January 5, 2018

What You Should Know About Insurance Coverage for Hospice Care

A very common concern among newly admitted hospice patients and their families is the costs associated with the extensive care. At Ardent Hospice & Palliative Care, we put patient care, comfort, and peace of mind first; we never want our patients to worry about the cost of their care.

Our billing and insurance departments are always fighting and working on the behalf of our patients to ensure they have the insurance coverage and care options to keep them comfortable during their final days. Insurance coverage can be intimidating, but it should be the last thing on a patient’s mind when they are considering hospice. Here are two important things we want our patients and their families to know about insurance coverage for hospice care.

Hospice Care Provides Full Medical Coverage, Usually at No Cost to Our Patients

Hospice patients with Medi-cal, Medicare, or who are under a VA insurance program will receive full coverage benefits at no cost to them or their families. With these insurance providers, patients should never have to pay out of pocket or receive a bill from us when they are on hospice care.

Once a patient comes onto hospice, our medical team takes on the responsibility of providing his or her full care. Because we are visiting our patients regularly in their homes and tending to their comfort levels and needs, visiting a physician in their office is no longer a necessity. In fact, while on hospice care, patients cannot continue to see the doctor who would typically treat them for the diagnosis they are on hospice care for. For example, a patient with congestive heart failure would no longer be able to see or be treated by their cardiologist once they begin receiving hospice treatment (for congestive heart failure).

Usually, when a patient comes onto hospice care, they have no desire to keep going to doctors’ appointments, especially when they’re no longer seeking curative treatments. With hospice care, they receive the same quality of specialized comfort care in their own homes, leaving them with more time to spend with their loved ones.

If You’re Not Covered by Insurance, We’ll Work with You

Very rarely, there are some insurances companies that do not provide any hospice benefit, and patients are left without coverage for hospice care. At Ardent, it’s never our intention to turn down a family, especially if it’s due to costs or insurance coverage. In these circumstances, our social worker will discuss options and possible insurance adjustments available to the patient and their family. For instance, some patients might meet the income requirements to be eligible for Medi-cal, other times their diagnosis may qualify them for Medicare disability and they can begin to receive the appropriate coverage.

There are other rare circumstances where patients and families request specific medications or durable medical equipment that are not covered by insurance, even through Medi-cal or Medicare. Because Ardent offers individualized care, we take these petitions on a case-by-case basis and work with families to find a solution. When a patient’s quality of life is truly impacted by the item they are requesting, be it a name brand medication or certain wheelchair model, we are, many times, able to grant their wishes—even if it comes out of our own budget. Our goal is to eliminate any financial burden on our patients and their families without sacrificing their quality of care.

At Ardent Hospice & Palliative Care, it’s so important to us that our patients are able to focus more on creating memories with their loved ones, and worry less about the cost of their care. If you have any questions about insurance, medical costs, or hospice care services, please contact us by calling (858) 952-1786 or visiting us online.