When facing a serious illness, understanding the financial landscape of palliative care can seem overwhelming. At Carolina Caring, we believe that financial concerns should never stand in the way of compassionate, expert care. This guide will help you navigate insurance coverage, financial assistance options, and practical considerations for palliative care services in North Carolina.
Understanding Palliative Care Coverage
Medicare Coverage
Medicare covers most palliative care services when deemed medically necessary. In 2025, Medicare Part A has a deductible of $1,676 per benefit period, while Part B has a yearly deductible of $257. These parts of Medicare cover different aspects of palliative care:
- Medicare Part A (Hospital Insurance): Covers inpatient hospital stays, short-term skilled nursing facility care, limited home healthcare, and hospice care for comfort at the end of life.
- Medicare Part B (Medical Insurance): Covers outpatient services including doctor’s appointments, durable medical equipment, mental health counseling, and rehabilitation therapy.
- Medicare Part C (Medicare Advantage): These plans, sold by private insurance companies, automatically cover the same services as Medicare Parts A and B, and often include additional benefits.
Medicaid Coverage
Medicaid also pays for palliative care depending on the specific treatment needed. Like Medicare, Medicaid generally doesn’t separate palliative care from other covered services, so your palliative care provider will be paid like any doctor. Eligibility requirements and covered services vary by state, so it’s important to check with North Carolina’s Medicaid office for specific details.
Private Insurance
Most private insurance plans cover palliative care services in various settings, including hospitals, rehabilitation facilities, skilled nursing or hospice facilities. Coverage includes normal cost-sharing like deductibles and copays. Each insurance plan is different, so we recommend contacting your carrier directly to understand your specific coverage.
Carolina Caring’s Financial Approach
At Carolina Caring, we are committed to ensuring everyone has access to quality palliative care, regardless of their financial situation.
Most palliative care services at Carolina Caring are covered by Medicaid, Medicare, and commercial insurance plans. We handle billing directly with your insurance provider and maintain transparency regarding any out-of-pocket costs.
We firmly believe every patient deserves compassionate and comprehensive care, regardless of insurance coverage. Thanks to the Carolina Caring Foundation, we never turn any family away because of finances. We offer a flexible billing policy based on financial need and never deny services due to inability to pay.
Financial Planning Considerations for Palliative Care
Understanding Out-of-Pocket Costs for Palliative Care
Even with insurance coverage, patients may still face some out-of-pocket expenses. These might include:
- Insurance deductibles
- Copayments for doctor visits
- Coinsurance percentages
- Prescription medication costs
- Services not covered by your insurance plan
Financial Assistance Programs
Beyond insurance, several resources can help manage palliative care costs:
- Non-profit assistance programs: Organizations like the Patient Advocate Foundation offer various programs, including small grants for eligible patients facing illness-related financial challenges.
- Charitable foundations: Many disease-specific foundations provide financial support for patients with particular conditions.
- Community resources: Local community organizations often provide supplemental support services.
- Veterans benefits: Special healthcare benefits may be available for veterans through the VA.
Practical Steps for Financial Navigation
1. Understand Your Insurance Coverage
Before beginning palliative care:
- Contact your insurance provider to verify coverage
- Understand your policy’s deductible, copayments, and coinsurance
- Ask about any pre-authorization requirements
- Confirm which palliative care providers are in-network
2. Talk with Your Healthcare Team
For specific guidance about palliative care costs, contact your carrier or health plan to determine coverage details, including copays, out-of-pocket costs, and other charges. Your healthcare team can help:
- Connect you with financial counselors
- Provide documentation for insurance claims
- Recommend appropriate levels of care based on your needs and coverage
3. Explore Financial Assistance Options
If you’re concerned about costs:
- Ask about sliding scale fees or payment plans
- Inquire about charitable care programs
- Connect with social workers who can help identify financial resources
- Research condition-specific foundations that may offer grants
Getting Started with Carolina Caring
If you are living with a serious illness, Carolina Caring is here to help. Our three-step enrollment process is quick and straightforward:
- Make the call: Contact us at 828.466.0466 or reach out online.
- Consultation: Meet with a member of our medical team for a one-on-one consultation.
- Develop a care plan: We’ll work with you and your medical team to create a comprehensive care plan.
Carolina Caring delivers palliative care in various settings, including the comfort of patients’ homes, hospitals, assisted living centers, nursing homes, and our six outpatient clinics across North Carolina.
Conclusion: Focus on Care, Not Costs
At Carolina Caring, we believe that financial concerns should never prevent anyone from receiving the care they need. Our dedicated team works diligently to navigate insurance complexities on your behalf, allowing you and your loved ones to focus on what truly matters—quality of life and meaningful moments.
Remember that palliative care is about enhancing comfort and quality of life at any stage of a serious illness. With proper financial planning and the support of Carolina Caring’s resources, you can access the compassionate care you deserve without overwhelming financial stress.
Download our free eBook: “Guiding You Through the Unexpected: Hospice and Palliative Care Essentials” for more comprehensive information on navigating palliative care services.
Contact us today at 828.466.0466 or visit www.carolinacaring.org to learn more about our palliative care services in North Carolina.
Carolina Caring proudly serves 12 counties in North Carolina: Alexander, Burke, Cabarrus, Caldwell, Catawba, Cleveland, Gaston, Iredell, Lincoln, McDowell, Mecklenburg, and Rowan counties.
