Facing a terminal illness brings many worries and concerns but paying for end-of-life care shouldn’t be one of them. Thankfully, there are many ways to pay for hospice, and many of them are free. Let’s take a look at 7 ways to pay for hospice care. Then, you can decide which options work best for your family and specific situation.
First, it’s important to note that hospice care refers to care and support in the final stages of illness. It focuses on quality of life and comfort rather than curing an illness. If you or a loved one are still trying to cure an illness, then it’s not time for hospice care. Now, let’s get started.
1. Pay with Medicare (Ages 65+)
If the terminally ill person has Medicare coverage, then the Medicare Hospice Benefit should cover the vast majority of expenses (often 100%) if you use a Medicare-approved hospice provider. Thankfully, more than 90% of all hospices are certified by Medicare, so you should have no trouble finding one.
While there are eligibility requirements, if you qualify, then the Medicare Hospice Benefit will cover (to name a few):
- All items and services needed for pain relief and symptom management
- Medical, nursing, and social care and services
- Drugs for pain management
- Additional levels of service if needed
- Durable medical equipment for pain relief and symptom management
- Supplies, such as catheters or bandages
- Aide and homemaker services
- Speech, occupational, and physical therapy
- Short-term inpatient care or short-term hourly care
- Respite care (to provide primary caregiver with relief; small co-payment may be required)
- Spiritual and grief counseling for you and your family
However, it’s important to note that the Medicare Hospice Benefit will not pay for treatments or prescriptions aimed at curing a terminal illness, room and board, services from a second hospice team (you must receive care from just one hospice team), and any inpatient/outpatient care or ambulance services you receive that are not arranged by your hospice (or are unrelated to your terminal illness).
To learn more, go to Medicare’s Part A coverage on their website.
2. Pay with Medicaid (Select Groups)
While Medicare is administered by the federal government and the rules are consistent throughout all U.S. states, Medicaid is a little different. Medicaid is funded by both state and federal monies, and each state is given flexibility to set their own eligibility requirements.
To that end, where you live plays a key role in determining your eligibility for Medicaid coverage.
Additionally, if you or a terminally ill loved one decide to move to a different state (perhaps to be closer to family), you must re-apply for Medicaid in your new state. Medicaid coverage doesn’t transfer from state to state.
Generally, Medicaid aims to assist low-income individuals, families, seniors, and people with disabilities. Medicaid offers similar services as Medicare, including:
- Nursing and physician services
- Counseling services
- Medical appliances and supplies
- Medication for symptom control and pain relief
- Home health aide and homemaker services
- Physical, occupational, and speech therapy
It’s possible to have dual coverage – both Medicare and Medicaid. If this is the case for you, you can use Medicaid to cover costs that Medicare doesn’t.
The best thing to do when using Medicaid to pay for hospice care is to call your State Medicaid Agency and find out if you meet their eligibility requirements for hospice care. Click here to see a full list of contact information for State Medicaid Agencies across the United States.
3. Pay with Private Insurance (Any Age)
If you are not eligible for Medicare or Medicaid, but you do have a work-based or private insurance plan, contact your health insurance provider to determine what your insurance plan covers.
Though private insurance plans vary greatly, many plans do provide at least some coverage for hospice care. However, keep in mind – even if your plan does offer some hospice care benefits, they may have limits on hospice expenses. This is why it’s so important to contact your provider to get a clear image of what options are available to you.
Additionally, your insurance provider may have specific eligibility requirements you must meet before you can access hospice care benefits. Make sure to ask about these requirements. At the very least, most insurance providers will require 1) a certification of a terminal illness from an attending physician, and 2) confirmation that the terminally ill person has elected not to seek curative treatments.
If your insurance plan does not cover the full cost of hospice care, there are other options to help your family supplement the cost of care.
4. Pay Using Veterans’ Benefits/Tricare (Any Age)
If you are a veteran, the Veterans Administration can help pay for hospice if you are enrolled in the VA Standard Medical Benefits Package. As long as you meet the clinical need for hospice services, you are eligible regardless of age. A few highlights of this coverage include:
- Care available at your home, nursing home, assisted living, or wherever you call home
- No co-pay for hospice care
- Medical equipment, medication, and personal care supplies
- Pain and symptom management
- Care coordinated with your doctors
- Physical, occupational, and other therapy services
- Spiritual care and support
- Volunteers with military experience (when available)
- Ongoing grief counseling for patients and family
To learn more about utilizing your VA benefits to pay for hospice care, contact your VA social worker and discuss your options.
For veteran spouses and children, CHAMPVA for Life is a health insurance program available to the spouses and/or children of veterans killed in action or permanently disabled. It covers most medically necessary care for individuals who are 65 or older, including hospice. To learn more about CHAMPVA, click here.
NOTE: If you or a loved one are a veteran, also look into veterans’ burial benefits. These benefits include burial and plot allowances to offset the cost of a funeral or memorial, free headstone and burial flag, military honors, and if desired, burial in a national cemetery (at no cost to the family).
5. Pay with Crowdfunding (Any Age)
If you have a large support network, then creating a crowdfunding campaign may be a viable option. GoFundMe is one of the most common platforms. On sites like this, you can share about your health journey and invite others into your final days.
While it’s best not to count on crowdfunding as a primary source of financial help, it can definitely make a dent in the cost of hospice care for yourself or a loved one. Additionally, there are foundations out there – like Hospice Help Foundation – that are focused on offering financial assistance to families who need financial assistance to afford hospice care.
6. Ask About Reduced Rates (Any Age)
If you’re uninsured or your available insurance just doesn’t cover the cost of hospice care, consider talking to your hospice care provider about reduced rates. Some hospice facilities offer free care for patients who lack the resources to pay. Additionally, hospices often seek out charitable donations, grants, or other community sources specifically so that they can assist families financially.
Even if the hospice cannot offer free care, they may be able to offer reduced rates or charge on a sliding scale. Either way, it doesn’t hurt to ask!
7. Pay with Personal Savings (Any Age)
While most people are unable to pay for hospice care out of pocket, if you are able to do so, it’s another way to pay for hospice. Of course, make sure that all other options available to you are exhausted before paying out of pocket. If you are eligible for benefits and services, it’s best to take full advantage of those options before taking a financial hit.
If you or a loved one have received a terminal diagnosis and you are looking into hospice care, there are many options available to pay for end-of-life care. Look into each one to see if you qualify. Also, most hospice providers employ financial support personnel, who can answer any questions you may have as you determine the best way to pay for hospice services.
Hopefully this information has helped you better understand some of the most common ways to pay for hospice care and gives you a path forward. As you consider other end-of-life concerns, look into estate planning and funeral planning so you can start providing answers to the questions your family will ask in the future.