End of life decisions are never easy, but after some grueling debate, you’ve decided that a hospice program is the best choice for your senior parent or family member. You’re probably worried, though, about paying for the service. If your senior’s Medicare doesn’t cover the costs past a certain point, does hospice take your assets?
Neither a hospice provider nor Medicare will seize your assets, including your property or that belonging to your senior parent or loved one. The only way that would happen is if you were found to be cheating Medicare.
Whew – that’s a relief, right? Now that you know that hospice agencies will not take your senior’s assets or your own, you can breathe a little easier.
There’s more to the subject, though.
In this guide, we’ll explain who pays for home hospice care or hospice at an inpatient facility. We’ll also cover what you’d pay if your senior doesn’t have private insurance, and what bearing (if any) that hospice has on social security checks.
How Does Hospice Work Financially?
Hospice is a palliative care organization focused on quality of life care for terminally ill patients. It does not provide medical care, per se, but does provide support services and physical care for those who have been diagnosed by a doctor to have a life expectancy of six months or fewer.
Depending on the type of care needed, hospice provides for care in either the home environment or in a hospice facility where ill individuals can live out their final days comfortably.
But, where does the funding for hospice come from? Keep reading – there’s valuable information ahead.
Medicare is the federal health insurance program that covers medical costs for seniors over age 65 in the United States (and certain younger people, as well). In most cases, a senior’s Medicare will pay for hospice services.
Medicare’s hospice benefit falls under the Medicare Part A plan. The insurance becomes active when medicare beneficiaries are admitted to a hospice facility or when hospice care begins in their home.
Usually, Medicare will usually cover 100 percent of the costs of hospice care, but not always. If it doesn’t, your senior would be responsible for the remaining payment.
If Medicare covers the full cost of your senior’s hospice, it’s usually through the Medicare Hospice Benefit.
In other instances, the U.S. Department of Veterans Affairs Veterans Health Administration may step up and provide some of the costs of hospice care.
According to the U.S. Department of Veterans Affairs website, to be eligible for VA health care, qualified veterans must have enlisted in the military either after September 7th, 1980, or begun active duty after October 16th, 1981 for 24 consecutive months.
For those who served earlier than September 7th, 1980 as well as those who were discharged over hardship or a disability, then the U.S. Department of Veterans Affairs may not apply a minimum duty requirement.
Healthcare through the Veterans Administration works much the same as Medicare for hospice, in that the insurance may pay for the entirety of the care but possibly will not.
It’s the least viable option, but we had to talk about paying for hospice care out of pocket, because for some adult children or caretakers, this might be the only option.
In this case, rather than have Medicare or VA benefits step in and reduce a huge portion of the costs, the entirety of your senior’s hospice care would be on you or your senior to cover.
We’ll talk later about how much hospice care costs without insurance, so make sure you keep reading!
Learn about the Pros And Cons Of Hospice.
Does Hospice Affect A Social Security Check?
I’m sure you were relieved to read that hospice will not take a senior’s assets if they’re overdue on the care bills. That said, your senior parent or loved one still receives a social security check every month.
Should you fall behind on hospice care, will hospice take those social security checks as a means of paying for your senior’s ongoing care?
Much like how hospice will not take your senior’s assets or properties, hospice also will not seize a senior’s social security check. The senior can continue to receive their social security in the mail.
In fact, if you’re applying for disability benefits through the Social Security Administration or SSA, you might be able to speed up the process by mentioning that your senior is in hospice care.
The SSA takes special considerations for those with a terminal illness. Those considerations usually account for those who require a cardiopulmonary life-sustaining device, those who have been in a coma for 30 or more days, those with advanced metastatic or stage four cancer, and those with certain medical conditions (AIDs or ALS). Hospice patients count as well.
Not only are there the disability payments that the SSA will issue, but auxiliary benefits as well for partners and family of the social security check recipient.
To be eligible for these auxiliary benefits, you must have a disabled child who became that way before reaching the age of 22 or a spouse who’s under the age of 62 who is a joint caregiver of a child who’s under 16 years old.
Is Hospice Covered By Insurance?
According to hospice resource VITAS Healthcare, up to 10 percent of families or loved ones seeking hospice for a senior will not use Medicare.
It’s unclear if that’s because the senior isn’t eligible for Medicare or if Medicare would not cover enough of the service costs, but these people explore other avenues, nevertheless.
Can one of those avenues be private health insurance?
Yes, this is usually another viable option for paying for the senior’s hospice care. You have the option of selecting health insurance via a public or private exchange or even going through your senior’s retirement program.
If your senior parent or loved one worked up until very recently before they were admitted to hospice care, then their former employer might still provide health insurance, although this would likely only be for a limited time.
How much would health insurance coverage through the federal government (Healthcare.gov) cost? That depends on the plan your senior has chosen, or what you select. Here’s an overview.
Bronze Plan Health Insurance Costs
If your senior chose the bronze health insurance plan, this has the highest out-of-pocket costs but a much lower premium.
Insurance would pay up to 60 percent and you would be responsible for the remaining 40 percent of hospice costs.
Silver Plan Health Insurance Costs
The silver-level health insurance plan has a lower premium, but the out-of-pocket costs are still quite high.
You’re paying as much as 30 percent whereas the insurance company would cover 70 percent of the accrued costs.
Gold Plan Health Insurance Costs
If your senior parent or loved one has a gold health insurance plan, now they have access to a higher premium.
The out-of-pocket costs are a lot lower as well. Insurance will pay for up to 80 percent of hospice care while you’re responsible for 20 percent.
Platinum Plan Health Insurance Costs
Finally, there’s a platinum health insurance plan. The premium for this plan is the highest and the out-of-pocket costs are the lowest.
Your senior’s health insurance would pay for up to 90 percent of hospice costs while you’d only have to pay for 10 percent.
Keep in mind that not all hospice services are necessarily covered under private health insurance. The services you can expect insurance to pay for include routine home care, inpatient care, continued care, respite care, medications, home medical supplies and equipment, nursing staff, and bereavement support.
How Much Is Hospice Care Without Insurance?
As we said we would, let’s discuss what you’d pay for your senior’s hospice care without any insurance or Medicare to cover the costs. This section will help you determine if paying out-of-pocket is a financially viable option.
All prices are courtesy of Hospice Valley and reflect 2021 prices.
- Level 1 Routine Home Care for 60 days – $199.25 per day
- Level 1 Routine Home Care past day 60 – $157.49 per day
- Level 2 Continuous Home Care – $59.68 per hour
- Level 2 Continuous Home Care for up to 24 hours – $1,432.41
- Level 3 Short-Term General Inpatient Care – $1,045.66 per day
- Level 4 Inpatient Respite Care – $461.09 per day
Keep in mind that average length of stay under hospice runs for upwards of six months, sometimes longer.
Let’s say your senior parent or loved one needed Level 3 Short-Term General Inpatient Care. At $1,045.66 a day, in a month, you’d pay $31,369.80. For six months, the fees would be $188,218.80.
If that’s affordable to you, then great! For many more people though, paying six figures for hospice care is simply too costly. We would recommend exploring the alternative payment options we’ve discussed to this point.
Are Hospices Free?
What if you’re completely out of options? Your senior isn’t eligible for VA benefits, they don’t have Medicare, and they lack private health insurance. You crunched the numbers and paying for hospice out-of-pocket feels impossible.
In some instances, hospice services may be free. We must stress that this depends very much on the hospice center, so don’t necessarily expect this.
Some will be generous enough to provide care to your senior if you can prove that you don’t have insurance nor any other way to pay for the care, though.
If you do receive financial assistance, it usually comes from community sources, grants, gifts, or donations the hospice center receives to otherwise stay afloat.
Other hospice centers, while not offering their services for free, might be willing to work with you and adjust payments on a sliding scale. This can make hospice more affordable than the numbers above would suggest.
If you’re still at the stage where you’re comparing hospice centers for your senior parent or loved one, it’s not a bad idea to ask what their policy is about free services or sliding scale payments.
Even if you’re in a good financial position now, being aware of their policy could come in handy later down the line if your financial situation changes.
Hospice does not take your senior’s assets or property, nor will the hospice care center come after your senior’s social security check. In most cases, Medicare will pay for the entirety of the hospice services.
If not Medicare, it’s usually VA care or a senior’s private health insurance that covers the costs. Some adult children or caretakers may opt to pay for hospice care out-of-pocket, but this isn’t always necessary.
A hospice center may be willing to work with you to adjust payments on a sliding scale or even offer hospice for free, so it’s a good idea to ask!