When the time arises for a loved one to be enrolled in hospice care, determining a payment method is understandably the furthest thing from the minds of the family members. Precious Healthcare can assist families in navigating the payment aspect of enrollment in hospice care.
Hospice services are covered by Medicare, Medicaid and most private health insurance providers, and Precious will never turn away a patient in need based on being uninsured or underinsured.
The most common form of insurance for patients who receive hospice care is Medicare. The Medicare Hospice Benefit is available to beneficiaries who are covered under Medicare Part A, and covers the cost of hospice care including medications and equipment related to the patient’s diagnosis. Patients who utilize the Medicare Hospice Benefit are still eligible for coverage under Medicare Part B for any services that are not related to their terminal illness.
U.S. citizens and many legal residents qualify for Medicare at the age of 65. Medicare also covers those under the age of 65 who have End-Stage Renal Disease (ESRD) or who have received Social Security Disability Income payments for 24 months (or for one month for patients with ALS).
Medicaid is a state-funded program that affords medical coverage for patients who have limited financial means. If a patient’s income is slightly higher than the amount for Medicaid eligibility, “spend-down” amounts must be satisfied in order to access maximum coverage of this benefit. The Medicaid Hospice Benefit also covers the costs of hospice care including medications and equipment related to the patient’s diagnosis.
Both Medicare and Medicaid Hospice Benefits reimburse Precious for hospice services.
Medicare HMO Coverage for Hospice
The Medicare HMO transfers coverage to Medicare Part A for hospice benefits and the entirety of the aforementioned Medicare Hospice Benefit applies.
Hospice benefits can vary significantly among private health insurance plans, so Precious will verify and negotiate benefits for patients with commercial or private health insurance.
Coverage will be determined at the time of hospice admission, and the allowable benefits will be explained clearly. In most cases, Precious negotiates a daily rate that provides coverage for hospice services. As with any healthcare benefit plan, deductibles and co-payments may be applied to the hospice benefit.
Coverage for the Uninsured
If a patient does not have health insurance coverage, Precious will provide services based on need, regardless of his or her ability to pay.
Discontinuation of Hospice Services
Patients have a right to choose at any time to discontinue their hospice services. Occasionally, patients may choose to pursue active treatment or alternative medical benefits as opposed to continuing with hospice care. With appropriate notification, this transition can be easily achieved. Also, Medicare, Medicaid and most private health insurance providers allow for hospice benefits to be reactivated at a later date.
You have Options
Medicare, Medicaid, Medicare HMO and most private insurance companies allow you to choose your own provider for hospice services regardless if the hospice is outside of the HMO network. Allow us to be there for you during life’s precious moments.