Who Pays for Hospice Care?

Friday, July 15, 2022


When a person chooses hospice care, they have decided they no longer want to seek curative treatments, or their doctor has determined that curative efforts are no longer working. A person is eligible for hospice care when their doctor has estimated that they have less than six months to live. Paying for care may seem daunting, but most health insurances, including Medicare, will pay for nearly all of your hospice care.

Basic hospice services are a benefit of Medicare and are also covered by private insurance or Medicaid for those not eligible for Medicare. Private payment, or “self-pay” is also accepted. Lumina’s nonprofit status and generous community support allow us to provide care to those who are eligible but do not have insurance nor resources to pay for their care.

Most hospice patients are eligible for Medicare, which covers all aspects of hospice care and services. There is no deductible for hospice services although there may be co-payments for prescriptions and for respite care (no more than $5 for each prescription drug and 5% of the Medicare-approved amount for inpatient respite care). For beneficiaries enrolled in a Medicare Advantage Plan, hospice is covered by Original Medicare.  To learn more about Medicare coverage, click here to view the Medicare Hospice Benefits pamphlet. To learn more about private insurance coverage, contact your health plan provider. If you would like more information about enrolling Medicare, check out this blog post from our partner’s at Clarity Wealth Development in Corvallis, Oregon.

As a nonprofit hospice, Lumina is able to provide care that goes above and beyond the minimum Medicare requirements at no charge to the patient or family – it is what we call our Margin of Excellence. Some examples of what our Margin of Excellence includes are lower nurse-to-patient ratios to ensure patients and families have the dedicated care they need, patient basic needs support to allow those without means and support to receive the end-of-life care they deserve, and enhanced patient therapies like acupuncture, pet, massage, and music therapy. To learn about all of the levels of our Margin of Excellence, click here.