How to Pay?
How is hospice care paid for?
Reimbursement for hospice services comes from Medicare, Medicaid, health maintenance organizations and other private insurance plans. In the Commonwealth of Massachusetts, all commercial insurers are required to provide a hospice benefit. If you are unsure as to the nature of the hospice benefit available in your insurance plan, speak with your insurer or a hospice representative.
What is the Medicare Hospice Benefit?
You can access hospice services under the regular Medicare benefit. In 1983, Congress expanded the Medicare insurance program to include hospice care. To be eligible for this benefit, a physician must certify that the patient has less than six months to live if the disease runs its normal course. The physician must recertify the individual at the beginning of each benefit period (two periods of 90 days each, followed by an unlimited number of 60 day periods). The patient signs an elective statement indicating he or she understands the nature of the illness and of hospice care. In addition to hospice services, the patient may continue to receive Medicare benefits not related to the terminal illness. In Massachusetts, Medicaid and private health plans provide a similar benefit to that of Medicare.
What if we have no health insurance?
Many hospices offer care on a private pay, sliding-fee scale or charitable basis for those who have insufficient insurance. Charitable care is provided through the generosity of grants, gifts and donations to nonprofit hospice organizations. In addition, for-profit hospices may have foundations to assist patients in need. Speak to your local hospice if you wish to pursue one of these options.