Mildred Savage, who is enrolled in the Allcare Medicare Advantage Plan, can receive hospice care coverage through Original Medicare once she elects hospice. Medicare Advantage plans do not directly cover hospice care costs; instead, hospice care is always covered under Original Medicare, even if the beneficiary has a Medicare Advantage Plan
. Here is what happens when Mildred chooses hospice care:
- Original Medicare will pay for all hospice care related to her terminal illness, including doctor care, nursing, home health aides, therapies, counseling, and medications for symptom management
- Mildred can remain enrolled in her Medicare Advantage Plan and continue to pay its premiums. The plan will still cover medically necessary services unrelated to her terminal illness, such as dental, vision, or other extras
- For health issues unrelated to her terminal illness, Mildred can choose to receive care either through her Medicare Advantage Plan network or through Original Medicare providers, with cost-sharing rules depending on the choice
- Prescription drugs related to her terminal illness are covered by hospice under Original Medicare, while drugs unrelated to the terminal illness remain covered by the Medicare Advantage Plan or Part D plan
- Mildred will pay her Medicare Part A and Part B premiums, a small copayment for outpatient drugs related to hospice care, and a 5% copayment for inpatient respite care, but hospice services themselves have no deductible
In summary, Mildred’s hospice benefits will be paid for by Original Medicare, not her Allcare Medicare Advantage Plan. She can stay in her Medicare Advantage Plan for other non-hospice benefits if she wishes, but hospice care coverage will be handled through Original Medicare once she elects hospice
