How Do You Pay for Hospice Care?

Hospice care is designated for patients with a terminal illness with a life expectancy of 6 months or less. If you live longer than six months, you are still eligible to rec

eivehospice care as long as a hospice physician has recertified that you’re terminally ill.

The majority of hospice patients are eligible for the Medicare Hospice Benefit, covering up to 100 percent of hospice-related services.

The Medicare Hospice Benefit covers up to 100 percent of all services related to the terminal illness under Medicare Part A. Therefore, there is no reason to forgo hospice care for financial reasons.

For patients that are not eligible for Medicare or Medicaid, hospice services can be paid for through private insurance, private pay, charitable programs, or any combination of these methods. 

EverHeart Hospice will never turn anyone away due to their inability to pay.

Who’s Eligible for the Medicare Hospice Benefit

If you have Medicare Part A AND meet all of these conditions, you qualify for the Medicare Hospice Benefit:

• You have been certified by a hospice physician, in collaboration with your primary care doctor, that you’re terminally ill and have been given a life expectancy of six months or less.
• You choose to receive non-curative or comfort care instead of care intended to cure your illness or have exhausted all treatment options. 
• You have elected to receive hospice services and signed a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions.

How Long Can I Receive Hospice Care?

Once qualified for hospice care, there are two 90-day benefit periods followed by an unlimited number of 60-day benefit periods.

At the start of the first 90-day benefit period, the hospice physician in collaboration with your primary care doctor will certify that you’re terminally ill and have a life expectancy of 6 months or less. 

After the initial 90-day period, a hospice physician will recertify that you meet the criteria to continue hospice; at that time, you will enter the second 90-day benefit period. 

After the conclusion of the second 90-day benefit period, there will be additional recertifications by a hospice physician every 60-days. 

Hospice Plan of Care

Once qualified for hospice care, you and your family will meet with your hospice provider to set up a care plan for your particular needs.

For specific information on a hospice plan of care, please contact a team member from EverHeart Hospice to discuss your individual care options.

You will have a care team of skilled professionals that include:

• Hospice Physicians
• Nurse Practitioners
• Hospice Nurses
• Hospice Aides
• Social Workers
• Chaplains
• Bereavement Coordinators
• Music Therapists
• Volunteers

When developing your care plan, you have the option to include your primary care doctor or nurse practitioner as part of your care team. If you reside in a nursing facility or assisted living facility, we also work in collaboration with their staff to help coordinate your care. 

The Medicare Hospice Benefit is designed to allow you and your family to stay together in the place you call home. If your physician determines that you require inpatient hospice care, your hospice care team will help guide and assist you with this transition.  

For additional information on eligibility and what is considered a covered service, please reach out to our professional team at 800-417-7535 to discuss any concerns or questions you may have.