Medicare, Medicaid, and most private insurances cover hospice care. If a patient has no
coverage for hospice services, St.Vincent Hospice can provide financial counseling. It is the
policy of St.Vincent Hospice that no one be denied services based on the ability to pay.
Hospice is covered by Medicare at 100%, so there is no charge for hospice services under the
Medicare benefit. With Medicaid, the patient will be required to meet the monthly spend down
before services are covered at 100%. With private insurance, a deductible or copay may need to
be met, or have a lifetime maximum benefit available.
Although Medicare pays for hospice care, Medicare does not cover room and board (known as
custodial care) in an extended care facility. Therefore, the patient pays room and board fees. If
the patient has both Medicare and Medicaid coverage, Medicare pays for hospice care and
Medicaid pays for room and board at an extended care facility.
Medicare pays hospice a daily amount for care, including staff, medications, and
equipment/supplies related to the terminal illness.
When a qualified patient elects to have Medicare pay for "Skilled" care (complex medical care
or rehabilitation) at an extended care facility, he or she is not eligible for hospice services
through Medicare at the same time. The hospice staff will help determine Medicare and/or
Medicaid eligibility and coverage.