Insurance coverage for hospice care is available through Medicare, Medicaid, and most private insurance plans. The patient and family should discuss payment options with the physician and hospice staff.
1. Medicare Hospice Benefit
In 1982 Congress expanded the Medicare insurance program to include hospice care, thus providing coverage for a number of health and social services not previously covered. Medicare regulations require that most of the patient's care be provided in the home setting, with short stays in an in-patient facility.
In order to qualify for the Medicare Hospice Benefit:
- A physician must certify that the patient has less than six months to live if the disease runs its normal course. The physician must recertify the individual at the beginning of each benefit period (two periods of 90 days each and every 60 days thereafter for an indefinite period).
- The patient signs an elective statement indicating that he or she understands the nature of the illness and of hospice care. By signing the statement, the patient surrenders rights to other Medicare benefits related to the terminal illness. (A family member may sign the election statement if the patient is unable to do so.)
2. Medicaid
In general, Medicaid is designed to help public aid recipients and people whose incomes are higher than public aid eligibility limits, but who meet other criteria and cannot pay for medical services. Thirty-eight states now offer the hospice benefit under Medicaid.
3. Private Insurance
Most private insurance companies include hospice care as a benefit. Be sure to inquire about your insurance coverage, not only for hospice, but also for home care.
4. Private Pay
If insurance coverage is not available or is insufficient, the patient and the family can engage providers and pay for services out of pocket. Most hospices provide services without charge if patients have limited or no financial resources.
|
|
