Hospice care is always covered under Original Medicare, even if you have a Medicare Advantage Plan. After electing hospice, care related to your terminal illness will follow Original Medicare’s cost and coverage rules. While you cannot receive curative care for symptoms related to your terminal illness, Medicare will cover treatment
Medicare Advantage
Hospice basics
Hospice is a program of end-of-life pain management and comfort care for those with a terminal illness. Medicare’s hospice benefit offers end-of-life palliative treatment, including support for your physical, emotional, and other needs. It is important to remember that the goal of hospice is to help you live comfortably, not
Home health care for chronic conditions
If you meet Medicare’s home health eligibility requirements, Medicare should cover your care regardless of whether your condition is temporary or chronic. Medicare covers skilled nursing and therapy services as long as they: Help you maintain your ability to function Help you regain function or improve Or, prevent or slow
Medicare Advantage and home health
All Medicare Advantage Plans must provide at least the same level of home health care coverage as Original Medicare, but they may impose different rules, restrictions, and costs. Depending on your plan, you may need to: Get care from a home health agency (HHA) that contracts with your plan Request
Services excluded from home health coverage
Medicare’s home health benefit does not cover all home care services. Services excluded from Medicare coverage include: 24-hour per day care at home Prescription drugs If you need prescription drug coverage, enroll in a Part D plan or a Medicare Advantage Plan that provides drug coverage. Meals delivered to your
Options for those who enrolled in a Medicare Advantage Plan by mistake or because of misleading information
If you enrolled in a Medicare Advantage Plan or Part D plan by mistake or after receiving misleading information, you may be able to disenroll and change plans. Typically, you have the right to change plans if you: Joined unintentionally: You may have enrolled believing you were joining a Medigap
TFL drug coverage and Part D
TRICARE for Life (TFL) offers a pharmacy program that provides creditable drug coverage. This means that if you are enrolled in the TFL pharmacy program, you can delay Part D enrollment without incurring a late enrollment penalty (LEP). Be sure to compare the costs and benefits of Part D and
Items and services excluded from Medicare coverage
Medicare does not cover all health care services. Services excluded from Medicare coverage include but are not limited to: Alternative medicine, including experimental procedures and treatments, acupuncture, and chiropractic services, except when manipulation of the spine is medically necessary to fix a subluxation of the spine (when one or more
Filling gaps in Medicare coverage and getting help with Medicare costs
There are a number of ways to fill gaps in your Medicare coverage and/or to get assistance with Medicare costs: Job-based insurance: If you or your spouse is still working, and you have insurance through that job, it may work with Medicare to cover your health care costs. You should
Medigap vs. Medicare Advantage
Know the difference before you choose Original Medicare is the familiar program that’s been around since 1965. In original Medicare, the government pays Medicare’s share of your medical bills directly to doctors and hospitals. You can go to any doctor or hospital anywhere in the country that accepts Medicare reimbursement.