Eligibility & Paying for Hospice | ReliantCare Hosipce

Eligibility & Paying for
Hospice

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Eligibility:

Hospice care is for people with a life expectancy of six months or less if their illness runs its normal course.

Patients can receive hospice care if they accept palliative care (for comfort) instead of care to cure their illness and they sign a statement choosing hospice care instead of other Medicare-covered treatments for their terminal illness and related conditions.

If a patient lives longer than six months, they can still receive hospice care, provided the hospice medical director recertifies that they are terminally ill.

Patients have the right to change their hospice provider.

ReliantCare Hospice offers a survey called "Hospice Care: Is it Time?" to help individuals determine whether hospice care is the right decision for themselves or a loved one.

Paying for Hospice:

ReliantCare Hospice accepts payment for services from Medicare, Medicaid, VA benefits, and most private insurance plans.

Medicare beneficiaries who elect hospice care receive non-curative medical care and supportive services for their terminal illness covered at little to no expense.

All services, treatments, hospital stays, medical equipment, supplies, and medications related to the hospice diagnosis must be authorized by the hospice interdisciplinary team for Medicare to maintain financial responsibility.

An individualized care plan based on the patient's goals of care is created by the hospice care team and the patient's physician.

Starting hospice care as early as possible helps ensure that the patient and their family receive the maximum benefit allowed.

We hope this helps provide clarity on the payment options available for hospice care at ReliantCare Hospice. Please don't hesitate to reach out to us if you have any questions or concerns.

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The Medicare Hospice Benefit:

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Most hospice patients are eligible for the Medicare Hospice Benefit.
Medicare covers up to 100% of hospice services, including all services related to the terminal illness.
There is no need to defer hospice care due to financial concerns.
Medicare Part A covers all hospice-related services, while Medicare Parts A and B continue to cover care that is unrelated to the terminal illness.
Normal Medicare rules apply for non-hospice related care, including co-payments, coverage guidelines, and deductibles.

At ReliantCare Hospice, we want to ensure that our patients and their families receive the best possible care without worrying about financial concerns. If you have any questions or concerns about Medicare hospice coverage, please don't hesitate to reach out to us.

The Medicare Hospice Benefit covers everything involved in hospice care.
Coverage includes visits by a nurse, physician, and other healthcare professionals, therapy, medication, and supplies.
The benefit also includes an interdisciplinary team of hospice professionals to provide care.
Home medical equipment and medication are also covered.
Respite care, continuous care, and inpatient care are included in the benefit.
Routine home care is covered as well.
Bereavement support is also included in the Medicare Hospice Benefit.

At ReliantCare Hospice, we work with the patient and their family to create an individualized care plan that addresses their unique needs.

The Medicare Hospice Benefit covers most hospice care services, but there are some items it does not include.
Curative treatment, including prescription drugs related to curative treatment, are not covered.
Emergency department care that is not related to the patient's terminal diagnosis or not arranged by their hospice provider is not covered.
Costs associated with room fees or rent for assisted living facilities and nursing homes, as well as food, are not covered. This includes mortgages or rent and food for patients living at home.
However, these items may be covered for hospice patients who are experiencing a medical crisis due to symptom exacerbation and are staying in an inpatient unit (IPU) for the short term.

To be hospice-eligible, a patient must receive a terminal illness diagnosis from a physician, with a life expectancy of 6 months or less if the illness follows its normal course.
However, sometimes patients live beyond this 6-month period.
If the hospice medical director or physician determines that the patient is no longer terminally ill with a prognosis of six months or less, they must discharge the patient from their care.
If the patient's terminal illness continues, they can be recertified for hospice.
The Medicare Hospice Benefit covers an unlimited number of 90-90-60-day recertifications as long as the patient remains hospice eligible.
Patients' physicians are involved in the recertification process and continue to monitor patient status and prognosis.

The Medicare Hospice Benefit covers end-of-life services related to a patient's terminal diagnosis in any setting, including a traditional residence, an assisted living facility, or a nursing home.
All services related to the terminal diagnosis are covered up to 100% by Medicare Part A, regardless of the location of hospice care.
If a patient's symptoms cannot be managed by the routine level of hospice care, additional levels of service such as 24/7 continuous care or inpatient hospice care will also be covered by Medicare Part A.
These additional levels of service will be covered at no additional expense to the patient or their family.

Hospice services provided in a nursing facility are covered by Medicare.
Hospice care in a nursing home setting helps patients, families, and nursing home staff by providing end-of-life resources and support.
The Medicare Hospice Benefit covers services, medications, supplies, and equipment that are related to life-limiting illness, but does not cover expenses associated with room and board in a skilled nursing facility.
Room and board expenses in a nursing home may be covered by Medicaid, depending on the patient's financial eligibility.
The Medicare and Medicaid Hospice benefit includes provisions for respite care and inpatient care, which can also be provided in a nursing facility for short stays.
The total costs associated with respite care and inpatient hospice care are covered under the hospice benefit when identified by the hospice team.

For those who are not eligible for Medicare or Medicaid, payment for hospice can come from private insurance or an HMO, as these also include a hospice benefit.
Hospices employ financial specialists to help families who do not qualify for federal assistance and do not have insurance find available resources.
Payment options for families who do not qualify for federal assistance or do not have insurance include self-pay and charitable organizations.
Facing a terminal illness can be challenging, and paying for end-of-life care shouldn't be one of the concerns.