One of the most common questions we receive regarding Norman hospice care is, “how much will it cost?” When your loved one has received a terminal prognosis, Medicare is an option to consider to help with costs.

Before you enter a hospice program, a doctor must certify that your loved one has been diagnosed with a terminal illness and a life expectancy of six months or less. If qualified, our hospice medical team will work with you to develop a plan of care that meets their specific needs.

Medicare covers hospice as long as it’s Medicare-approved. If your loved one is in a Medicare Advantage Plan like an HMO or PPO and wants to begin hospice, here’s a guide to receiving care at minimal to zero cost.

What a Medicare Advantage or Other Medicare Health Plan Will Cover

Once the hospice benefit starts, Medicare will cover everything you need in relation to your terminal illness. Medicare also covers these services if you choose to remain in the Medicare Advantage Plan or another health plan.

If you were in the Advantage Plan prior to starting hospice, you can remain in it as long as you pay the premiums. If you stay in the plan and choose to receive services unrelated to your terminal illness, you’ll need to refer to providers in your plan’s network or other Medicare providers.

Navigating Coverage For Your Other Conditions

You can still receive coverage for conditions unrelated to your terminal illness. In fact, Original Medicare can cover the services provided to manage other health problems aside from your terminal illness. However, keep in mind that you’ll pay the deductible and coinsurance amounts.

What you’ll pay will largely depend on the plan and whether you follow plan rules like seeing in-network providers. If your plan covers other services like dental or vision, your plan will continue to cover these as long as you continue to pay your plan’s premiums.

Medicare Coverage: Part A vs. Part B

If you’re in a Medicare Advantage Plan, you may encounter different rules in Part A then you would Part B. However, both plans must provide the same coverage as Original Medicare. In general, Medicare Part A covers hospital care, skilled nursing, hospice and home health services.

In contrast, Medicare Part B covers two types of physician services: medically necessary and preventative. Medically necessary includes the services and supplies need to diagnose or treat your medical condition. Preventative covers the health care needed to prevent illness or detect at an early stage when treatment typically performs best.

Under Part B, you don’t pay anything for most preventative services as long as you receive them from a provider who accepts assignment. More specifically, Medicare Part B covers things like clinical research, ambulance services, inpatient and outpatient visits, medical equipment and prescription drugs.

In Summary

All Medicare-covered services received under hospice are generally covered under Original Medicare — even for some conditions unrelated to your illness. The Medicare Advantage Plan is a type of health plan offered by private insurance companies that partners with Medicare in providing all your Part A and Part B benefits. However, keep in mind that hospice care is covered directly by Original Medicare even if you have an Advantage Plan.

To learn more about hospice and how we can help your loved one pay little to no cost for care, reach out to our team today at one of our two locations.

Norman: (405) 360-2400

Ada: (580) 332-6900

Need Help Choosing the Right Norman Hospice Care?

Between referrals and Google listings, it can be stressful trying to find the right hospice provider for your loved one. In this checklist, we share our best qualification questions so you can find the perfect match. Click below to download it now!

23 Questions to Identify the Right Hospice Company