Contrary to popular belief, Medicaid actually does pay for hospice care.
Medicaid is a federal and state-funded program that provides healthcare coverage to eligible individuals and families with low income and limited resources. Hospice care is a covered benefit under the Medicaid program.
Medicaid hospice benefits are similar to Medicare hospice benefits, including the coverage of medical care, pain and symptom management, emotional and spiritual support, and assistance with daily activities. Medicaid also covers respite care for caregivers, as well as grief counseling for families.
Medicaid Hospice Eligibility
Medicare is a federal health insurance program that primarily serves people who are 65 or older, while Medicaid is a joint federal and state program that serves people with low income and limited resources.
To be eligible for Medicaid hospice benefits, the individual must be eligible for Medicaid and have a life-limiting illness with a prognosis of six months or less, as certified by a physician. The individual must also choose to receive hospice care instead of curative treatment for their illness.
Medicare hospice benefits cover all services that are necessary for the palliative care of the patient\’s terminal illness, including medical care, pain and symptom management, emotional and spiritual support, and respite care for caregivers. Medicaid hospice benefits also cover these services, but the specific services covered may vary by state.
Differences Between Medicaid and Medicare for Hospice Care
Medicare and Medicaid are different government-funded healthcare programs that may provide medical coverage, but there are some differences between the two programs when it comes to paying for hospice.
Covered services
Medicare hospice benefits cover all services that are necessary for the palliative care of the patient\’s terminal illness, including medical care, pain and symptom management, emotional and spiritual support, and respite care for caregivers. Medicaid hospice benefits also cover these services, but the specific services covered may vary by state.
Payment
Medicare pays hospice providers a per diem rate for hospice services, while Medicaid pays hospice providers a set fee for each day of care provided. The specific payment rates may vary by state.
Cost-Sharing
Medicare hospice beneficiaries are responsible for paying a 5% coinsurance for the cost of prescription drugs and for any respite care received. Medicaid hospice beneficiaries are generally not responsible for any out-of-pocket costs.
Coverage Duration
Medicare hospice benefits cover hospice care for as long as the patient has a life-limiting illness with a prognosis of six months or less. Medicaid hospice benefits may also cover hospice care for as long as the patient has a life-limiting illness, but the specific duration of coverage may vary by state.
Please note that it\’s important to consult with a hospice provider or healthcare professional to understand the specific benefits available to you under your program.
Charlin Hospice Services
At Charlin Health Services, we pride ourselves on honor, integrity, excellence, compassion, dignity, and trust. Our Interdisciplinary Hospice Team functions as a family unit to assist each patient and their loved ones during this journey of life. Each member of any Charlin Hospice team can be reached anytime seven days a week.
If you have any needs or questions about hospice care, health services, or other medical needs, please send us an email or give us a call.
