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Medicare & Inpatient Hospice

Medicare & Inpatient Hospice

Hospice care is a special kind of care that provides comfort, support, and dignity at the end of life, typically when you or your loved one’s life expectancy is six months or less. This care addresses your physical, emotional, social, and spiritual needs, and enables you to spend time focusing on what matters most to you.

Sometimes you or your loved one may experience severe pain and symptoms, and your healthcare provider or hospice nurse might recommend the inpatient level of hospice care. The inpatient level of hospice care is usually provided in an inpatient hospice facility such as The Samaritan Centers at Voorhees and Mount Holly.

Who pays for this inpatient level of care at the end of life? If you or a loved one are on Medicare, you probably already know it covers many medical services. One of those medical services is comprehensive hospice care coverage including inpatient hospice care.

Is Inpatient Hospice Covered by Medicare?

The Medicare Hospice Benefit is comprehensive coverage that pays for 100% of your services in the hospice plan of care, including a team of professionals — physicians, nurse practitioners, nurses, social workers/ bereavement counselors, spiritual support counselors, certified home health aides – plus, medication, equipment, supplies, and inpatient services or respite, if necessary. Please note: you may be responsible for a small co-payment.

Also included under the Medicare Hospice Benefit are the four levels of hospice care, and inpatient hospice is one of those four levels. Medicare will pay for inpatient hospice care for patients who have Medicare Part A (Hospital Insurance) or Part C (Medicare Advantage Plans) and meet the following conditions:

  • Your regular doctor and the hospice medical director certify that you have a life expectancy of six months or less.
  • You accept hospice care instead of care to cure your terminal illness.
  • You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness and related conditions.

Medicare & Inpatient Hospice Care FAQ

What is Inpatient Hospice Care?

In hospice care, sometimes you or your loved one may experience symptoms that are severe and unrelieved. A hospice team will do their best to manage these symptoms in your home environment. These symptoms include pain, shortness of breath, nausea and vomiting, and severe anxiety. The hospice team will work with you, your family, and your physician to make any necessary changes to you or your loved one’s medicines or other treatments to relieve these symptoms.

However, sometimes these symptoms do not respond to the regular medications available in the home environment. When these symptoms do not improve over 24 to 48 hours, then the hospice nurse may decide to transfer you or your loved one to an inpatient center so symptoms can be managed more quickly.

How Long Does Medicare Pay for Inpatient Hospice Care?

Medicare will pay for inpatient hospice care as long as you or your loved one are experiencing severe pain and symptoms related to the hospice diagnosis. The goal of inpatient hospice care is to get those symptom under control so you or your loved one can return to the comfort of your home.

What Inpatient Hospice Care Services Does Medicare Cover?

The Medicare Hospice Benefit is comprehensive coverage that covers you or your loved one’s stay in an inpatient hospice facility, including medications, supplies, and equipment, plus visits from a team of experts including a physician, nurse practitioner, nurse, social worker, spiritual support counselor, certified home health aide and a volunteer.

What Are the Medicare Requirements for Inpatient Hospice Coverage?

Medicare requirements for inpatient hospice coverage include:

  • Your doctor or specialist certifies that you have a life expectancy of six months or less.
  • You choose comfort care instead of curative treatments.
  • You are experiencing severe pain and symptoms that would best be treated in an inpatient center rather than at home or in a nursing home or assisted living facility.

Got More Questions about Medicare and Inpatient Hospice Care?

If you have questions about hospice care in South Jersey or Medicare and inpatient hospice care, please call our nurse care coordinator at (800) 229.8183.