How to Pay for Palliative Care with Medicare or Private Insurance

Coverage for comfort-focused palliative care varies by provider and insurance plan. This page contains some general information about insurance and palliative care. For specific guidance, contact your carrier or health plan to determine coverage details, including copays, out-of-pocket costs, and other palliative care charges.

Is Palliative Care Covered by Medicare & Medicaid?

Medicare and Medicaid cover palliative care patient visits by a physician or advanced practice nurse. These visits may require copays.

Some Medicare Advantage and Commercial Plans offer coverage for palliative care visits and services, but specifics vary by plan.

How Long Will Medicare Cover Palliative Care?

Medicare coverage for palliative care can vary based on specific state regulations, the patient’s specific needs, and their treatment plan. It generally lasts for as long as the patient has a serious illness, until the patient enters hospice care, or until the patient no longer needs or responds to palliative care services.

A life expectancy of six months or less is required to receive hospice care. Hospice care will usually begin after a doctor’s formal request or referral. Patients are required to re-certify as seriously ill after six months of receiving hospice care.

Learn more: Who Pays for Hospice?

Does Medicare Cover Palliative Care at Home?

Medicare can cover certain at-home palliative care services. The length of time that Medicare will cover at-home palliative care depends on a variety of factors. Patients should contact their provider to discuss details related to their specific circumstances.

How Do You Pay for Palliative Care with Private Insurance?

If a patient is not eligible for Medicare, private insurance may cover palliative care. Coverage can vary widely based on the patient’s plan. It’s important to check with the insurance company for details about what is covered and what is not. Remember to ask about copays and deductibles that may apply.

Call VITAS to learn if palliative care can help you, your loved one or your patient.