Does Medicaid Cover Hospice Care?
In some states, Medicaid does cover hospice care for its recipients, under very specific circumstances. In other cases, hospice care is not available to Medicaid-only patients, although people who receive both Medicaid and Medicare are eligible for hospice care. The regulations about hospice care are determined on a state by state basis, and they are constantly changing, so the best way to get reliable information about Medicaid coverage is through a social worker.
It is important to distinguish between Medicaid and Medicare when discussing hospice benefits. Both programs provide medical assistance to Americans in need, but Medicaid is based on income, while Medicare is an entitlement program. To qualify for Medicaid, someone must prove that he or she has an income below a certain level, while Medicare is provided to American seniors who have paid into the Medicare program. Some seniors are on both Medicaid and Medicare, while Medicaid-only patients do not qualify for Medicare, which usually means that they are younger individuals.
Individual states get to decide how they want to use their Medicaid funds, with the government providing a few rough guidelines such as the income cutoff, and a mandate to ensure that children have access to healthcare. Many states treat hospice care as an optional treatment, rather than a vitally necessary medical treatment, and as a result, they may choose not to cover hospice, or to cut hospice care assistance if funding becomes tight. Other states do offer hospice benefits, but the requirements are usually very specific.
In order to qualify for Medicaid assistance with hospice care, a patient must qualify for Medicaid and demonstrate that he or she is terminally ill. Certification is generally provided by a doctor. The patient must opt for hospice care rather than other types of hospitalization, and he or she must use the services of a hospice which has been approved as a provider by Medicaid. Benefits are also limited to a set period of time, so if a patient's stay exceeds the period covered by Medicaid, he or she will be charged.
Hospice care can be very valuable for terminally ill patients. It is designed to provide palliative care and promote comfort and dignity for people who are dying. Hospice usually includes pain management programs, and it may include therapeutic treatments like discussions with a psychologist, massage, special nutrition, and other supportive measures which keep the patient as comfortable as possible. Hospice advocates argue that it should be viewed as a necessary treatment under Medicaid, supporting classification as “mandatory” so that it will be covered across the United States by law.
Written by S.E. Smith
