VA Hospice Care

01What it is

VA hospice is for veterans in the last stages of an incurable disease who are expected to live 6 months or less, with care focused on comfort rather than cure¹. It relieves suffering and controls symptoms in a way that respects personal, cultural and religious beliefs, and includes bereavement support for the family¹.

02Eligibility and cost

Hospice care is part of VA’s standard medical benefits package, so every enrolled veteran is eligible if VA finds a clinical need and the service is available locally². Not every VA medical center offers every program, so ask a VA social worker what exists near you.

There are no copays for VA hospice care, whether provided by VA or a community provider VA pays for¹.

03VA and Medicare hospice

Medicare also covers hospice for people with a terminal illness and a life expectancy of 6 months or less³. Families should ask a VA social worker which benefit to use. See VA and Medicare.

04How to ask

1. Enroll in VA health care, if not already enrolled⁴.
2. Ask the primary care team or a VA social worker for a referral to hospice care².
3. Complete VA Form 10-10EC if VA tells you a copay may apply⁵.

05Where hospice is provided

VA hospice can be provided at home, in an outpatient clinic or in an inpatient setting, including VA Community Living Centers; VA also works closely with community and home hospice agencies to provide care in the home¹. There are no copays whether VA or a contracted organization provides it¹. VA’s extended care copay rule also excludes hospice from its definition of nursing home care⁶.

06How Medicare hospice works

Medicare Part A covers hospice in two 90-day benefit periods followed by unlimited 60-day periods, and you pay nothing for covered hospice services. Once Medicare hospice starts, Medicare won’t cover treatment intended to cure the terminal illness, care from a hospice you didn’t choose, or room and board at home or in a nursing home³.

07Worked example

A Korean War veteran with end-stage COPD lives with his son. His VA doctor confirms a life expectancy of 6 months or less and he stops curative treatment. VA arranges a community hospice agency to visit at home at no copay¹. When his son needs a break, the team can arrange short respite⁷. After his death, his widow may qualify for Survivors Pension or DIC, and the family may claim a burial allowance⁸.

08Hospice vs. palliative care

Palliative care uses comfort care to relieve suffering and control symptoms so a veteran can keep doing what matters most; unlike hospice, it can be combined with treatment aimed at curing or controlling the illness and can start at diagnosis⁹. It’s part of the standard benefits package for enrolled veterans with a clinical need, but copays may be charged, while hospice has none⁹¹.

Source: VA hospice and palliative care pages¹⁹.

09Support for the family

Hospice provides bereavement support to the family, and the veteran and family build the plan of care together with the team to cover medical, social, spiritual and psychological needs¹. Family caregivers can also call the VA Caregiver Support Line at 1-855-260-3274¹⁰.

10Step by step

1. Talk to the VA primary care provider or social worker about hospice¹.
2. Agree on goals of care and a plan with the hospice team¹.
3. Choose the setting: home, inpatient unit or CLC¹.
4. Plan ahead for burial with a pre-need eligibility determination¹¹.

11Common mistakes

• Waiting too long. Hospice is for the final phase, typically six months or less, and more support is possible when it starts earlier¹.
• Assuming it means giving up all care. Comfort and symptom care continue¹.
• Missing bereavement support, which hospice provides for the family¹.

12Getting help