Medicare and Medicaid are the most common funding sources for individuals who enroll in Hospice care. Medicare is a health insurance program offered by the government for seniors age 65 and older. People under age 65 with certain disabilities or end-stage renal disease are also eligible for Medicare.

Hospice is available as an option to Medicare beneficiaries entitled to hospital insurance (part A), who have terminal illnesses and a life expectancy of six months or less.

• This coverage is elected in Lieu of standard Medicare for management and treatment of their terminal condition

  • Standard Medicare benefits for other diagnosis not related to the terminal condition

• Only care provided by a Medicare certified agency is covered under the provisions

• To be covered, hospice services must be reasonable and necessary as determined by a physician for the palliation or management of the terminal illness and related conditions.

• When hospice is elected, the beneficiary waives rights to Medicare B except for professional services of an attending physician that is not a full time staff member of the hospice.

• Hospice enrollees always have the right to revoke their hospice benefits and return to Part A Medicare.

Medicare has three parts:

Part A - Hospital Coverage.

Part A helps cover inpatient care in hospitals and nursing homes. It also helps cover hospice care, and some home health care. You must meet certain conditions to get these benefits.

Part B - Physician and Outpatient Coverage

Part B helps cover doctor and outpatient services. It also covers some of the services of physical and occupational therapists, and some home health care, when they are medically necessary. There are premiums and deductibles associated with Medicare Part B.

Part D - Prescription Drugs.
Medicare Prescription Drug Coverage plans are Medicare-approved private insurance plans, offered by private companies like Evercare. Most people will pay a monthly premium for this coverage.

The official Medicare Web site contains a great deal more specifics if you need them.

Medicaid is for low-income individuals.
Medicaid is a program for people who can't afford to pay for medical care. It is offered by states to state residents who are United States citizens or qualified immigrants. Medicaid is for pregnant women, children, members of a low-income family, blind or disabled, or aged. State income standards can be viewed on the Center for Medicare and Medicaid Services Web site, along with certain other requirements that are available for your state.

To find out even more about Medicare and Medicaid please download the complete Medicare & You Handbook (PDF 614 KB) .