Hospice is a program of care and support for if you’re terminally ill. The focus is on comfort, not on curing an illness. Hospice care helps manage your pain and symptoms, while helping you live as fully and comfortably as possible.
TRICARE covers hospice care in the United States, District of Columbia, and U.S. territories. Hospice care isn’t covered overseas. TRICARE covers hospice care when:
- You, your primary physician, or authorized family initiates hospice care.
- Your doctor orders hospice care.
- You complete and give an election statement to the hospice provider. The hospice provider then files the election statement with your regional contractor.
The TRICARE hospice benefit covers:
- Supportive services, including pain control and counseling services
- Home health aide services
- Personal comfort items
Are services for an injury or unrelated condition covered? Yes. The regular TRICARE benefit covers injuries or unrelated conditions, like a broken bone or diabetes.
TRICARE doesn’t cover room and board unless you’re getting inpatient or respite care. If you cancel hospice care, you may get other TRICARE services or benefits. If you’re under 21 years old, you may receive both. See concurrent care below for more information.
TRICARE doesn’t cover care for the illness unless the hospice provides or arranges for the care.
TRICARE provides hospice care in three benefit periods*:
- Period one: 90 days
- Period two: 90 days
- Period three: Unlimited 60-day periods
You need pre-authorization for each benefit period. Each 60-day period requires recertification of terminal illness. You’ll give up any remaining days in that period if you cancel your hospice care.
*If you’re under age 21 and getting hospice services and curative care, these benefit periods don’t apply.
Levels of Care
The hospice benefit offers four levels of care:
- Continuous home care
- General hospice inpatient care
- Inpatient respite care
- Routine home care
What types of care are covered? Care within each level may include:
- Physician services
- Nursing care
- Medical equipment and supplies
- Medical social services
- Physical and occupational services
- Short-term inpatient care
- Speech and language pathology
Canceling Hospice Care
You can cancel hospice care by submitting a signed and dated statement to your hospice care provider. You’ll lose any remaining days in that benefit period. You may choose hospice coverage again for another benefit period at any time.
This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.
Last Updated 6/18/2020