If you, a loved one or someone you know needs hospice care, please make sure that they get the care they need.  You should not be concerned about insurance coverage or paying for care as there are many options for payment and insurance coverage as shown below.

Who Pays for Hospice Care?
Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers.  Medicare is the primary payer for nearly two-thirds of hospice patients.  If a person does not have coverage through Medicare, Medicaid or a private insurance company, hospice will work with the person and their family to ensure needed services can be provided.

Medicare.  If the terminally ill individual is a Medicare beneficiary, hospice is a covered benefit under Part A.  All other Medicare services continue under Parts A & B, including those of the person's attending physician. Hospice payments do not interfere with any other Medicare payments for other illnesses, diseases or care.

Hospice coverage under Medicaid.  Hospice coverage under Medicaid is available in the State of Texas.  In general, Medicaid hospice benefits parallel the Medicare benefit, although there may be some variations in certain states.

Private Insurance.  Most insurance plans issued by employers and many managed care plans offer a hospice benefit. In most cases, the coverage is similar to the Medicare benefit, although there may be some variations between employers.

Tricare.  Tricare is the health benefits program for military personnel and retirees. Hospice is a fully covered benefit under Tricare. Only Medicare-certified hospices can provide for the Tricare hospice benefit, so it is important that patients and family check with their health benefit advisor or health care finder to help them locate a qualified hospice agency.

Private Pay.  If insurance coverage is unavailable or insufficient, the patient and the patient's family can discuss private pay and payment plans.

Charity Care.  Under Medicare law, no person may be refused hospice care due to inability to pay. Funds may be available from donations, gifts, grants or other community sources to help cover the costs of care.