FAQ's

Changing misconceptions about Hospice Care – Q&A

Q. – Does it require a physician order to visit a patient to discuss hospice services, or to evaluate a patient’s eligibility for hospice care?

A. – No, a patient is certified for eligibility upon admission to service. An order is not required to meet with a patient or family to discuss services however, an order is required to “touch” or “assess” a patient.

Q. – Is it a requirement that a patient must die within 12 months to be eligible for the Medicare hospice benefit?

A. – Not necessarily, the certification of terminal illness is based on the physician’s clinical judgment regarding the normal course of an individual’s illness.

Q. – Does a patient have to be “ready to die” to elect the hospice benefit?

A. – No, denial is an accepted coping mechanism. The Medicare benefit does not mandate that a patient/family accept that they are dying to receive hospice care. The patient must however be aware that the purpose of hospice is comfort and symptom management not cure.

Q. – If a patient chooses the hospice benefit, do they have to give up their regular physician?

A. – The patient chooses the physician that they wish to be their primary or attending physician. The physician is identified by the individual as having the most significant role in the determination and delivery of the patient’s medical care.

Q. – To be eligible for hospice care, does the patient have to first stop treatment that he or she is receiving?

A. – Medicare does not mandate that a patient stop treatment rather that the treatment cannot cure the illness. If the treatment will significantly prolong the life expectancy they would not be eligible. The treatment may be being utilized for palliative purposes only, which would allow the patient to be hospice eligible.

Q. – Who pays for hospice care?

A. – Medicare A, Medicaid and most insurance have a hospice benefit. This includes coverage of the hospice team, medications, supplies and medical equipment related to the hospice diagnosis. There is never an “out of pocket” expense to the patient or family.

Q. – What if my condition improves?

A. - There is no Medicare penalty for getting better. If you are no longer hospice eligible, our social worker will assist in transferring you to a non hospice provider.

Q. – When should one consider hospice?

A. – After a life limiting diagnosis has been determined by your physician and when curative treatment is no longer an option.

Q. – Is hospice only for cancer?

A. – No, hospice cares for many terminal diagnoses. Some of these life-limiting diagnoses include, but are not limited to: Heart disease, COPD/lung disease, Renal disease, Liver disease, Alzheimer’s/Parkinson’s disease, or Cancer.