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20C E N T E R S f o r M E D I C A R E & M E D I C A I D S E R V I C E S
Medicare Hospice Benefits
This
official government
booklet includes
information about Medicare hospice benefits:
Who’s eligible for hospice care
What services are included in
hospice care
How to find a hospice provider
Where you can find more information
C E N T E R S f o r M E D I C A R E & M E D I C A I D S E R V I C E S
Medicare Hospice Benefits
This
official government
booklet includes
information about Medicare hospice benefits:
Who’s eligible for hospice care
What services are included in
hospice care
How to find a hospice provider
Where you can find more information
Welcome
Choosing to start hospice care is a difficult decision. The
information in this booklet and support from a doctor and
trained hospice care team can help you choose the most
appropriate health care options for someone who’s terminally
ill. Whenever possible, include the person who may need
hospice care in all health care decisions.
The information in this booklet describes the Medicare
Program at the time this booklet was printed. Changes
may occur after printing. Visit Medicare.gov, or call
1-800-MEDICARE (1-800-633-4227) to get the most current
information. TTY users can call 1-877-486-2048.
Paid for by the Department of Health & Human Services.
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Table of contents
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Hospice care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
Care for a condition other than your terminal illness . . . . . . . . . . . . . .
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How your hospice benefit works . . . . . . . . . . . . . . . . . . . . . . .
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Who’s eligible for the hospice benefit . . . . . . . . . . . . . . . . . . . .
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Finding a hospice provider . . . . . . . . . . . . . . . . . . . . . . . . .
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What Medicare covers . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Respite care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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What your hospice benefit won’t cover . . . . . . . . . . . . . . . . . . . .
Hospice care if you’re in a Medicare Advantage Plan or other Medicare
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health plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
Information about Medicare Supplement Insurance (Medigap) policies . . . .
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What you pay for hospice care . . . . . . . . . . . . . . . . . . . . . .
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How long you can get hospice care . . . . . . . . . . . . . . . . . . . .
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Stopping hospice care . . . . . . . . . . . . . . . . . . . . . . . . . .
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Your Medicare rights . . . . . . . . . . . . . . . . . . . . . . . . . . .
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For more information . . . . . . . . . . . . . . . . . . . . . . . . . .
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Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Notice of Availability of Auxiliary Aids & Services . . . . . . . . . . . . . .
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Nondiscrimination Notice . . . . . . . . . . . . . . . . . . . . . . . .
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Hospice care
Hospice is a program of care and support for people who are
terminally ill (with a life expectancy of 6 months or less, if the illness
runs its normal course) and their families. Here are some important
facts about hospice:
■ Hospice helps people who are terminally ill live comfortably.
■ Hospice isn’t only for people with cancer.
■ The focus is on comfort (palliative care), not on curing an
illness.
■ A specially trained team of professionals and caregivers provide
care for the “whole person,” including physical, emotional,
social, and spiritual needs.
■ Services typically include physical care, counseling, drugs,
equipment, and supplies for the terminal illness and related
conditions.
■ Care is generally given in the home.
■ Family caregivers can get support.
Palliative care
Palliative care is the part of hospice care that focuses on helping
people who are terminally ill and their families maintain their
quality of life. If you’re terminally ill, palliative care can address your
physical, intellectual, emotional, social, and spiritual needs. Palliative
care supports your independence, access to information, and ability
to make choices about your health care.
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Care for a condition other than your terminal illness
Your hospice benefit covers care for your terminal illness and
related conditions. Once you start getting hospice care, your
hospice benefit should cover everything you need related to your
terminal illness, even if you remain in a
Medicare Advantage Plan
(like an HMO or PPO) or other
Medicare health
plan.
After your hospice benefit starts, you can still get covered services
for conditions not related to your terminal illness.
Original
Medicare
will pay for covered services for any health problems that
aren’t part of your terminal illness and related conditions. However,
you must pay the
deductible
and
coinsurance
amounts for all
Medicare-covered services you get to treat health problems that
aren’t part of your terminal illness and related conditions.
Important: If you were in a Medicare Advantage Plan before
starting hospice care, and decide to stay in that plan, you can get
covered services for any health problems that aren’t part of your
terminal illness and related conditions. You can choose to get
services not related to your terminal illness from either your plan
or Original Medicare. For more information on hospice care if
you’re in a Medicare Advantage Plan or other Medicare health
plan see page 10.
Words in
blue
are defined on
pages 15–16.
