Written by:
Edited by:
Reviewed by:Hospice care provides a supportive environment for patients and families when you or a loved one is facing the end of life. While healthcare costs can be a concern for many, the good news is that hospice is very accessible and most costs are covered by Medicare. Additionally, you may be able to cover costs through Medicaid, private insurance, VA benefits, or charitable programs offered by hospice providers. In this post, we’ll discuss how much you can expect to pay for hospice and your options for covering the costs.
Key Takeaways
- Hospice provides palliative care for patients with a terminal illness diagnosis, but does not include curative treatments.
- Hospice costs are generally covered by Medicare, Medicaid, VA Benefits, or private insurance.
- Even if you have no means to pay for hospice, providers may cover your expenses through charity care.
- There are a few expenses not covered by Medicare that could require out of pocket payments, but these costs should be minimal, if any.
While hospice care can cost a lot, the good news is that most costs are covered by Medicare — so there are generally minimal expenses for patients and their families. The cost of hospice varies by location and the level of care, but you can get a general idea of the cost by looking at the amount Medicare pays toward services. According to the National Hospice and Palliative Care Organization (NHPCO), these are the 2024 Hospice Payment Rates:
- Routine Home Care (days 1-60): $218.33
- Routine Home Care (days 61+): $172.35
- Continuous Home Care: $65.23 per hour ($1,565.46 per day)
- Inpatient Respite Care: $507.71 per day
- General Inpatient Care: $1,145.31 per day
Keep in mind, these amounts are what Medicare pays hospice providers, not the amount you’ll pay out of pocket. With that being said, these figures suggest that hospice costs between $172 to $218 per day for routine care in the patient’s home, an assisted living facility, or a nursing home. Other forms of care are more expensive if the patient has specific needs, but again, most costs should be covered by Medicare.
However, there are a few hospice costs that aren’t covered by Medicare. Most notably, Medicare will not cover a treatment plan to cure the patient’s terminal illness, including prescription drugs other than for symptom control or pain relief. Some hospice providers may also require a copay of up to $5 per prescription drug that Medicare does not fully cover. Medicare also won’t cover room and board while receiving hospice services unless the care team determines the patient needs short-term inpatient or respite care. If inpatient respite care is needed, Medicare may require the patient to cover 5% of costs. Finally, outpatient care such as ambulance transportation is also not covered as part of Medicare’s hospice coverage unless it’s arranged by the hospice team.
You generally don’t have to pay anything for hospice care, as most patients will be eligible for Medicare which will cover most aspects of care. Medicaid and private insurance can also provide benefits to help cover costs, and military families have hospice coverage through Tricare. If you cannot cover hospice costs through any of these means, many providers have a process to help provide care for people with insufficient resources.
Insurance may not be needed to pay for hospice care, as patients should be able to cover costs through Medicare or Medicaid. If you’re ineligible for these programs and don’t have insurance, then hospice may cost around $172 to $218 per day out of pocket for routine home care. However, even without Medicare, Medicaid, or private insurance — you may not have to pay anything because many hospice providers offer a process to cover costs if the patient cannot afford care.
If you require hospice and are wondering how to cover the costs, there are plenty of options including several that will pay for most care expenses. About 90% of hospice patients rely on Medicare and Medicaid to pay for hospice care, but there are additional ways to cover costs if you’re ineligible or have remaining expenses.
Medicare
If you qualify for Medicare Part A (hospital insurance), the Medicare Hospice Benefit will cover up to 100% of all hospice services related to your terminal illness. To qualify for Medicare’s hospice benefits, you must have a terminal diagnosis with a life expectancy of six months or less and agree to cease any curative treatments. Medicare is the largest payer of hospice services, and recipients who require hospice care may have no out of pocket expenses.
Medicaid
Private Insurance
If you have private health insurance, most companies will cover a portion of hospice costs. The degree of coverage will depend on your insurer and plan details, so you’ll need to contact the insurer or agent to see specific details about your benefits. Additionally, if you have long-term care insurance, it generally covers hospice care as well. You may be able to use insurance benefits to cover any lingering costs that aren’t covered by Medicare or Medicaid
VA Benefits
Hospice care is included in the VHA Standard Medical Benefits Package, so enrolled Veterans and their family members are eligible if they meet the requirements for hospice services. Like other benefit programs, eligibility requires a terminal illness diagnosis and agreement to no longer seek treatment other than palliative care. The VA offers hospice care services at home, in an outpatient clinic, or in an inpatient setting like a Community Living Center. To help with choosing a hospice facility, the VA offers survey scores for hospice care providers including VA Community Living Centers and Non-VA Settings.
Charitable Care
If you need hospice care and have no way to pay for it, hospice providers may be able to pay for your services through charity care. According to the Hospice Foundation of America, “all Medicare certified hospices are required to provide some amount of charity care” as a mechanism to provide services for people who medically need hospice care but don’t have the resources to pay for it. Additionally, you may be able to get financial assistance through charitable programs like the AccentCare Hospice Foundation or Capital Caring’s Patient Care Fund.
Out of Pocket
If you’ve exhausted all other options and still have remaining hospice costs, you’ll need to pay out of pocket. The good news is that hospices should be willing to work with you so you aren’t stuck with a huge bill due all at once. You may be able to work out a payment plan to spread hospice costs over time so it’s easier to manage.
To cover out of pocket expenses, you can use savings or tapping into other assets. For example, you may be able to take a reverse mortgage or sell your home. If you have a life insurance policy, you may also be able to sell it through a viatical settlement which can provide a lump sum cash payment that’s greater than the surrender value, but greater than the death benefit. If you’re curious about the value of your policy, you can use our life settlement calculator to see how much it’s worth or contact us for a free estimate.
