Hospice care is always covered under Original Medicare, even if you have a Medicare Advantage Plan. After electing hospice, care related to your terminal illness A terminal illness is a disease or condition that cannot be cured or adequately treated, with a life expectancy of six months or fewer. will follow Original Medicare’s cost and coverage rules.
While you cannot receive curative care Curative care is the treatment of a patient with the intent of curing the patient’s disease or condition. For example, chemotherapy treatments to cure breast cancer. for symptoms related to your terminal illness, Medicare will cover treatment for unrelated conditions. For example, if you have elected hospice because you have terminal cancer and you fall and break your hip unrelated to the cancer and meet other requirements, Medicare would cover the physical therapy Physical therapy is exercise and physical activities used to condition muscles and regain movement and strength in a body area. It is helpful to improve or restore physical function for those with debilitating illness or injury. you need for the broken hip. If you have a Medicare Advantage Plan and need care unrelated to your terminal condition, you can choose to either see providers in your plan’s network A network is a group of doctors, hospitals, and pharmacies that contract with a Medicare Advantage Plan to provide health care services. Generally, plan members will have the lowest costs when using providers and facilities in the plan’s network. Networks may be made up of both preferred and non-preferred providers. or see Original Medicare providers.
- When seeing Medicare Advantage providers, you should follow your plan’s coverage rules, including seeing in-network providers. You should owe your usual Medicare Advantage cost-sharing Cost-sharing is the portion of medical care costs that you pay yourself, such as a copayment, coinsurance, or deductible, if you have health insurance coverage. See also: Out-of-Pocket Costs. .
- If you see Original Medicare providers, you will pay Original Medicare cost-sharing.
Your Medicare Advantage Plan or Part D plan should also cover prescription drugs unrelated to your terminal condition, and the plan’s cost and coverage rules will apply.
Your Medicare Advantage Plan will also continue to cover any additional benefits it provides, such as vision or dental services.