When you elect the hospice benefit, Original Medicare pays for all of your pain relief and management care related to your terminal condition, even if you have a Medicare Advantage Plan. You will be responsible for paying up to $5 for outpatient prescription drugs covered through the hospice benefit (prescription drugs related to pain relief and symptom control). Drugs for pain relief and symptom control received as an inpatient of a hospice, hospital or nursing facility are covered in full.
Drugs not covered by the hospice benefit may be covered by the Medicare drug benefit if you are enrolled in a Medicare private drug (Part D) plan. The costs for those drugs vary by plan.
You will pay a copay of no more than 5% of the Medicare approved amount for each day of inpatient respite care. Respite care is a part of the hospice benefit that provides relief to caregivers. Your total copays should be no more than the inpatient hospital deductible amount for the year you first elected hospice care. The hospital deductible is $1,340 in 2018.
While you have hospice, you can still get Medicare coverage for treatment of all illnesses and injuries unrelated to your terminal condition. However, the costs you usually pay for services will apply. If you have a Medicare Advantage Plan, that plan will be responsible for all other costs.
If you have questions about billing for hospice care you should contact your Medicare Administrative Contractor (MAC). MACs are regional, you should call 1-800-MEDICARE to find out how to contact your local MAC.