While most patients use Medicare or Medicaid for hospice services, some patients use private health insurance plans to cover hospice care.

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Private health insurance plans protect patients and their families from paying the full cost of medical expenses for illnesses, injuries and medical conditions. This is most often provided by an employer or retirement program, but it may also be purchased privately from a health insurance provider or through the Affordable Care Act Marketplace.

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Most private insurance plans cover hospice care and other end-of-life care services. These insurance plans typically cover the full cost of hospice services. However, each health insurance company may have its own unique requirements a patient must meet before they can begin hospice care.

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At a minimum, most private insurance plans require that the patient be diagnosed with a terminal illness with a reduced life expectancy of six months or less. They also require that a patient discontinue curative measures before beginning hospice care.

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What hospice services does private insurance cover?

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The majority of private insurance plans model their hospice insurance coverage on the federal Medicare hospice benefit program and cover 100% of hospice costs. It is important to contact the insurance provider for specific details on what the patient’s plan will cover and what costs the patient may be responsible for.

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Hospice services include:

• A highly skilled team of physicians, nurses, hospice aides, social workers, chaplains, bereavement coordinators and volunteers.

• Medical equipment related to the patient’s terminal diagnosis including wheelchairs, hospital beds, and walkers.

• Necessary medical supplies including bandages and other wound care supplies, incontinence supplies, and catheters.

• Medications prescribed by the patient’s physician to manage pain and control symptoms related to their terminal diagnosis.

• Short-term in-patient care if needed to manage symptoms related to the patient’s terminal diagnosis.

• Short-term respite care for up to 5 days for the patient at an inpatient care facility to give family caregivers the chance to take a break.

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Patients should always speak with their health insurance provider about these services, so they have the peace of mind of knowing what services are and are not covered.