Who Is Appropriate For Hospice

Potential hospice patients may be identified by a diagnosis, symptoms or a combination of both. Below are some signs and symptoms that may indicate a patient is hospice eligible:
Frequent hospitalizations or emergency room visits in the past six months, Unplanned weight loss or unable to feed self, Decrease in ability to perform activities of daily living, Increased or uncontrollable pain, Shortness of breath, Inability to swallow or frequent aspiration, Repeat or multiple infections, Change in mental status, Increased weakness or fatigue, Uncontrolled nausea and vomiting.

Hospice Myths & Realities

Reality: Receiving hospice care does not mean giving up hope or that death is imminent. The earlier an individual receives hospice care, the more opportunity there is to stabilize a patient’s medical condition and address other needs.

Reality: A large number of hospice patients have congestive heart failure, Alzheimer’s disease or dementia, chronic lung disease or other conditions.

Reality: The Medicare benefit, and most private insurance, pays for hospice care as long as the patient continues to meets the criteria necessary. Patients may come on and off hospice care and reenroll in hospice care, as needed.

Reality: Many times individuals are eligible for hospice much sooner than they realize. Obtaining early support from hospice helps individuals and families more quickly control symptoms and maintain a better quality of life.

Reality: Hospice care is appropriate at the time of the terminal prognosis, regardless of the patient’s physical condition. Many of the patients served through hospice continue to lead productive and rewarding lives. Together, the patient, family and physician determine when hospice services should begin.

Reality: While hospice teams are available 24 hours a day, 7 days a week, they are not the primary caregiver. Rather, hospice will create a plan of care customized to meet the needs of the individual and their family. Hospice staff can help the family locate resources and support to meet those needs.

Paying for Hospice

Hospice care is paid for in a variety of ways. This section explains the type of payment coverage available.
Medicare – If the terminally ill individual is a Medicare beneficiary, hospice is a covered benefit under Part A.

Medicaid – Nearly all states offer hospice coverage under Medicaid. In general, Medicaid hospice benefits parallel the Medicare benefit, although there may be some variations in certain states.

VHA Medical Benefit – All enrolled veterans are eligible if they meet the clinical need for service.

Private Insurance – many managed care plans and most employer issued insurance plans offer a hospice benefit.

Private Pay – If insurance coverage is unavailable or insufficient, the patient and the patient’s family can discuss private pay and payment plans.