If Mom goes on hospice will we still pay privately or will Medicare pick it back up due to hospice care?

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If Mom goes on hospice will we still pay privately or will Medicare pick it back up due to hospice care?

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Mom is in a nursing home. Currently, we are private pay as Medicare days are spent. Just found out her cancer may have returned. Will know in two weeks. She has said if it is back she is not having any treatment. My question is if she goes on hospice will we still pay private or will Medicare pick it back up due to hospice? We aren't able to pay privately past January. We were planning on applying for Medicaid, But hospice may be more beneficial to her at this point.

Financial Planning Hospice Paying for Care

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I would apply for Medicaid now, ASAP. Whether she goes on Hospice or not, when her funds run out you’ll need to have Medicaid already in place. The NH can help you apply.

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This can be very tricky. If she applies for Medicaid and she is not eligible (maybe she has more resources than allowable) she will get denied and have to reapply anyway. It is best to consult with an elder law attorney. There is so much misconception over medicaid that money to an elder law attorney can be money well spent.

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Medicare will not pay for the residential portion of the bill. It will pay for all hospice related expenses. So, yes apply for Medicaid now.

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So what will they pay for once on hospice?

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Medications if not life sustaining, hospital bed, nurse once a week, CNA daily. Social worker, counseling for family. Call hospice and ask what services are covered. There are many.

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Not necessarily a CNA daily. My mom got only twice a week.

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Seems like there is a common misunderstanding here - to a layperson, "Medicare will pay" would be interpreted that no more bills come in, period. But to Medicare - we will cover HOSPICE costs, but NOT ROOM AND BOARD if in a facility. So then those costs have to be paid, by insurance, by family, etc. Huge difference financially!

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The Hospice that I used, and volunteer for/with is a Not for Profit Hospice.
As far as I know Respite is covered, In home care is covered (and if a person is in a facility they are covered but Hospice does not pay for the facility)
Equipment is covered, supplies are covered. I had a Nurse in the house 1 time a week, a CNA came in 3 times a week (early on it was 2 times a week but it was increased as my Husband declined) I had a Social Worker 1 time a month and a Chaplain was available as well. (I also had the option of having many different therapies music, massage, art...but none of those would have helped my Husband) All of these were covered by Hospice through Medicare.
Had we not had Medicare or any other insurance this particular Hospice does not turn ANYONE away due to the inability to pay for services.
Each Hospice, just like any other business operates independently. Call and interview the Hospices in your area and determine what one will work best, what one will help you and your Mom.
Apply for Medicaid, the Social worker at the facility where she is now may be able to help, Hospice might be able to help with the application process as well.

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My mom is with Hospice. She does live with me and my husband. Hospice pays for her hospital bed, transport chair, bedside commode. As far as supplies, they bring Chux pads and disposable briefs. You have to purchase flushable wipes and hand wipes. Disposable gloves also. Although the nurse and health aide usually have those. A nurse comes once a week, as well as a pastor, aide and counselling being offered. We have a home health aide that comes when we are at work who is Private Pay.
Medicare, who pays hospice, also covers her medications. So, they are truly a blessing! I do know that if you're in a hospice facility, Medicare does not cover the room & board.

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Respite is also covered. Available to my mom is 5 days per quarter. They find the facility, pick her up and bring her home. We have not used this as of yet.

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Hi Kannie - so sorry to hear this.... I am not sure of the answer, but was wondering why "Medicare" is "spent".... Can you max out or something?

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Yes!!! Medicare only covers a limited number of days. You can go to www.medicare.gov to find out more information.

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It is true that Medicare will only pay for Hospice services in a nursing home; not room and board.
If, however, Hospice services are being delivered in a free-standing Hospice facility or in a dedicated portion of a hospital, Medicare will pay the full cost of care including room and board.

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So if I moved her to a hospice facility they would then pay?

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I'm with sideline........does Medicare max out or get spent? I didn't see a response to this question in the answers.

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Look at the reply to "sidelined"-- in short, Medicare essentially pays for temporary stays only-- rehab after surgery or hospitalization, for example. Only for so long, and only if there is progress being shown. If no progress, or if they determine from the therapists' notes that the patient has had enough progress to no longer need the SNH, they're stop paying.

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It sounds like she had been in the hospital and then went to skilled care for rehab. So Medicare does pay for 60 days ( or whatever their number is) and then it becomes private pay if you don’t go home. If she stays in the skilled care facility on hospice, Medicare pays for hospice but not the room and board as others have stated.

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Our bill after medicare stopped twenty days...was a ten thousand dollar bill for room and board or full pay, after I recovered from the confusion only wanting what was best for Dad, I started applying for Medicaid..This took two months as I keep paying all of dads Social,a nd pension aid and attendance 937 plus 800 social...…….if u do not have the proper supplemental...150 per month u get hit until Medicaid kicks in...so its expensive Medicaid is not free to the utter confusion of many. franklly I would have been better off getting an 1800.00 dallar apartment for him
as he would have been cleaner more room as he had a roommate,and
I had to check rthigsout everyday to the dissatisfaction of the staff...its too expensive stay home and find extra care help..its too damn expensive espaeciall since the rating on this home was one star!!!!and I don't feel
the Medicaid term as poor,lowincome of 1900.00 to be a poor person!!!!!
The only way is to have long term care insurance but Dad was able to stay home until 97yrs old...I also say a lot of mishaps in the nursing home...medication errors,no staff,cold unchewable food,slow delivery of food,unattended hall ways at night,falling off bed and not being found,sitting on a toilet seat no resposse to call bell...his roommate told me!!!THESE PEOPLE ARE VULNERABLE AND THEY SHOULD BE USING TECNOLOGHY!!!!!CAMERAS MAN!!!BUT I SUSPECT THERE ARE PRIVACY ISSUES OR JOB LOSS ISSUES...………...I WAS GOING TO PUT MY OWN CAMERA IN DADS ROOM...ALSO NO WARNING BELT ON BED...MAYBE THEY WERE SUED OR SOMETHING...

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My FIL was moved to a hospice facility (from the hospital) in June, and we were told Medicare would pay 100%, that his supplemental policy wouldn’t even have to kick in. He died 5 days later. So far we haven’t gotten a bill. Check with hospice in your area and see what they cover so you'll know for sure and help to avoid confusion.

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My mom has been a hospice patient since 2016 and Medicare pays for everything except eyes and teeth. They are so wonderful, the nurse comes 2 times per week and all her medications are delivered to the house.

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When my mother got on hospice they started paying for everything, she lives with me now since my father died. Good luck

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If she enters Hospice, will she be at home or in a nursing home? It is my understanding that in a nursing home Medicare pays for hospice but NOT for room and board. In my opinion, this is rather misleading since it seems that the big costs would be the room and board part and most people would naturally assume that saying "Medicare pays for hospice" would mean the whole deal, including room and board. Any comments on this? Have the laws changed? Do I understand this correctly?

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You understand correctly. Is crazy. The room and board is the biggest cost. And our rural community does not have a hospice facility so a nursing home is out only option. Doesn't seem quite right.

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Read Ralph Robbins answer. Evidently, ,and I did not know this, Medicare will pay for room and board in a freestanding hospice facility or if in a hospice wing at a hospital.

Is there a limit to the number of days?

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We were told Medicare would pay for 2 weeks in a hospice facility.

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When my MIL was on hospice they would only accept her at the freestanding hospice facility if she was expected to live 2 weeks or less. Before that, Medicare only provided the services listed by others in previous posts. Not room and board. Call you local hospice provider and discuss this with them.

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Medicare will pay but you may need a supplement to pick up what they do not pay.

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If you have no way to pay, then hospice will take her disability check or social security check. Medicare will pick up and pay some but I'm not sure exactly when and for how long. I'd call hospice and have them come to my house and talk to me about it. Rules change daily.

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Hospice is covered by Medicare they won’t take any of her income

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Kannie; how are you and how is your mom? Sending good thoughts!

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If Mom goes on hospice will we still pay privately or will Medicare pick it back up due to hospice care?

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