Hospice care
Understanding all the various options and services available can be daunting but it doesn’t have to be. Archway Hospice is here to support you with your journey.
What Is Hospice?
According to Title 18, Section 1861 (dd) of the Social Security Act, the term “hospice care” means the following items and services provided to a terminally ill individual by, or by others under arrangements made by, a hospice program under a written plan (for providing such care to such individual) established and periodically reviewed by the individual’s attending physician and by the medical director (and by the interdisciplinary group described in paragraph (2)(B)) of the program–
- nursing care provided by or under the supervision of a registered professional nurse,
- physical or occupational therapy, or speech-language pathology services,
- medical social services under the direction of a physician,
- (D)(i) services of a home health aide what has successffully completed a training program approved by the Secretary and
- (ii) homemaker services,
- medical supplies (including drugs and biologicals) and the use of medical appliances, while under such a plan,
- physicians’ services,
- short-term inpatient care (including both respite care and procedures necessary for pain control and acute and chronic symptom management) in an inpatient facility meeting such conditions as the Secretary determines to be appropriate to provide such care, but such respite care may be provided consecutively over longer than five days,
- counseling (including dietary counseling) with respect to care of the terminally ill individual and adjustment to his death, and
- any other item or service which is specified in the plan and for which payment may otherwise be made under this title.
Criteria for Hospice Eligibility
An individual may be self-referred, referred by family or medical provider to Archway Hospice Services. Medical eligibility for hospice care is determined by your medical provider and a hospice medical director. Typically, hospice care is appropriate if you:
- Have a life expectancy of six months or less (if the disease runs its normal course) as determined by your physician and the hospice medical director.
- Desire palliative treatment instead of curative care.
- Prefer not to return to the hospital or emergency room.
- Are experiencing pain and/or other discomfort.
- Want to stay home as long as possible.
- Would like assistance with emotional, social and/or spiritual needs.
Insurance Coverage for Hospice Eligibility
Medicare/Medicaid Hospice
Care is a covered benefit under Medicare Part A and certain categories of Medicaid.
Private Insurance Hospice
Services are covered by most private insurance plans. Your hospice team will advise you of your specific hospice coverage and its scope. If you have two or more insurance policies, please inform your hospice team so they may coordinate your available coverage.
Limited or No Insurance
Your hospice social worker will assist you in determining your potential eligibility for Medicaid and/or uncompensated care. You may also pay out-of-pocket for your hospice care; information regarding the cost of hospice services is available from your hospice social worker or nurse.
Ambetter Health
Archway Hospice proudly provides services to those insured under all Ambetter Health plans, including Essential, Balanced & Secure plans.