Medicare Supplement and Hospice Care
Understand how Medigap plans work with Hospice
If you're searching for information on Hospice care and Medicare supplement plans, you're either incredibly thorough in your attempt to understand all the various Medicare benefits and how they interact with Medigap coverage or your faced with the decision of whether Hospice care is needed for yourself or a loved one. Let's hope it's the former. Either way, it's important to understand how this benefit applies so you are well-versed. Let's take a look at Hospice care through Medicare and how Medicare supplements work to fill in the gaps.
First, what is Hospice care? This term is not familiar to everyone so we should probably start there. Hospice care is given to a person who is terminally ill. Terminally ill means that there is no (never say never) or very low chance of survival and the estimated time of life left is generally considered under 6 months. This eligibility needs to be certified by a doctor or licensed facility in order to qualify for coverage of Hospice coverage under Medicare. Hospice care can be given in a person's home or through a facility and Medicare handles hospice care coverage under Part A (hospital or facility) regardless. You do not need part B to qualify for Hospice care coverage. How does Hospice care differ from traditional medical care?
Hospice care is qualitatively different in its goal. The focus is on keeping the patient comfortable as opposed to trying to treat a person's disease. By requesting Hospice care coverage, you are essentially forgoing other treatment geared towards treating the underlying disease. This is obviously a big decision especially in the U.S. where doctors and patients are pretty determined to exhaust any and all options for medical treatment to the very end and understandably so. Medicare has a few requirements that generally fall along these lines in order to use Hospice benefits. First, the person must have Part A coverage. Your doctor and the Hospice medical care coordinator must certify that you are terminally ill and have 6 months or less to live if the illness runs it's normal course. You sign a statement saying that you will forgo other Medicare health benefits for Hospice care with the exception that Medicare will still cover health benefits not associated with your terminal illness. The final requirement is that you receive care from a Medicare-approved Hospice program. These are the parameters to Hospice eligibility under Medicare. How do the Medicare supplement plans work for this type of care?
With just traditional Medicare, you will generally
pay $5 copays for prescription medication and other treatments used
to manage pain and symptoms. You would also pay 5% of Medicare
hospice approved inpatient respite care. The majority of the
Medicare supplement insurance plans will cover this copay and
co-insurance expense at 100%. The K and L Medigap plans will cover
a percentage of these amounts. The best value proposition, the
Medicare F plan will cover Hospice copays and co-insurance at 100%
which is one more reason to like it. We're more concerned with the
5% since any inpatient care can quick become expensive.