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Who Pays for Hospice Care at Home? Your Options, Explained

5 minute readLast updated May 1, 2023
Written by Chacour Koop
Reviewed by Todd Austin, home care expertTodd Austin, an Aging Media "40 under 40" winner and home care expert, heads Home Care Pulse, a leading home care agency software solution.
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For a person nearing the end of their life, hospice care can provide much-needed relief and comfort. It can also benefit grieving family members. Many patients and their families prefer receiving hospice care within the comfort of a home rather than in a hospital or other type of clinical setting. Fortunately, most hospice care providers do provide services at home. Medicare, Medicaid, TRICARE, and veterans benefits will generally cover the cost of hospice, and additional resources may be available for people with limited income or no insurance.

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What is hospice care, and where is it provided?

Hospice is a type of medical care for people who are terminally ill and nearing the end of their life.[01] It’s most commonly offered when a doctor determines a patient has a life expectancy of six months or less. However, it can be extended if your loved one’s doctor sees fit.

Typically, a team of health care professionals provide services intended to bring comfort and manage pain. Additionally, hospice care may provide counseling, respite care, and support to family members. For older adults, hospice care doesn’t include treatments designed to cure their illness.

People who decide to receive hospice care can get services in their home, an assisted living community, a nursing home, a hospital, or facilities dedicated to hospice. Most hospice services are provided at home, where a family member serves as the primary caregiver.

Hospice care is different from palliative care, though the two are sometimes confused. Palliative care is a supplement to a patient’s current treatment that can be provided at any stage of their disease. It offers medical, spiritual, physiological, and social support for the whole person, rather than focusing on a specific condition. Oftentimes, palliative care is partially or fully covered by insurance.

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Top 4 payment options for hospice care at home

Seniors and their family members who prefer to receive hospice care costs at home have several funding options, including Medicare, Medicaid, and private insurance. At-home palliative care related to hospice may also be paid for by these programs. Additionally, hospice providers, family members, and community organizations may provide funding for people without the resources to pay.

Here’s a closer look at how these funding sources can help pay for hospice care at home.

Medicare

Medicare is a common way for seniors to pay for hospice care at home.[02] To qualify, a senior must have Medicare Part A (Hospital Insurance) and meet the following requirements:

  • A hospice doctor and primary physician must certify that the senior has a terminal illness and a life expectancy of six months or less.
  • The senior must accept hospice care rather than seek a cure to their illness.

Seniors enrolled in Medicare pay nothing for hospice care at home except a small copayment for prescription drugs intended to manage their pain and symptoms. If a drug isn’t covered, the hospice provider can contact your Medicare insurer to determine whether Part D covers it.

Medicaid

Medicaid generally covers hospice care costs for qualifying lower-income seniors.[03] However, every state administers Medicaid programs differently, meaning the benefits a senior receives vary depending on where they live. Additionally, each state decides the length of life expectancy a senior must have to qualify for hospice care.

Generally, hospice care covered by Medicaid is intended to help with symptoms. Medicaid will not pay for care to cure or treat a senior’s terminal illness.

Like Medicare, Medicaid usually covers the entire cost of hospice care for qualifying recipients. In most states, copays aren’t required for enrolled seniors.

TRICARE and other VA benefits

TRICARE, the health care program run by the Defense Health Agency, covers hospice care in the home for military service members, retired service members, and select members of their families.[04,05] The care must be provided in the U.S. or U.S. territories and isn’t covered overseas.

Some of the hospice services covered by TRICARE include the following:

  • Physician services
  • Nursing care
  • Counseling
  • Medical equipment
  • Medications
  • Physical, occupational, or speech therapies
  • Short-term inpatient care
  • VA benefits

The U.S. Department of Veterans Affairs (VA) is a separate government program that also provides hospice care at home as a benefit for veterans and their families.[06] This benefit is for individuals with a terminal illness who aren’t expected to live longer than six months and who are no longer seeking treatment.

For veterans and their families who want to receive hospice care at home, the VA collaborates with community and home hospice agencies to provide this type of care.

Private insurance

Many medical insurance plans can help a senior and their family pay for hospice care at home.[07] However, the covered services and benefits vary from insurer to insurer.

Additionally, long-term care insurance may be able to pay for hospice care at home, depending on the services covered by the plan.[08] This may include continuous home care.

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Other ways to pay for hospice care at home

While most seniors qualify for one of the insurance options above, some may have to find alternative ways to cover end-of-life costs. Private savings, charity organizations, and family contributions can all be used to pay for hospice care at home.

For seniors who don’t qualify for Medicaid, or for those who have private insurance that doesn’t fully cover hospice care, hospice providers often hire financial advisors to help find the funds necessary to pay for care.

Charity funding

In some cases, a senior may be unable to pay for care. Many providers have a funding mechanism through which they can provide services to medically eligible people who don’t have insurance and must pay out of pocket.[06]

Similarly, community organizations might pay for some or all of the costs associated with hospice care services, depending on the senior’s eligibility and financial situation.

Private pay

With all the resources available that pay for hospice care at home, seniors rarely have to rely heavily on personal funds or savings. However, if your loved one chooses a hospice provider that isn’t in network for their insurance plan or isn’t certified by Medicare or Medicaid, they may have to pay out of pocket. This is generally the case with luxury hospice providers or providers affiliated with certain religions.

Table of Contents

SHARE THE ARTICLE

  1. Mayo Clinic. (2021, March 2). Hospice care: Comforting the terminally ill.

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

  3. Centers for Medicare and Medicaid Services. (2016, February). An overview of the Medicaid hospice benefit.

  4. TRICARE. (2022, March 20). Covered services: Hospice care.

  5. TRICARE. (2021, August 3).Retired service members and families.

  6. U.S. Department of Veterans Affairs. (2023, February 15). Geriatrics and extended care: Hospice care.

  7. Hospice Foundation of America. Paying for hospice care.

  8. U.S. Department of Health and Human Services. (2020, February 18). What long-term care insurance covers. LongTermCare.gov.

Meet the Author
Chacour Koop

Chacour Koop is a former copywriter at A Place for Mom, where he published articles focused on Medicare, Medicaid, dementia, and wellness with a hope that other families can use the information to improve their lives. As a former family caregiver, Chacour Koop strives to bring practical knowledge about senior care to readers who are navigating this complex topic. Before writing about senior living, he was a journalist with bylines in The Associated Press, Miami Herald, Sacramento Bee, and dozens of other publications. He earned a degree in journalism from Eastern Illinois University and a master’s degree in public affairs reporting from the University of Illinois Springfield.

Edited by

Danny Szlauderbach

Reviewed by

Todd Austin, home care expert

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