Medicare benefits do not run out for hospice care.
Unlike hospitalization and skilled nursing facility benefits, hospice care is not tied to a limited benefit period. Hospice care periods are composed of two periods of 90 days each followed by an unlimited number of periods of 60 days each.
Misconception
In order to qualify for hospice, a doctor must certify that the patient has a condition that, if it continues to run its expected course, will lead to death within six months. Some people assume that if they are still alive six months later, they will have exhausted their hospice benefit. This is not the case.
Recertification
The patient's appropriateness for hospice is evaluated by the physician and the hospice team at the end of each benefit period. If the doctor and the team still believe the patient's condition is likely to lead to death within six months, the patient is recertified for another benefit period.
Clinical Discharge
If the doctor and the hospice team believe the patient's condition improved to a point at which it is no longer likely to lead to death within six months, the patient is clinically discharged from hospice care. A patient who is discharged may be readmitted to hospice if his medical condition declines.
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