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Does Medicare Cover Palliative Care at Home?

5 minute readLast updated May 22, 2023
Written by Rebecca Schier-Akamelu, assisted living writer
Reviewed by Lucinda Ortigao, CFPLucinda Ortigao is president of Cape Investment Consulting Inc. and is a Certified Financial Planner.
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Watching someone you love manage the discomforts of a serious illness can be heartbreaking. Many seniors wish to age in place and would prefer to receive palliative care at home. However, these costs can quickly add up. If your parent or loved one has Medicare, their at-home palliative care may be covered in certain circumstances. Learn how Medicare pays for palliative care, explore the key differences between palliative care and hospice care, and discover other payment options for palliative care at home.

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What is palliative care?

Palliative care, sometimes known as comfort care, generally focuses on pain and symptom management and is offered holistically with the goal of increasing a person’s quality of life. It might be part of your loved one’s care plan if they have heart failure, cancer, Parkinson’s disease, or another serious or long-term illness.[01]

Seniors can receive palliative care soon after a diagnosis, as there’s no need to wait for serious discomfort before seeking palliative care.

When does Medicare cover in-home palliative care?

Medicare may cover some in-home palliative care costs if a patient receives home health care services. Home health care often includes skilled nursing services such as wound care and IV therapy, along with physical, occupational, and speech therapy. Because most palliative care services are similar to home health services, Medicare doesn’t have explicit guidelines for palliative care coverage.

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Medicare will cover home health services if your loved one meets the definition of “homebound.” To be considered homebound by Medicare, the following conditions must be met:[02]

  • Your loved one has trouble leaving their home without assistance because of their illness.
  • Their doctor has recommended that they remain at home because of their condition.
  • Your loved one isn’t able to leave their home on a regular basis because of the significant effort involved.

Using Medicare to pay for palliative care

Different parts of Medicare will cover certain palliative care expenses. While some of your loved one’s care plan may be covered, there still may be a deductible to meet or a copayment for certain services. Keep in mind that some palliative care services or treatments may not be included in coverage.

It’s also important to note that Medicare doesn’t cover the cost of 24-hour home health services. It only covers part-time, intermittent services.

Medicare Parts A and B (Original Medicare)

The following palliative care costs are covered by Medicare Part A:[03]

  • Inpatient hospital stays
  • Skilled nursing facility stays
  • Limited home health services
  • Durable health equipment

The following aspects of palliative care treatment are covered by Medicare Part B:[04]

  • Mental health services
  • Durable medical equipment
  • Home health services
  • Outpatient rehabilitation therapy

Medicare Part C (Medicare Advantage)

Medicare Part C plans are offered through Medicare-approved private insurance companies. These plans offer the same coverage as original Medicare, and in some cases, they may cover services that Original Medicare doesn’t.[05]

It’s important to check with your loved one’s insurance company to find out whether their palliative care costs are covered.

Medicare Part D

Part D covers prescriptions that may be used in a palliative care plan to help manage pain and symptoms of an illness.[03]

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Palliative care vs. hospice care

If you’re a caregiver for someone with a serious illness, you may come across the terms palliative care and hospice care frequently. Sometimes they’re used synonymously, but there are actually several key differences between palliative care and hospice care that you should be aware of — especially when you’re determining whether Medicare will pay for your loved one’s care.

Keep these differences in mind:[01]

  • Palliative care can be offered alongside medical treatments designed to cure an illness. Hospice care requires that your loved one forgo lifesaving treatments.
  • Palliative care can be offered soon after a diagnosis for an undetermined amount of time. Hospice is generally only offered once your loved one has six months or less to live.

Medicare offers clearer guidance on hospice care, and your loved one may be able to receive Medicare-certified hospice care at home.[06]

Other payment options for at-home palliative care

If your loved one is looking for other ways to pay for palliative care, they have a few options.

Private insurance covers palliative care, although your loved one should confirm which specific services their plan covers. Because each insurance policy is different, you may find that your loved one’s insurance doesn’t cover all aspects of palliative care.

Outside of palliative care services, you may want to consider home care as a way to get your loved one — or yourself — some extra assistance. An in-home caregiver can offer a range of services, from helping out with taxing household chores, to respectful assistance with personal care, to respite care, which provides family caregivers some much-needed relief.

You can use several methods to pay for home care, including:

Each home care agency has different guidelines on payment options, so it’s best to clarify how to pay ahead of time.

If you’re ready to explore home care options, A Place for Mom’s Senior Living Advisors can assess your loved one’s needs and budget and will connect you with trusted providers, all at no cost to your family.

SHARE THE ARTICLE

  1. National Institute on Aging. National Institutes of Health. What are palliative care and hospice care?

  2. Centers for Medicare and Medicaid Services. Home health services. Medicare.gov.

  3. Centers for Medicare and Medicaid Services. Costs. Medicare.gov.

  4. National Hospice and Palliative Care Organization. (2019). Palliative care or hospice?

  5. Centers for Medicare and Medicaid Services. Compare Original Medicare and Medicare Advantage. Medicare.gov.

  6. Centers for Medicare and Medicaid Services. Hospice care. Medicare.gov.

Meet the Author
Rebecca Schier-Akamelu, assisted living writer

Rebecca Schier-Akamelu is a senior copywriter at A Place for Mom, specializing in topics such as assisted living and payment options. With more than a decade of experience as a content creator, Rebecca brings a person-centered approach to her work and holds a certificate in digital media and marketing from Duke University.

Edited by

Leah Hallstrom

Reviewed by

Lucinda Ortigao, CFP

The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.

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