Does Insurance Cover Hospice?

If you or a loved one are considering enrolling in hospice care, you may be concerned about any potential costs that could accrue. In fact, 99 percent of hospice patients have no out-of-pocket expenses1. About 90 percent of hospice patients rely on Medicare and Medicaid to cover their care, and the rest turn to other financing sources, which for most people means private insurance.

Most people enroll in health insurance plans through an employer or retirement program, while others purchase theirs privately through a provider. Private insurance plans generally cover hospice and palliative care costs in full, but the terms and conditions of eligibility of each plan will vary.

Most private health insurance plans align with Medicare in their requirements for hospice: A patient must be diagnosed with a terminal illness indicating a life expectancy of six months or less and choose not to receive curative treatment.

Hospice Services Covered by Private Insurance

Once you’ve met the qualifications outlined by your insurance provider, you should confirm what services will be covered by the plan, and which—if any—expenses you are responsible for.

Here are some hospice services commonly covered by private health insurance plans modeled after the Medicare Hospice Benefit:

  • An interdisciplinary team of hospice professionals
  • Home medical equipment and supplies
  • Medications related to the terminal diagnosis
  • Respite care
  • Continuous care
  • Inpatient care
  • Routine home care
  • Bereavement support

1National Hospice and Palliative Care Organization, "Facts and Figures: Hospice Care in America," 2015 Edition

Call VITAS to learn more about hospice and palliative care options.

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