Does Medicare Cover Palliative Care at Home?
Often, yes. Medicare doesn’t have a separate “palliative care benefit,” but Original Medicare Part B generally covers medically necessary visits from physicians and nurse practitioners, including visits at home. That’s how most in-home palliative care is billed.
What You May Pay with Original Medicare
Palliative visits are billed like a doctor’s visit. After you meet your yearly Part B deductible, you typically pay 20% coinsurance for each visit. A Medicare supplement (Medigap) plan may cover some or all of that amount.
Medicar Advantage & Private Insurance
- Medicare Advantage: most plans cover palliative visits. Copays and rules, such as which providers are in network, vary by plan.
- Private insurance: most plans cover palliative care at some level. Ask about copays, deductibles, and any limits on visits.
What Palliative Coverage Doesn’t Include
Palliative visits cover the clinician’s time and care. Medications, medical equipment, and supplies go through your own insurance, the same way they do today.
How Palliative Coverage Differs from Hospice
Hospice is a separate Medicare benefit under Part A for people with a life expectancy of six months or less who choose comfort-focused care. It covers medications, equipment, and supplies related to the hospice diagnosis.
Palliative care has no prognosis requirement and works alongside your current treatment.
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Not sure what your plan covers? Call us, and we’ll check for you.