Palliative Care Costs and Benefits
Palliative care, a relatively new medical term, has been provided by hospice programs for more than 30 years. It is now being used by other healthcare providers as well to help people who are seriously ill. Palliative care and hospice focus on helping a person be comfortable by addressing issues causing physical or emotional pain or suffering. The goals of palliative care are to improve the quality of a seriously ill person’s life and to provide support to the family during and after treatment. The goals of hospice are to relieve symptoms and support patients with a life expectancy of months, not years, and their families. Hospice is a defined set of services, while palliative care is not.
If you and a family member or friend with a life-limiting illness are considering palliative care or hospice, click on any subject below for more information.
- What is Hospice?
- What is Palliative Care?
- Choosing a Hospice
- Choosing a Palliative Care Program [PDF]
Two of your biggest questions may be how much palliative care and hospice cost and how your family member or friend will pay for it. Hospice is covered under the Medicare Hospice Benefit, the Medicaid Hospice Benefit, and most private health insurance plans. Palliative care may be covered by your loved one's Medicare, Medicaid, or private health insurance or long-term care insurance plan, HMO, or other managed care organization. If they don't have insurance, or their insurance does not cover hospice, don't let worries about cost keep them—or you—from contacting hospice. While each hospice has its own policies concerning payment, it is a tradition of hospice to offer services based on need, rather than on the ability to pay.
Click on any subject below for more information:
What Palliative Care Benefits are Available?
Palliative care primarily involves services by health care providers such as hospitals, hospices, or other community health providers to improve the quality of a seriously ill person's life and to support that person and his or her family during and after treatment. Learn more about palliative care.
Medicare
If you have Medicare Part B (medical insurance), it may cover some treatments and medications that provide palliative care, including visits from doctors, nurse practitioners, and social workers. Medicare does not use the term palliative, so coverage is provided by standard Medicare Part B benefits. The palliative care provider (the organization offering you the services) will bill Medicare for services provided, but be sure you understand what co-pays or fees, if any, you will be asked to pay. Ask about your responsibility for fees and request a fee schedule before agreeing to receive services.
Medicaid
If you are covered by Medicaid, a health insurance plan for people with low income and few assets, it may cover some palliative care treatments and medications, including visits from doctors. Medicaid does not use the term palliative, so coverage is provided by standard Medicaid benefits. The palliative care provider (the organization offering you the services) will bill Medicaid for services provided, but be sure you understand what co-pays or fees, if any, you will be asked to pay. Ask about your responsibility for fees and request a fee schedule before agreeing to receive services.
Private insurance, HMOs, managed care programs
Many private health insurance plans provide some coverage for palliative care as part of their hospice or chronic care benefits. If you own a long-term care policy, there may be palliative care benefits provided by that policy. Check with your health insurance or long-term care insurance representative.
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