Medicare out of pocket for hospice care

What costs are covered and what are the
“out-of-pockets” to be paid by the patient?
Medicare pays the hospice directly for the patient’s
hospice care. Patients may have to pay no more than
5 percent — up to $5 for each prescription — for
outpatient drugs for pain relief and symptom control.
The hospice patient may also be responsible for 5
percent of the Medicare payment amount for inpatient
respite care.

Is a patient’s Medicare coverage forfeited if
hospice care is chosen?
Not at all. A patient retains full Medicare coverage
for any health care needs not related to the terminal
diagnosis, even if the patient elects hospice care. The
patient must continue to pay the applicable deductible
and coinsurance amounts under the standard Medicare
Plan or the copayment under a Medicare managed
care (HMO) plan.

How long can a patient receive hospice care?
For as long as the physicians continue to recertify the
terminal illness, patients can receive hospice care.
Two 90-day periods of care are followed by an unlimited
number of 60-day periods, as long as the patient
remains eligible. Hospice care is provided only to
patients who have been certified by their doctor and
the hospice medical director as terminally ill with a
life expectancy of six months or less.