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Hospice and End Stage Renal Disease (ESRD)
When the terminal diagnosis is ESRD and the beneficiary continues to receive health services under the ESRD benefit, the beneficiary may not elect the hospice benefit. Two government benefits cannot pay for the same illness/condition of the beneficiary. The beneficiary may choose to elect hospice when no longer choosing to access the ESRD Medicare benefit.
A beneficiary with ESRD, who is also receiving health services under the ESRD benefit, may elect the Medicare hospice benefit when the terminal diagnosis is unrelated to the ESRD. However, remember that when services are being provided to the beneficiary that, in the physician’s opinion would extend the prognosis past six months, the beneficiary would not be considered eligible to receive services under the Medicare Hospice benefit.
Page last updated: March 20, 2008
