Reply #104: yes and no [View All]

Similar thinking and structure for paying for doctor's office visits (same E and M codes used in billing, but Medicare was structured with a focus on illness not prevention (because that's what medicine was when Medicare was founded). Medicare also doesn't pay or cover many things that private health insurance covers. http://www.medicare-partd.com/PartD-NotCoveredUnderMedicarePartAandB.php

12 years ago, Medicare would only pay for 6 months of hospice, so doctors had the unfortunate job of trying to predict when a patient had no more than 6 months left to live. 1 day over the 6 month mark, and the care would not be covered. Some patients didn't receive the full benefit of hospice due to a fear of starting it too soon and going over 6 months.