Hospice – Criteria
Patients with a terminal illness do not have to pay for hospice care. Currently, most hospice patients have their costs covered 100% by Medicare through the Medicare Hospice Benefit. Medicaid also covers Hospice care through the Medicaid hospice benefit for those not eligible for Medicare or Medicaid, payment for hospice can come from private insurance or an HMO, since these also include a hospice benefit.
Traditional Home Health and Hospice accepts most insurances. If your insurance is not on our list of approved payers, our billing specialist may be able to work with your insurance company to negotiate coverage.
Anyone who has been diagnosed by a physician as have a life expectancy of six months or less if the disease runs its normal course qualifies for hospice care.
Hospice eligibility criteria
To be eligible to elect hospice care under Medicare, an individual must be entitled to Part A of Medicare.
The patient must be certified as being terminally ill. An individual is considered to be terminally ill if the medical prognosis is that the individual’s life expectancy is 6 months or less if the illness runs its normal course.