A Guide to Medicare Hospice Coverage and Programs

Document with title medicare part a.

Hospice is a service offered to preserve a patient’s quality of life in the end stage of life or during a terminal illness. It also addresses the patient’s spiritual, emotional, medical and physical needs. This important service provides care and comfort to both patients and their loved ones, and under certain requirements, can be covered by Medicare. Here is a quick guide to these requirements from our assisted living hospice neighborhood in South Jersey.

Medicare Eligibility Requirements for Hospice Services 

In order to be covered by Medicare for hospice services, your loved one must:

  • Meet eligibility requirements for Medicare Part A (hospital insurance);
  • Be certified by a doctor and hospice medical director as terminally ill with six months or less to live;
  • Have a signed document from a legal guardian stating that hospice care is being chosen instead of other treatments covered by Medicare; and
  • Choose a Medicare-approved hospice care provider.

Hospice Services Covered by Medicare 

If eligible, the following 10 hospice services WILL BE covered by Medicare:

  1. Nursing care and doctor services
  2. Hospice aid services
  3. Physical and occupational therapies
  4. Social worker services
  5. Medical equipment (for example, a wheelchair) and medical supplies
  6. Pain relief and symptom control medications
  7. Nutritional counselling
  8. Grief and family counselling
  9. Short-term respite care
  10. Short-term inpatient care

The following services are NOT covered by Medicare:

  • Treatments designed to cure the terminal illness;
  • Prescription medication to cure the terminal illness (only symptom management is covered);
  • Room and board for hospice care, unless covered by short-term inpatient care or respite care requirements;
  • Any care that is not arranged by the hospice medical team. If you want a service from a different hospice provider, you need to officially change your selected Medicare-approved hospice provider; and
  • Emergency care, including ambulance transportation, inpatient facility care or emergency room care unless it is arranged by your hospice medical team or it is the result of healthcare needs unrelated to the terminal illness.

Speak to our Team at Bridges, an Assisted Living Neighborhood Dedicated to Hospice and Palliative Care at The Shores in Cape May County, NJ for Advice 

At The Shores, a part of the well-known United Methodist Communities non-profit organization in New Jersey, we offer compassionate, professional hospice care in the Jersey Shore area called Bridges. This program focuses on creating a nurturing and comforting environment for patients and their loved ones through customized care programs and compassionate support.

To find out more or if you need advice on hospice care options and Medicare, please visit our website at https://umcommunities.org/theshores/hospice-care-nj/ or contact us today.

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