Medicare Hospice Benefit vs. Medicare Home Health Benefit
There are several dissimilarities in the services that are provided and covered by the Medicare Hospice Benefit and the Medicare Home Health Benefit. While both benefits provide services to the patient’s home, the Medicare Hospice Benefit is limited to individuals with terminal illness.
The Hospice Benefit is more cost effective for terminally ill patients and their loved ones than the Home Health Benefit. The Hospice Benefit has pain and symptom management protocols optimal for terminally ill patients as well as supportive services for both the patients and their loved ones.
| SERVICES | MEDICARE HOME HEALTH BENEFIT | MEDICARE HOSPICE BENEFIT |
|---|---|---|
| Physician | Not covered, but 80% of approved charges are covered under Part B | Attending physician 80% covered under Part B; Hospice physician 100% covered |
| Skilled Nursing | Covered for skilled care, if part-time or intermittent, or daily for 21 days or less | Covered for skilled and supportive care |
| Medications | Not included | Covered, related to terminal illness |
| Durable Medical Equipment | 80% of approved amount covered | 100% covered |
| Medical Supplies | Medical supplies covered | Medical and personal supplies covered |
| 24-hour On-call Nurse | Not required | Included |
| Medical Social Work | Covered for patient | Covered for patient and caregivers |
| Homemaker / Home Health Aide | Covered if part-time or intermittent, must provide “hands-on, personal care”, 28-35/wk with SN & HHA | Covered, no hourly restriction |
| Volunteers | Not included | Included for patients and loved ones |
| Chaplain Services | Not covered | Covered |
| Bereavement Care | Not included | Included |
| Dietician | Not covered for individual patients | Covered |
| Physical, Speech, and Occupational Therapy | Covered, limitations on occupational therapy | Covered |
| Services to Nursing Facility Residents | Not covered | Covered, not including Room & Board |
| Inpatient Care | Not covered | Covered |
| Respite Care | Not covered | Covered for up to 5 consecutive days, possible coinsurance |
| Skilled Continuous Care | Not covered | Covered, during periods of medical crisis |
