Understanding Medicare's Hospice Benefit Periods
Medicare's hospice benefit is designed to provide ongoing support for those nearing the end of life. It operates through benefit periods:
Initial and Subsequent Periods
Two 90-day benefit periods: Medicare initially covers two 90-day periods.
Unlimited 60-day benefit periods: After the initial 180 days, you can receive an unlimited number of 60-day benefit periods.
To continue receiving hospice benefits, a physician must recertify that the patient remains terminally ill at the start of each benefit period.
A doctor must recertify that you are terminally ill at the start of each benefit period.
You must continue to choose hospice care over standard Medicare benefits for your terminal illness.
If your condition improves, and you no longer meet the criteria for hospice care, you can be discharged from hospice. You can also re-elect the hospice benefit if your condition later declines.
What Medicare Covers in Hospice Care
Medicare covers a comprehensive range of services when you're in hospice:
Doctor and nursing services.
Medical equipment and supplies.
Prescription drugs for symptom control and pain relief.
Therapies (physical, occupational, and speech).
Home health aide and homemaker services.
Social work services.
Counseling (dietary and other).
Short-term inpatient care (for pain control or symptom management).
Respite care (short-term care to give caregivers a break).
While Medicare covers most hospice care costs, you may still have some out-of-pocket expenses:
A small copayment for prescription drugs.
A small copayment for respite care.
You may still need to pay for care unrelated to your terminal illness.
Medicare provides extensive support for individuals in hospice care, offering ongoing coverage as long as they meet the eligibility criteria. Understanding the benefit periods and covered services can help patients and their families navigate this challenging time. For more insight into how this concept interacts with others, see our detailed guide on Medicare Advantage Plans, which further explores other Medicare coverage options and their implications in greater depth.
