Palliative Care

What is covered under Palliative Care?

Hospital Cover for Palliative Care includes hospital treatment to provide quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain. 

This clinical category includes these treatments listed in the Medicare Benefits Schedule (MBS).

Treatments covered under the Palliative Care category are meetings with your doctor and a palliative care team. 

You may have to pay for some treatments or equipment, including:

• medicines and/or home nursing 
• specialised equipment for use at home
• respite services that charge a fee
• an excess if you go to a private hospital
• private health professionals, such as psychologists, which are not fully covered by Medicare.

Some treatments you might expect to be in the Palliative Care clinical category are under different clinical categories. For example, treatments for managing pain are under Pain Management. 

Which Hospital Cover tiers include Palliative Care?

What does it mean if cover is ‘optional’?

‘Optional’ means that the Australian Government allows insurers to choose whether or not to cover the clinical category under that Hospital Cover tier.

What does ‘restricted cover’ mean? 

Restricted cover means the insurer pays only limited benefits. 

If insurers offer cover for Palliative Care under Basic, Bronze or Silver Hospital Cover, they can do so on a ‘restricted’ basis. If you are admitted as a private patient in a private hospital for treatments under this clinical category, you will face considerable out-of-pocket costs.

Always check with your insurer before agreeing to be treated as a private patient in a private hospital if you have restricted cover for Palliative Care. 

Does Medicare cover Palliative Care?

Yes. Medicare includes all treatments under the Palliative Care clinical category.

If there is an MBS item number for the treatment, Medicare covers it. 

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