Eligibility for Hospice Services
Hospice Eligibility; How Does It Work?
Anyone with a potentially life-limiting illness or combination of illnesses may be eligible for hospice care. Hospice is traditionally an option for people whose life expectancy is six months or less, and involves palliative care (pain and symptom relief) rather than ongoing curative measures, enabling you to live your last days to the fullest, with purpose, dignity, grace, and support. While some hospitals, nursing homes, and other health care facilities provide hospice care onsite, in most cases hospice is provided in the patient’s own home. This enables you to spend your final days in a familiar, comfortable environment, surrounded by your loved ones who can focus more fully on you with the support of hospice staff.
In order to receive hospice care, two physicians must confirm your eligibility. This typically includes your attending physician or specialist, and the Alliance Hospice Care physician.
Once it is confirmed that hospice care is the right type of care for you, one of our interdisciplinary team members will review with you and your loved ones, the specific hospice care services available. During this time, you will gain an in-depth understanding of both the clinical care, as well as the psychosocial support available through hospice care. Once the paperwork and review is finalized, your hospice care begins.
Cost of Hospice Care
Costs for all patient care, supplies and medications related to the life-limiting hospice diagnosis are covered by hospice: there is generally no cost to the patient. This coverage includes medications and medical equipment like wheelchairs, hospital beds, and walkers. If you are 65 years or older, your hospice services are paid in full, 100% by the Medicare federal insurance program. Medicaid and commercial insurers also have a hospice benefit that mirrors the Medicare benefit. Our staff will assist you with understanding Medicare and if necessary, how to go about applying for it or for other benefits.
Admission to Hospice
Admission to hospice services is a voluntary process that the patient and family choose to participate in. To qualify for hospice services, a patient’s physician certifies the patient has a terminal illness, with a limited life expectancy. When you elect the hospice program, you have made the choice to take a comfort course of care rather than a curative approach. Alliance Hospice Care is a Medicare certified, ACHC accredited agency and complies with all of the State and Federal regulations that govern hospice services. This means that while you are under our care, all services, treatments, hospitalizations, durable medical equipment and drugs related to your life-limiting illness must be provided, coordinated and authorized by your hospice team.
Discharge from Hospice
Sometimes patients elect to leave their hospice program. Reasons for leaving (or discharge) may include:
- Their disease goes into remission
- They are moving out of the service area
- They simply decide that they no longer wish to have hospice services
This process of moving from hospice to another care setting is very simple.
Medicare Hospice Benefits
The Medicare hospice benefit covers the costs of all care, medications, counseling, equipment and supplies related to your life-limiting illness. You are eligible to receive hospice care under the Medicare hospice benefit if you meet all of the following conditions:
- You’re eligible for Medicare Part A (hospital insurance)
- Your doctor and the hospice medical director certify that you have a life-limiting illness and have six months or less to live if your illness runs its normal course. This is based upon the physician’s judgment — many patients live much longer
- You sign a statement choosing hospice care instead of other Medicare- covered benefits to treat your life-limiting illness
- You get care from a Medicare-approved hospice program
The Hospice Care visits begin almost immediately. Members of our interdisciplinary care team, the hospice physician and nurse case manager, chaplain, social worker, nursing assistants, and trained volunteers will be in touch to make sure that you get the care you need. Alliance Hospice Care manages the setting up and ordering of any necessary medical equipment needed. We can also arrange for medications so you and your loved ones can spend more time together.
The cost of hospice care, including medical equipment and prescriptions related to the terminal illness, is typically covered by Medicare, Medicaid and many of the private health insurance plans.
If you would like to know whether or not your insurance includes a hospice benefit-the Alliance Hospice Care team would be happy to assist you.
Just give us a call at (617) 402-5202 or request a consultation using the button on the right-hand side of the page.
Alliance Hospice Care provides our patients with the most extraordinary service. Every phone call is met with immediate follow up by our friendly, competent and thorough staff. Our own staff trusts their unequalled dedication to the total health and wellness of every patient.
Refer Someone You Know
Alliance Hospice Care personnel are available 24 hours a day, seven days per week to accept referrals.
Referrals are accepted from any of the following individuals:
- Discharge planners
- Social Service agencies
- Individual patients and/or families/caregivers
- Case managers
- Home Health agencies
- Other hospice organizations
- Family members
If you think you or someone you know may benefit from our services, please provide us with some basic information and one of our care specialists will get back to you shortly. For inquiries or to call a referral into the office, please call us at (617) 402-5202.