Medicare will help pay for your hospice care if you meet all of the following criteria:
- You have Part A;
- The hospice medical director (and your doctor, if you have one) certify that you have a terminal illness (your life expectancy is six months or less)*
- You sign a statement electing to have Medicare pay for palliative care such as pain management, rather than care to try to cure your condition
- Your terminal condition is documented in your medical record
- You receive care from a Medicare-certified hospice agency
You do not need to be homebound to qualify for the Medicare hospice benefit. The benefit is a comprehensive set of services delivered by a team of providers. A lot of hospice services are provided in the home but inpatient care is covered under specific circumstances.
The hospice benefit is always covered under Original Medicare. If you have a Medicare Advantage plan and elect hospice, your hospice care will be paid for by Original Medicare.
*The hospice benefit includes two 90-day hospice benefit periods followed by an unlimited number of 60-day benefit periods. You must have a face-to-face meeting with a hospice doctor or nurse practitioner if you reach your third benefit period. The third benefit period begins on day 180 of hospice. After that, you must continue to have face-to-face meetings with a hospice doctor or nurse practitioner before the start of each following 60-day benefit period. The meeting must take place no earlier than 30 days before the new benefit period to confirm you still qualify for hospice care.