We Have Answers
You and your loved one have made the decision to seek hospice care. We know that it has been a difficult journey, and the staff of ABC Hospice is available to ease this transition. Below, you will find answers to many frequently asked questions regarding hospice care.
Q. Who may receive Hospice care?
A. Hospice care is specifically for people with life-limiting illnesses who also meet the following hospice guidelines:
- The patient’s physician has said that the patient’s prognosis is life-limiting, and the physician agrees to work with our hospice team in order to give the patient the best possible care.
- If that is not possible, the ABC Hospice Medical Director can manage the patient’s care.
- There is a desire for comfort care at a time when aggressive, curative treatment may have stopped, been refused or has been deemed inappropriate for the current stage of the patient’s illness.
- The patient is aware of the nature of his/her illness to the extent that the illness allows.
Q. Do I give up my rights to see my doctor while on the hospice program?
A. No, your participation in the ABC Hospice home care program will not prevent you from seeing your doctor regardless of the type of coverage you have. For Medicare patients, doctors’ visits are billed under Part B of Medicare, and hospice services are billed under Part A. Medicaid also covers doctors’ visits.
Doctors’ visits for patients with private insurance coverage are billed separately from hospice services. If you wish and are able to go to your doctor’s office, ABC Hospice will work as a team with your physician in order to provide you with the optimum level of care. Please inform your primary nurse if you have an appointment with a physician and also inform your physician that you are receiving hospice care.
Q. Can I still go to the hospital?
A. Yes, you maintain the right to go to the hospital. However, there is the possibility that your status in the hospice program may be affected. In most cases, a 911 transfer to a hospital is not part of a hospice plan-of-care unless it is unrelated to the patient’s terminal diagnosis (e.g., a fractured hip, blood clot to the leg, etc.) If you need to go to the hospital, your caregiver needs to notify ABC Hospice immediately. Your hospice team will work with your caregiver to determine the next steps regarding your plan of care.
Q. How is hospice care paid for?
A. ABC Hospice cares for all patients regardless of insurance or income. We are a for-profit agency. ABC Hospice is reimbursed for services from a variety of sources. These sources include:
- Medicare and Medicaid
- Insurance companies
- Donations and other private payments
Medicare and Medicaid pay a daily rate under a specific hospice benefit. Our services are provided to you at that rate.
Private Insurance companies sometimes provide a hospice benefit for the insured. When an insurance company is involved, coverage is verified by ABC Hospice, and you will be informed of the terms of your coverage. Some insurance company benefits for hospice care are very similar to Medicare’s benefits. Other insurance companies have very specific coverage provisions and limits for hospice services.
ABC Hospice receives a limited amount of funds from private donations to help patients with limited financial means receive hospice care. If you need financial assistance for service coverage, contact your hospice nurse as soon as possible so that we may review your financial needs and determine the assistance available.
Q. Which hospice services are covered by insurance or Medicare/Medicaid?
A. Medicare/Medicaid and most insurance companies will reimburse ABC Hospice for the following services:
- Interdisciplinary hospice team services - Physician, RN, Social Worker, Nursing Assistant, Chaplain, volunteers and bereavement follow-up;
- Durable medical equipment (DME) such as a hospital bed, oxygen, bedside commode or wheelchair, if needed;
- Medications for pain and symptom control (e.g., anti-nausea meds, anti-itching meds, etc.) and medication related to your terminal diagnosis will be covered. The admission nurse and primary RN will clarify this issue with you and your family;
- Antibiotics used to treat a non-hospice related illness usually are not covered under the hospice provision and should be obtained by you in the normal manner. Check with a Hospice team member if you have any questions as to whether a particular medication is covered;
ABC Hospice will bill for you, whether you are a Medicare, Medicaid or insurance patient.
Q. Can I return to the ABC Hospice Home Care Program if I have revoked participation or have been discharged?
A. Yes, if you still meet the criteria for hospice. The procedure to reinstate you to the hospice home care program is very simple. Call 866-847-8660 to begin the reinstatement process.
Q. Can I still receive radiation or chemotherapy treatments while on the home care hospice program?
A. Generally, radiation and chemotherapy treatments are considered aggressive treatments and are not covered by Medicare/Medicaid or insurance. In some cases, however, radiation and chemotherapy may help relieve the symptoms related to the terminal illness. You must discuss any decision to receive radiation or chemotherapy with your nurse and physician.
Q. What happens if I no longer meet the criteria for hospice after I have been admitted into the hospice home care program?
A. Your interdisciplinary ABC Hospice team repeatedly reviews your plan-of-care, and if you no longer meet the criteria for hospice, we will work with you on a transition plan for other options.