To receive hospice care coverage, a patient does need to meet a specific set of medical criteria while also having a doctor’s order indicating a life-limiting illness. While most hospice patients are older, Avera@Home serves patients of all ages. A person with a terminal illness prognosis of six months or less may benefit from hospice services.
Avera@Home hospice services are covered under Medicare and some Medicaid plans when services are provided in a residential home. Hospice care provided in a nursing home, independent or assisted living environment may include additional costs not covered under the benefit.
Many insurance policies and other managed care policies include hospice coverage for all or a portion of related costs. When patients don’t have insurance, Avera will work with them to identify ways to pay for hospice services. Ask a member of our team to check your eligibility.
Even though a general prediction following a terminal illness diagnosis is six months or less, a patient can stay in hospice care longer. They can continue to receive hospice care if they meet the criteria of having a terminal prognosis and are recertified with a limited life expectancy of six months or less.
Sometimes, a hospice patient may even leave hospice care to pursue new treatment or if they are showing signs of recovery or remission. Patients always have the right to withdraw from hospice and pursue traditional care at any time, for any reason.
Yes. Even after hospice services start, your primary care or designated provider remains in charge of your care. This includes giving final approval on any medication changes. They will also receive regular updates from hospice staff to continue to be an active member of your care.
