Share of Cost, Do You or a Loved One Receive Hospice Care? Tips to Avoid Fraud
Hospice is comprehensive care for people who are terminally ill. Hospice includes pain management, counseling, respite care, prescription drugs, inpatient care, and outpatient care, as well as services for the terminally ill person’s family. Understanding the Medicare hospice benefit can help you avoid Medicare fraud while you or your loved one receives the most appropriate care during this difficult time. The tips below are from the Medicare Minutes program.
Step 1: Understand how and when Medicare covers the hospice benefit.
You must meet the following criteria to receive the Medicare hospice benefit:
- The hospice medical director and your doctor certify that you have a terminal illness, meaning that your life expectancy is six months or less;
- Elect to have Medicare pay for palliative care treatments; and
- Receive care from a Medicare-certified hospice agency.
Hospice services are always covered under Original Medicare, even if you had a Medicare Advantage plan before electing hospice.
Choosing to elect hospice is a significant and private decision between you, your family, and your primary care physician. Most hospice providers provide very important and beneficial care to people with Medicare, but a small minority tries to recruit patients who clearly lack a terminal condition.
Beware of any hospice that says it provides curative care or that offers gifts or other payments if you elect to receive hospice.