For people living with a serious, life-limiting illness, palliative care provides specialized medical support for the patient and their families. Throughout the palliative care process, health care providers focus on relieving symptoms, but also address the emotional toll the illness is taking on the patient and their loved ones. The palliative care team will work together to improve quality of life for everyone involved.
Palliative care and hospice are often confused. Hospice is a type of palliative care, but palliative care can be provided regardless of whether or not the illness can be cured. While palliative care can be practiced in a hospice setting, it is also practiced cooperatively with treatments for other illnesses either in the home, hospital, or in a skilled nursing facility.
If you or a loved one has been diagnosed with a serious illness, such as cancer, congestive heart failure, chronic obstructive pulmonary disease, kidney disease, or Alzheimer’s disease, your health care provider may suggest you begin palliative care in tandem with your treatment. This specialized care provides emotional, psychological, and spiritual support for patients and their family members. It is important for you to know whether your Medicare insurance covers palliative care, and exactly what that care entails.
What to Expect from Palliative Care
If you are receiving hospice care in your home or an inpatient facility, your healthcare team of providers will design a care plan that may include some of the following services:
- Doctor and nursing care services
- Medical equipment such as walkers, wheelchairs, or portable toilet and
medical supplies like catheters
- Prescription drugs needed for symptom or pain relief
- Special services such as: hospice aide, physical or occupational
therapy, social work, nutritionist counseling, grief counseling
- Short-term inpatient care as needed for pain or symptom management
- Short-term inpatient respite care for up to 5 days at a time in a
- Various other services aimed at pain and symptom management that
is covered by Medicare
For people who are facing a life-limiting illness, palliative care providers offer support for their families through this difficult time. Discuss your options with your health care provider so you can make the best decision for you and your family regarding palliative care.
Even if you are not in hospice, palliative care may still include care from an interdisciplinary team of specialists, including a nurse, pharmacist, social worker, and dietician. Your care will focus on making the patient as comfortable as possible while you undergo treatment.
How Medicare Can Help Pay for Palliative Care
Medicare Part A (Hospital Insurance) will cover hospice care if you meet the following conditions:
- Your physician certifies that you are terminally ill with a life
expectancy of 6 months or less.
- You want palliative care for comfort rather than treating
- You must sign a statement declaring that you choose hospice care
rather than other benefits covered by Medicare which may treat
your terminal illness.
Even though Original Medicare covers all costs for hospice care, you may have a copayment for prescription drugs or other medications when you are in your home. This copayment is no more than $5.00 per prescription. You may also have to pay 5 percent of your Medicare-approved amount for inpatient respite care. Check with your hospice provider for the details of your coverage.
If you are not in hospice, Medicare Part B (Medical Insurance) may help cover the costs of palliative care, including medically necessary services and supplies, mental health care, and durable medical equipment.
If you have Medicare coverage through a Medicare Advantage plan, you will have at least the same benefits as Original Medicare, but many Medicare Advantage plans include additional coverage.
Medicare Part A