Private Insurance Hospice Coverage Information.
While most patients are eligible to use Medicare or Medicaid for hospice services, some patient’s hospice care are covered by private health insurance plans.
Private health insurance plans protect patients and their families from paying the full cost of medical expenses for illnesses, injuries, and medical conditions. This is most often provided by an employer or retirement program, but it may also be purchased privately from a health insurance provider or through the Affordable Care Act Marketplace.
Most private insurance plans cover hospice care and other end-of-life care services. These insurance plans typically cover the full cost of hospice services. However, each health insurance company may have its own unique requirements a patient must meet before they can begin hospice care.
At a minimum, most private insurance plans require that the patient be diagnosed with a terminal illness with a reduced life expectancy of six months or less. They also require that a patient discontinue curative measures before beginning hospice care.
What hospice services does private insurance cover?
The majority of private insurance plans model their hospice insurance coverage on the federal Medicare hospice benefit program and cover hospice costs at 100%, but it is important to contact the insurance provider for specific details on what the patient’s plan will cover and what costs the patient and their family may be response for.
Hospice Services Include:
- A highly skilled team of physicians, nurses, hospice aides, social workers, chaplains, bereavement coordinators and volunteers.
- Medical equipment related to the patient’s terminal diagnosis including wheelchairs, hospital beds, and walkers.
- Necessary medical supplies including bandages and other wound care supplies, incontinence supplies, and catheters.
- Medications prescribed by the patient’s physician to manage pain and control symptoms related to their terminal diagnosis.
- Short-term in-patient care if needed to manage symptoms related to the patient’s terminal diagnosis.
- Short-term respite care for up to 5 days for the patient at an inpatient care facility to give family caregivers the chance to take a break.
Patients will private insurance should always speak with their health insurance provider about these services, so they have the peace of mind of knowing what services are and are not covered and any associated costs.
Private insurance hospice coverage FAQ.
What services are covered by the insurance policy’s hospice plan?
The insurance provider will able to confirm what services are and are not covered by the patient’s existing plan.
Are there any out-of-pocket expenses?
It is important to understand what copayments and deductibles the patient and their family may be responsible for, so they can plan for these expenses.
How does Crossroads Hospice & Palliative Care bill private insurance for hospice care?
Crossroads Hospice & Palliative Care bills private insurance providers directly for patients with private insurance coverage or other third-party payers. Patients are responsible for charges not paid by their insurance provider.
What if a patient is under-insured or uninsured?
Crossroads Hospice & Palliative Care works with patients and families who meet hospice care eligibility to ensure they have the support they need regardless of their ability to pay for services.
When is the patient eligible for hospice care?
Most patients are eligible for private insurance hospice coverage when they have been diagnosed with a terminal illness with six months or less to live if the disease follows a typical progression.
Learn more about hospice insurance coverage.
Crossroads Hospice & Palliative Care provides patients and their families will a team of hospice care professional who will address the patient’s physical, psychosocial, emotional, and spiritual needs at end of life.
Crossroads Hospice & Palliative Care is committed to providing patients with the support they need and will be by the patient’s side when they need us most. In addition, all Crossroad patients are offered special programs to enhance quality of life including Veteran Recognition services, our Life Journal Program, and the Gift of a Day. These programs allow families to continue to create positive moments and memories together.
If you know someone who may be eligible for hospice services, please call us by using the blue Help Center Bar on this page and schedule a consultation. Our team is available 24 hours a day, 7 days a week, 365 days a year to answer questions, admit patients, and provide care.
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