Hospice Care Cost/Financing Options

Under Medicare, hospice benefits are limited to persons whose physician has determined they have six months or less to live. Hospice patients are recertified for Medicare after the first 90 days, again after the second 90 days and every 60 days thereafter.

The Typical Costs Associated With Hospice Care

Hospice Care is very cost efficient when compared to care in a hospital or skilled nursing facility. A Duke University study showed that hospice services reduce Medicare’s hospital costs by an average of $2,309 per patient.  According to the HOA, the average rates for Hospice Care as of October 1, 2010 were $146.63/day for routine home care, $855.79/day for continuous care (24-hour) or $35.66/hour if a nurse is in the home less than 24 hours; and $151.67/day for respite care. The average length of stay in a hospice program increased from between 52.6 and 69 days to 83 days by 2008.

How Much of The Cost Does Medicare Cover?

Medicare pays all hospice related charges in almost all U.S. states although payments are adjusted in relation to geographic differences in the wage index. This information is based on Medicare certified programs/agencies. Reliable data about non-certified hospices are unavailable and anyone considering their use should not only research them thoroughly but should understand that Medicare is unlikely to pick up the tab.

What About Insurance for the Things Medicare Won’t Cover

Medicare remains the primary source of financing for Hospice Care; however, a 1998 study by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation indicated that 46 out of 52 private health insurance plans cover hospice care.

It is emphasized that Medicare will not cover any treatments or medications, like chemotherapy or radiation, meant to cure the terminal illness. All hospice patients sign a form authorizing Medicare payment for hospice care rather than other forms of treatment for the terminal illness. However, Medicare will still pay for any covered benefits for health problems, like asthma, that are not related to the terminal illness.  If the patient’s health improves hospice care can be stopped and the individual can be transferred to an acute care facility, but the option of returning to a hospice program is always open.

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