Who Pays for Palliative Care at Home?

Palliative care can help seniors navigate life-limiting illnesses and chronic health issues. To be eligible to receive palliative care, your parent must have a doctor’s referral for their condition.

Palliative care professionals often provide support for seniors with a variety of conditions, which may include the following:

• Alzheimer’s disease and other forms of dementia
• Cancer
• Liver and renal disease
• Diabetes
• Congestive heart failure or heart disease
• Chronic obstructive pulmonary disease (COPD)

Palliative care teams focus on managing pain and debilitating symptoms of these and other illnesses. Caregivers can also provide emotional support, spiritual guidance, and help with decision-making about treatment and care options.

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Some insurance policies will likely cover the medical services of at-home palliative care including home health services and prescriptions. However, the broad spectrum of in-home palliative care services may not be fully covered.

Medicare, Medicaid, and private insurance often cover inpatient and outpatient palliative care. Your loved one’s unique medical situation and where they choose to receive care — whether at a hospital, hospice, or local medical center — will affect coverage.

• Medicare guidelines don’t specifically outline coverage of at-home palliative care, as every senior’s case is different. While it’s likely that Medicare will cover some in-home palliative expenses, like home health aides and medications, other services will have to be paid out-of-pocket. Medicare Part A will cover palliative care if you’ve also accepted hospice benefits. Medicare Part B can cover medical fees (like doctor’s visits) for outpatient palliative care. Medicare Part D covers prescription medications, many of which are associated with palliative care plans.

Read more: Medicare, Medicaid, and Long-Term Care

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• Medicaid coverage will vary on a state-by-state basis. Some states provide full coverage for palliative care for specific illnesses, while others only cover inpatient medical costs.
• Private insurance will likely cover a portion of palliative care. However, if you choose to receive care at home, there may be unique conditions insurance companies will require seniors to meet.

Seniors and their families opting for in-home palliative care should be aware that there are likely some treatments and medications that won’t be covered. Copayments, coinsurance, and policy premiums will likely still apply before palliative services are covered.

Because coverage varies depending on condition, place of treatment, and insurance plan, be sure to connect with your parent’s insurance agent or Medicare representative to get personalized cost quotes.

If your family member’s insurance doesn’t cover the entire cost of in-home palliative care, there are other options to consider. Families often take a mix-and-match approach to pay for home care.

• Personal savings like retirement funds, pensions, or stocks can be used to supplement parts of in-home palliative care that aren’t covered by insurance.
• Long-term care insurance plans may include home care benefits. Contact your parent’s insurance agent to see if palliative services are covered by their senior care insurance policy.
• Selling the family home is one option many consider when looking for opportunities to pay for senior care. Some also choose to rent their home and use it as an investment property. If selling or renting is out of the question, explore how a reverse mortgage could fund long-term care.

While it can be hard to support a parent as they’re navigating a serious medical condition, being prepared to manage finances together can make the journey less difficult.

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