Payment for Care
Hospice is paid through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers. If a person does not have Medicare, Medicaid or a private insurance, Hospice of Guernsey, Inc. will work with the person and their family to ensure that needed services will be provided.
Note: Most private insurances follow Medicare guidelines for Hospice care.
Medicare Hospice Benefit:
The Medicare Hospice Benefit, started in 1983, is covered under Medicare Part A (hospital insurance). Medicare beneficiaries who choose hospice care receive a full scope of medical and support services for their life-limiting illness. Hospice care also supports the family and loved ones through a variety of services.
Sometimes a person’s health improves or their illness goes into remission. If that happens, your doctor may feel that you no longer need hospice care. Also, you always have the right to stop getting hospice care, for any reason. If you stop your hospice care, you will go back to the type of Medicare coverage that you had before you elected hospice. If you are eligible, you can go back to hospice care at any time.
Who is eligible for Medicare Hospice Benefits?
You are eligible for Medicare hospice benefits when you meet all of the following conditions:
- You are eligible for Medicare Part A (Hospital Insurance), and
- Your doctor and the hospice medical director certify that you have a life-limiting illness, and if the disease runs its normal course, death may be expected in six months or less, and
- You sign a statement choosing hospice care instead of routine Medicare covered benefits for your illness (see Note), and
- You receive care from a Medicare approved hospice program.
Note: Medicare will still pay for covered benefits for any health needs that are not related to your life-limiting diagnosis.
What does Medicare Cover?
Medicare has a set of ‘core services’ that hospices are required to provide to each patient they serve, regardless of the patient’s insurance coverage. Those services are:
- Doctor services
- Nursing Care
- Medical equipment related to the terminal diagnosis
- Medical supplies related to the terminal diagnosis
- Drugs for symptom control and pain relief
- Short term inpatient care for pain and symptom management or family respite
- Home health aide and homemaker services
- Physical, Occupational and Speech therapy
- Social Work services
- Dietary counseling
- Grief support to help the patient and family
Medicare does NOT Cover:
- Treatment intended to cure your illness
- Medications NOT directly related to your hospice diagnosis
- Care from another provider that is the same as hospice provides
- Nursing Home Room and Board.
Note: Room and board are not covered by Medicare. You may receive hospice services wherever you live, even in a nursing home, but the Medicare Hospice Benefit does not pay for nursing home room and board.