End of Life Counseling and Medicare

Medicare was established by the federal government as a way to provide health insurance for people 65 years old and above, as well as younger people with disabilities. This program provides coverage through a variety of different plans for different services, such as skilled nursing home care, hospice care, doctor visits, outpatient care, as well as prescription drug services. Depending on the plan covered under, Medicare will pay for a specific amount of counseling services, which now will also include end of life counseling services.


Roughly 25% of Medicare spending is done for beneficiaries in their last year of life, and with the largest number of older adults turning 65 years old a day in United States history, end of life planning is more important than ever. While many doctors consult their patients about their wishes as they near closer to the end of their life, Medicare now will cover end of life care and advance care planning. Supporters of the change think that this will now allow doctors and other medical professionals to spend the time necessary with the patient to make these advance plans and have important conversations, since they are able to also bill for that time.


Currently only 17% of adults say they have had end of life discussions with their doctor or health care provider, but majority said they would want to have one. As of January 1, 2016, the Center for Medicare and Medicaid Services regulations for advance care planning will be in effect and directly cover costs instead of partially reimbursing any planning discussed. It will be billed to Medicare at $85 for the first 30 minutes to meet regarding explanation of advance directives and standard forms, and $75 for every 30 minutes thereafter. Medicare is currently working to establish a national final fee schedule for the counseling, and expects the Medicare administrative contractors to assist with that process for claims.


In Congress, legislation has been proposed under the Care Planning Act of 2015, which will cover advance illness planning and care coordination services, along with discussions regarding the patient’s options and preferences at the end of life, as well as planning for those patients who are in the end stages of serious or life threatening illnesses. Additionally, the Personalize Your Care Act of 2013 has been introduced for advance care planning coverage under both Medicare and Medicaid. This proves the very apparent need to plan for the future of our elderly population so that they are able to carry out their last wishes with dignity.

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