Hospice Service Eligibility
To qualify for hospice care, a hospice doctor and your doctor (if you have one) must certify that you’re terminally ill, meaning you have a life expectancy of 6 months or less. When you agree to hospice care, you’re agreeing to comfort care (palliative care) instead of care to cure your illness. You also must sign a statement choosing hospice care instead of other benefits Medicare covers to treat your terminal illness and related conditions.
Coverage includes:
- All items and services needed for pain relief and symptom management
- Medical, nursing, and social services
- Drugs for pain management
- Durable medical equipment for pain relief and symptom management
- Aide and homemaker services
- Other covered services you need to manage your pain and other symptoms, as well as spiritual and grief counseling for you and your family.
Medicare-certified hospice care is usually given in your home or other facility where you live, like a nursing home.
Only your hospice doctor and your regular doctor (if you have one) can certify that you’re terminally ill and have a life expectancy of 6 months or less. After 6 months, you can continue to get hospice care as long as the hospice medical director or hospice doctor recertifies (at a face-to-face meeting) that you’re still terminally ill. Hospice care is usually given in your home but may also be covered in a hospice inpatient facility. Original Medicare will still pay for covered benefits for any health problems that aren’t part of your terminal illness and related conditions, but this is unusual. When you choose hospice care, you decide you no longer want care to cure your terminal illness and/or your doctor determines that efforts to cure your illness aren’t working. Once you choose hospice care, your hospice benefit will usually cover everything you need.
For more information please follow this link to the Medicare Coverage website.
These are some of the disease-specific eligibility criteria for hospice.
- Respiratory Disease
- Cardiovascular Disease
- Liver/Renal Disease
- Neurological Disease
- Alzheimers Disease
- Congestive Heart Failure
- Pulmonary Disease
- Cancer
- Stroke
- HIV/AIDS
Qualifying for Hospice:
- Patient must have an order from a physician
- Patient must be in the end stage of their diagnosis
- Patient should have a primary caregiver in the home
- The patient is rapidly declining despite medical treatment (weight loss, mental status decline, inability perform activities of daily living).
- The patient is ready to live more comfortably and forego treatments aimed at prolonging life.
Diseases that Qualify for Hospice:
- End Stage Respiratory Disease
- End Stage Cardiac Disease
- Alzheimer’s
- Cancer
- End Stage Renal Disease
- HIV
Why Anchor Hospice?
1. Admit within 24 hours
2. 24 hour follow up skilled nursing visit
3. Wound Care Team
4. Dementia Certified Hospice
5. POC decided with family
6. Team is COVID-19 tested every 2 weeks