Hospice and home health care: what Medicare covers

Home health care

Medicare covers part-time skilled care at home if:

• You're homebound: leaving home is hard or not advised because of an illness or injury.
• A doctor or other provider sees you in person and orders the care.
• You need part-time or intermittent skilled nursing, or physical, speech or occupational therapy.
• A Medicare-certified home health agency provides it.

Covered: skilled nursing, therapy, medical social services, and home health aide help alongside skilled care. You pay $0 for covered home health services and 20% of the Medicare-approved amount for medical equipment, after the Part B deductible.

Not covered: 24-hour care at home, meal delivery, homemaker services, or personal care (like bathing and dressing) when that's the only help you need.

Hospice care

Hospice focuses on comfort rather than cure. You qualify if you have Part A and:

• Your hospice doctor and your regular doctor certify that you're terminally ill, with a life expectancy of 6 months or less.
• You choose comfort care instead of treatment to cure the illness, and sign a statement choosing hospice.

You pay $0 for hospice care, up to $5 per prescription for pain and symptom relief, and 5% of the Medicare-approved amount for inpatient respite care (short stays that give a caregiver a rest). If you live in a nursing home, room and board usually isn't covered.

Hospice is covered for two 90-day periods, then an unlimited number of 60-day periods, as long as a doctor recertifies that you're terminally ill. You can stop hospice at any time, and Medicare still covers care for health problems unrelated to the terminal illness.