six months.

If you live longer than six months, you can continue to receive hospice benefits as long as the doctor recertifies your condition.

Paying for Hospice Care

Medicare pays the hospice provider for your hospice care. There’s no deductible. You’ll pay:

  • Your monthly Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) premiums
  • A copayment of up to $5 per prescription for outpatient prescription drugs for pain and managing symptoms
  • 5% of the Medicare-approved amount for inpatient respite care

If you or a loved one has been diagnosed with a life-limiting illness, we are here for you. Hospice of Huntington, together with Tri-State LifeCare, offers a wide variety of programs to meet patients and families wherever you are in the stages of a chronic illness.  

Don’t wait. Reach out to our team today to learn more. Call 304.529.4217 or complete the form below.

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304.529.4217 | 800.788.5480
P.O. Box 464, Huntington, WV 25709
1101 Sixth Avenue, Huntington, WV 25701