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Who Pays For Palliative Care

Who pays for palliative care is a good question to ask when speaking to your doctor about starting palliative care. It is often handled much like a referral to a cardiologist, neurologist or other specialist and may be covered by Medicare, Medicaid or your private insurance.

Some illnesses and diagnosis may limit the ability to access care out of the home. In these cases, palliative care can be provided in the home by skilled nurses and therapists. Talk to your doctor to request a referral for home-based palliative care which is covered by Medicare under some circumstances.

Medicare

If you have Medicare Part B (medical insurance), it may cover some treatments and medications that provide palliative care, including visits from doctors, nurse practitioners, and social workers. Medicare does not use the term palliative, so coverage is provided by standard Medicare Part B benefits. The palliative care provider (the organization offering you the services) will bill Medicare for services provided, but be sure you understand what co-pays or fees, if any, you will be asked to pay. Ask about your responsibility for fees and request a fee schedule before agreeing to receive services.

Medicaid

If you are covered by Medicaid, a health insurance plan for people with low income and few assets, it may cover some palliative care treatments and medications, including visits from doctors. Medicaid does not use the term palliative, so coverage is provided by standard Medicaid benefits. The palliative care provider (the organization offering you the services) will bill Medicaid for services provided, but be sure you understand what co-pays or fees, if any, you will be asked to pay. Ask about your responsibility for fees and request a fee schedule before agreeing to receive services.

Private insurance, HMOs, managed care programs

Many private health insurance plans provide some coverage for palliative care as part of their hospice or chronic care benefits. If you own a long-term care policy, there may be palliative care benefits provided by that policy. Check with your health insurance or long-term care insurance representative.

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