Do Medicare Advantage Plans Pay for Hospice Care?

There are some aging adults who choose to receive Medicare benefits through a Medicare Advantage plan. Medicare Advantage plans, which are offered by private insurers, bundle Medicare Part A, Part B, and oftentimes Part D together with extra benefits such as dental, vision, fitness, and hearing. Medicare Advantage plans offer more benefits than and cost less than original Medicare. However, the reason these cost-cutting measures are available is because you’re often limited in which providers you can use. It’s a trade-off all Medicare Advantage users may need to consider.  

‍

At a minimum, Medicare Advantage plans can cover everything that Medicare covers, except hospice care. Medicare Advantage plans do not technically cover hospice care costs. However, if you have a Medicare Advantage plan, original Medicare can step in to fully cover your hospice care services.

‍

Should Seniors on Hospice Keep their Medicare Advantage Plan?

Individuals using the Medicare hospice benefit are given the option to leave their Medicare Advantage plan. After all, original Medicare is the insurance plan that covers hospice services, not the MA plan. If you stay on your Medicare Advantage plan, original Medicare can continue paying for your hospice care. You can also choose whether original Medicare or your Medicare Advantage plan pays for any health care costs you incur that are unrelated to your terminal illness.

‍

When deciding whether you should keep your Medical Advantage plan or switch to Medicare, consider the cost and your supplemental benefits. MA plans cost less on average, so switching to original Medicare may cost you more. Additionally, if you give up your MA plan, you can also lose your supplemental benefits. This could make prescription drugs and any dental, vision, or hearing care you receive a lot more expensive.

‍

Seniors who choose to drop their MA plan also end up paying for the premiums associated with traditional Medicare (Parts A and B).

‍

In the long run, aging adults who choose to keep paying their Medicare Advantage plan premiums can continue to receive additional plan benefits, even while on hospice care. Take the time to consider which option is best for the you.

‍

Who Qualifies for Hospice Coverage under Medicare?

The same requirements apply for anyone with Medicare or a Medicare Advantage plan when it comes to receiving hospice care. Patients must meet a minimum criteria defined by Medicare to receive hospice benefits. If you select a Medicare-approved provider, these are the conditions you have to meet:

‍

• Your regular doctor and a hospice doctor need to certify that you are terminally ill, with fewer than six months to live
• You agree to receive comfort care, also called palliative care, instead of curative treatments
• You sign a document stating that you are choosing to receive symptom management instead of curative treatments for your terminal illness and any related conditions

‍

What Hospice Services Do Medicare Advantage Beneficiaries Receive?

Whether you pay for original Medicare or a Medicare Advantage plan, you receive the same hospice benefits. With a few small exceptions, Medicare fully covers all services laid out in your hospice care plan. This includes doctor care, nursing care, home health aides, rehabilitation therapies, grief counseling for you and your family, and more. You’ll owe nothing out-of-pocket other than your health insurance premiums.

‍

Want more details? Check out exactly what hospice care services Medicare covers. → link to Medicare paying for hospice care article

‍

Will My Medicare Advantage Plan Cover Anything While I’m on Hospice?

You have the option to leave your Medicare Advantage plan while you’re receiving hospice care. However, keeping it may help you pay for hospice costs that traditional Medicare won’t cover. For example, many Medicare Advantage plans include prescription drug coverage. With this benefit, you may not have to pay anything for your pain or symptom management prescriptions.  

‍

Receiving Hospice Care With Medicare Advantage Plans

When you have exhausted as many options as possible trying to manage a terminal illness, it can be hard to think about how to pay for care at the end of life. These issues can be mitigated by preparing early and reviewing your options. Regardless of what you choose to help you pay for hospice care, you can get your costs covered without wasting precious time.

‍

‍

References

1. “Hospice Care.” Medicare.gov, www.medicare.gov/coverage/hospice-care.
2. “Medicare Hospice Benefits.” Medicare.gov, Centers for Medicare & Medicaid Services (CMS), www.medicare.gov/Pubs/pdf/02154-Medicare-Hospice-Benefits.PDF.