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Hospice

Providers of Hospice services submit claims to insurance companies first. They will send you statements about the billings. Contact your insurance provider for specific coverage information, including criteria, deductibles, and copays.

A person living in a facility such as personal care home or nursing home is eligible for Hospice benefits, as long as the person pays for room and board. A person under Hospice care may use up to five days of respite care in a nursing home or a hospital stay for pain management.

Commercial Insurance
Commercial Insurance may include hospice coverage. Contact your insurance representative to review coverage. Commercial Insurance may reimburse some services not covered by Medicare.

Managed Care Insurance
Managed care insurance companies identify their "network" health systems, and you may have to select a hospice within that network to receive coverage. Contact your managed care insurance provider to discuss how your hospice selection may impact reimbursement.

Medicare/Medicaid
Hospice services are reimbursed under Medicare. Under the Medicare/Medicaid Hospice Benefit, patients are eligible for many services not ordinarily covered by Medicare/Medicaid. Services in this benefit may include (as "medically appropriate"):

• Routine registered nurse visits
• Registered nurse emergency "on-call"
• doctor services
• Social work services
• Homemaker home health aide
• Physical, speech, and occupational therapy
• Dietary counseling
• Chaplain and spiritual care
• Bereavement counseling
• Prescription medications
• Medical equipment
• Medical supplies
• Palliative radiation treatment
• Continuous nursing care
• Inpatient short-term care
• Respite care
• Medical transportation

Services not covered by Medicare under the Hospice benefit may include:

• Medical care for illness and disease unrelated to terminal illness (regular Medicare or Medical Assistance covers these services)
• Inpatient care in a non-contracted facility
• 24-hour sitters or caregivers
• Medical transportation (except as arranged by the hospice)
• Over-the-counter medications
• Aggressive or curative treatment

Medical Assistance
Elderly nursing home residents on Medical Assistance may continue to receive the room and board coverage from Medical Assistance, while receiving hospice care.

U.S. Veteran's Benefits
U.S. Veteran's Benefits includes provisions for hospice care. Contact your representative for specific coverage information.

Long-term Care Insurance
Long-term Care Insurance may reimburse some services not covered by Medicare. If you have long-term care insurance, check your policy or call the insurance company to find out if the care you need is covered.