Medicare and private insurance providers can pay for Home Health Care Services. Out-of-pocket payment is also available but can be prohibitively expensive. Medicare/Insurance and out-of-pocket payment methods can be combined in some cases depending on coverage and services needed.
Both Medicare and private insurance providers have different requirements for hospice coverage. In-home and facility-based hospice care may have different requirements, depending on patient insurance plans.
What You Need for Hospice Coverage
Getting coverage for hospice care from both Medicare and private insurance providers requires some initial legwork. An evaluation is required to confirm the needs of a patient for potential hospice (and other) services.
One of the main requirements for being approved for hospice care coverage is an end-of-life expectancy of 6 months or less. This is not always the case, but is generally a good estimate for anyone seeking potential hospice care.
Hospice Evaluations
Medicare requires patients to be evaluated by a doctor and to be under a medical plan established by that doctor to be eligible for Home Health Care benefits. The doctor must certify that you need one or more of the following to receive Medicare Home Health Care benefits:
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Intermittent skilled nursing care (other than drawing blood)
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Physical therapy
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Speech-language pathology services
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Continued occupational therapy
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Social Worker Services
Private insurance providers often have many different criteria for patients to be eligible for Home Health Care services and benefits, including hospice care. If you are looking for Home Health Care benefits from a private insurance company, please contact your provider for more information.
Who Pays for Hospice?
Hospice benefits are 100% covered by Medicare A, Medicaid, and some private insurance providers. These benefits include:
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Provision of medications related to the terminal diagnosis
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Nursing care
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Counseling services
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Medical equipment
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Medical supplies
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Dietary consultation
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Physical, speech, or occupational therapy consultation
Please note that many covered consultation services will not cover certain recommended services. The consultation is covered but the recommended services may not be. This differs from provider to provider. Please talk to your insurance provider for more information.
Charlin Hospice Services
At Charlin Health Services, we pride ourselves on honor, integrity, excellence, compassion, dignity, and trust. Our Interdisciplinary Hospice Team functions as a family unit to assist each patient and their loved ones during this journey of life. Each member of any Charlin Hospice team can be reached anytime seven days a week.
If you have any needs or questions about hospice care, health services, or other medical needs, please send us an email or give us a call.
