Medicare, Medi-Cal, and Private Insurance

Hospice care is a fully covered benefit under Medicare Part A and the Medi-Cal program. Most private insurances will provide coverage for hospice care, but they are subject to the patient’s policy deductibles and out-of-pocket limitations. When you are considering hospice care, your insurance coverage will be reviewed and discussed to ensure you understand the financial benefits and costs. Questions will be resolved prior to the start of care.

Regardless of your insurance coverage, your hospice benefit will cover our visits, medical supplies, medications related to your terminal condition, and durable medical equipment. When you elect the hospice benefit for a specific disease diagnosis, you are opting out of traditional Medicare coverage, which means you agree to pursue comfort and palliative measures only. This means you will not receive aggressive or curative therapy for your disease process. If you are seeking curative treatment for a diagnosis that is not related to the terminal condition, you can do so, and it will be covered under your Medicare program.

Your insurance will cover the following services while receiving care:

  • Physician visits
  • Nursing visits
  • Certified Home Health Aide visits
  • Medical Social Worker visits
  • Spiritual care visits
  • Bereavement counseling
  • Dietary counseling
  • Volunteer visits
  • Physical, occupational, and speech therapy
  • Medications related to your terminal condition
  • Medical supplies
  • Durable medical equipment
  • Short-term general in-patient level of care, focused on symptom relief
  • Respite level of care for the primary caregiver
  • Short-term continuous care focused on symptom relief

The following services will NOT be covered by your insurance while on care:

  • Treatment for the terminal illness that is not for palliative symptom management
  • Care provided by a home health
  • Care provided by another hospice agency
  • Private caregiver or sitter services
  • Dietary supplements, unless noted to be part of your terminal condition
  • Ambulance transportation without Skirball Hospice approval or arrangements
  • Supplies not related to your terminal condition
  • Chemotherapy medications or other medications deemed aggressive in nature
  • Medications deemed not related to your terminal condition
  • Diagnostic studies or any treatment not authorized by Skirball Hospice
  • Services not authorized by Skirball Hospice, such as 911 calls to the emergency room or admission to the hospital