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Medicare Advantage and Hospice Coverage

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 for unrelated conditions. For example, if you have elected hospice because you have terminal cancer and you fall and break your hip unrelated to the cancer and meet other requirements, Medicare would cover the physical therapy you need for the broken hip. If you have a Medicare Advantage Plan and need care unrelated to your terminal condition, you can choose to either see providers in your plan’s network or see Original Medicare providers.

  • When seeing Medicare Advantage providers, you should follow your plan’s coverage rules, including seeing in-network providers. You should owe your usual Medicare Advantage cost-sharing.
  • If you see Original Medicare providers, you will pay Original Medicare cost-sharing.

Your Medicare Advantage Plan or Part D plan should also cover prescription drugs unrelated to your terminal condition, and the plan’s cost and coverage rules will apply.

Your Medicare Advantage Plan will also continue to cover any additional benefits it provides, such as vision or dental services.

© 2021 Medicare Rights Center. Used with permission.

The content is developed from sources believed to be providing accurate information. The information in this material is not intended as tax or legal advice. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. This material was developed and produced by FMG Suite to provide information on a topic that may be of interest. FMG, LLC, is not affiliated with the named broker-dealer, state- or SEC-registered investment advisory firm. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security. Copyright 2021 FMG Suite.

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