Medicare Hospice Drug Coverage
When medical care cannot offer a cure, hospice provides care, comfort and support for persons with life-limiting conditions as well as their families.
Drugs related to your hospice condition are covered under your hospice benefit under Part A. In the rare case that your drug isn’t covered by the hospice benefit, your drug may be covered under your Part D benefit. Your hospice provider is encouraged to submit a care plan to MedicarePlus upon your hospice election. This care plan will include a list of your medications and indicate if they are related to your hospice condition.
According to Medicare Guidance, Pain medications, laxatives, anti-nauseants, and anti-anxiety drugs are commonly related to a hospice condition and are covered by Part A. If you are taking a drug that is a pain medication, anti-nauseant, laxative or anti-anxiety drug, and it is not related to your hospice condition, prior authorization will be required for it to be covered as part of your Part D drug benefit.
Your hospice or prescribing physician must provide the information necessary to override a rejected claim to MedicarePlus.
If you have questions on your hospice benefit, contact MedicarePlus.