Date: January 15, 2018

Author: Sarah Peterman

When it comes time to consider hospice and palliative care, one of the options to weigh must be the cost. The cost of end-of-life care can be expensive, so it is important to have some information upfront when making decisions. Below we will cover the average cost of hospice and palliative care covered by Medicare.

How Much Does Hospice Cost?

Many hospice costs can be paid by Medicare, but there remains plenty of costs left over for the patient or the family to contend with. For this reason, many patients wait until the very end before entering hospice. This is not an easy admission for the family to make. To qualify to have hospice care paid for by Medicare, both the patient’s doctor and a hospice medical director have to certify that the patient has six months or less to live. Medicare pays hospice agencies a daily rate and hospice payment rates are updated annually. For Medicare and hospice costs, there are four levels of care with different rates. The levels of care are RHC (routine home care), CHC (continuous home care), IRC (inpatient respite care), GIC (general inpatient care).In 2018, the hospice care costs covered by Medicare daily are:

  • Routine Home Care (Days 1–60): $193
  • Routine Home Care (Days 61+): $151
  • Continuous Home Care: $976
  • Inpatient Respite Care: $173
  • General Inpatient Care: $744

For more information regarding how much hospice costs per day, please review the hospice services payment system provided by MedPAC. In order to understand your out-of-pocket expenses, and to figure out how much hospice costs per month, you’ll need to ask the hospice provider about their daily cost of hospice care. Make sure to also discuss the portion that is covered by Medicare. From there, you’ll be able to calculate your monthly costs.

Additional Options Through Private Insurance and Medicaid

Some private insurance companies will pay for the hospice cost. If so, the cost of palliative care will often be included as part of their chronic care benefits. In addition, there are options for long-term care policies. The premiums for these policies can be expensive, but they will cover the costs of hospice care that Medicare will not. For lower income families, if you are covered by Medicaid, it may cover some additional hospice care treatments and medications. It is important to be sure you understand what is covered, and what is not, and if there are any co-pays or other fees. It is always best to ask up front so that there are no surprises later on.

All Hospice and Palliative Care Is Not the Same

It is imperative to understand that not all hospice treatment facilities are the same. Depending on their size and budgets, the services they offer will be different. Smaller hospice centers will be less likely to offer more expensive end-of-life treatments since Medicare and your insurance will not pay for these. These types of centers simply don’t have the budget to absorb the hospice care facility costs. As hospice care is intended to make a patient comfortable and not to attempt to cure them, determining which treatments will be covered by Medicare, or insurance, and which will not, becomes tricky. A treatment that can be used to cure a disease can often be used to make someone more comfortable as well. When this happens, often the treatment will not be covered, and the patient or patient’s family will need to pay for it. If you are concerned that a particular hospice facility will not offer the services your loved one needs, then make sure to look around and review your options. At the end of the day, what matters most is finding a hospice center that will work with you and your family to ensure that your loved one’s final days are as comfortable and pain free as possible.

Date: January 15, 2018

Author: Sarah Peterman

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