Who Pays for Palliative Care? Your Questions Answered

Some Medicare plans will cover palliative care and associated costs for eligible seniors 65+ and adults with disabilities.^[01] This coverage varies depending on the type of Medicare coverage an individual has:

• Medicare Part A (Hospital Insurance). This covers hospice care, which may also include comfort care measures that are similar to palliative care.^[02]
• Medicare Part B (Medical Insurance). This typically covers palliative care. It can potentially help with the costs of durable medical equipment, hospital beds, and wheelchairs required for palliative care treatment and support.^[03] However, this plan has coverage limitations, and copays and deductibles may apply in certain situations. Some types of medically necessary treatments and medications may also not be covered under Medicare Part B.^[01]
• Medicare Part C (Medicare Advantage). If your loved one has this plan, they’ll likely be able to utilize the hospice coverage from Part A and the durable medical equipment support from Part B.^[04]
• Medicare Part D. This Medicare plan may help seniors pay for medications, such as prescription pain relievers or anti-nausea medications, that are part of palliative care treatment plans.^[04]
• Medicare Special Needs Plans (SNPs). People with severe or chronic health conditions, such as chronic heart failure, end-stage liver disease, and certain neurologic disorders, may find that expenses related to palliative care can be covered through SNPs.^[05]

Contact Medicare at 800-MEDICARE (800-633-4227) or chat with someone from Medicare online to learn more about coverage for your loved one’s unique situation.

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Medicaid generally covers palliative care for beneficiaries. It typically provides coverage for low-income people.

Similar to Medicare, Medicaid may not cover all types of palliative care services. Some medications or treatments may not be covered, and your loved one may also have to pay a copay or deductible in some instances.^[01]

If your loved one is receiving palliative care services as part of hospice care through Medicaid, they may qualify for the following to be covered:^[06]

• Medical appliances and supplies
• Home health aides and homemaker services
• Physical therapy
• Other medically necessary services

As a state-administered program, Medicaid coverage may vary from state to state. To learn more about what’s specifically covered, contact the state Medicaid office where your loved one lives.

Most private insurance plans cover palliative care to some degree. However, not all plans include palliative care as a covered service or only partially cover services, treatments, and medications related to palliative care. Closely review the specific insurance policy to learn if and how palliative care is covered.

Your loved one’s unique medical situation and health issues will play a role in the types of things covered by their private insurance. You or your loved one’s medical care team, a patient advocate, or a social worker may be able to help identify palliative care resources that can be delivered at home. To learn what’s covered under your loved one’s plan, it’s essential to contact your loved one’s insurance provider before treatment begins.

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If insurance won’t cover all palliative care costs, your loved one may be able to use the following to help cover expenses:

• Retirement fund and pension
• 401(k)
• IRA
• Savings account
• HSA
• Veterans benefits

If funds are limited, some palliative care programs might offer sliding scale options. There may also be charitable funding options offered by some palliative care programs. You or your loved one’s social worker or medical care team may be knowledgeable about other alternative pay options for palliative care.