Paying for Hospice Care
As a nonprofit hospice, our mission is to ensure that everyone in our community needing hospice care receives it. Our services are covered by Medicare, Medicaid, managed care, private health insurance and private pay. Through the community’s generous support to the Tidewell Foundation, we can help cover care and other essential needs for those having difficulty paying.
Medicare Hospice Benefit
Once you start receiving hospice services, Medicare begins paying for your care under its Part A (hospital insurance) benefit. When your care is covered by the Medicare hospice benefit, you also may be covered by your original Medicare plan for any services unrelated to your hospice care. Your medications related to your hospice diagnosis will be covered. If you choose to remain enrolled in a Medicare Advantage Plan while receiving hospice care, you will have to pay your plan’s monthly premium.
Medicaid Hospice Benefit
If you are uninsured and in need of hospice services for yourself, your child or other family members, you may apply for Medicaid and possibly receive Tidewell Hospice services under a Medicaid plan. Once enrolled in Medicaid, all hospice services listed above will be covered for you or your family member.
Tidewell Hospice serves anyone, regardless of their ability to pay, through the charity care funds provided by the Tidewell Foundation. The Foundation is supported by our community through donations and grants. The Tidewell Foundation also fulfills last wishes for patients and families – from a special evening out, a wedding vow renewal and more. These wishes offer beautiful memories family and friends will cherish. Tidewell Treasures Resale Shops also support patients and families with each donation and sale.
Claiming Your Hospice Benefit
Your hospice benefit is provided under Part A (hospital insurance). To receive hospice care in connection with your Medicare benefits:
- Your physician and your hospice’s medical director must certify that you have a serious, life-limiting illness and six months or less to live if your illness runs its normal course.
- You must sign a statement indicating that you choose to have hospice care instead of other Medicare-covered benefits to treat your terminal illness.
- Your care must be provided by a Medicare-approved hospice program, such as Tidewell Hospice.
- Medicare will still pay for covered benefits for any health problems not related to your hospice diagnosis.
Services You Receive With the Hospice Medicare Benefit
When you qualify for hospice care you will have a hospice team available to help you and your family cope with your illness. Your doctor and hospice team will work with you and your family to set up a plan of care that meets your needs. Your plan includes hospice services covered by the Hospice Medicare Benefit. Most costs are paid for under the benefit.
Services covered include:
- Doctor’s visits when necessary
- Nursing care
- Medical equipment related to your hospice diagnosis (wheelchairs, walkers, etc.)
- Medical supplies related to your hospice diagnosis (bandages, catheters, etc.)
- Pain and symptom medication related to your hospice diagnosis
- Short-term inpatient care at our care centers when necessary
- Home health aide services
- Physical, speech and occupational therapies
- Social work, counseling and spiritual care
- Dietary counseling
- Hospice volunteer services
- Grief counseling for you and your family
Respite care allows a patient’s caregiver time to rest while someone else assumes the role of caregiver. As a hospice patient, you may have one person who takes care of you each day, perhaps a family member. But occasionally your caregiver might need to tend to things that need to be done or just get some rest. Respite care is available for up to five days at a time.
Hospice Care If You Are In a Medicare Advantage Plan
All Medicare-covered services you get while in hospice care are covered under the Original Medicare Plan, even if you are in a Medicare Advantage Plan (like an HMO or PPO) or other Medicare Health Plan. However, your plan will continue to cover you for any extra services not covered by the Original Medicare Plan (like dental or vision benefits). If you choose to stay in your Medicare Advantage Plan while getting hospice care, you must continue to pay your plan’s monthly premium.
Care For A Condition Other Than Your Hospice Diagnosis
You should continue to use the Original Medicare Plan to get care for any health problems not related to your hospice diagnosis. The hospice team determines whether any other medical care you need is or is not related to your hospice diagnosis so it will not affect your care under the hospice benefit. You must pay the deductible and coinsurance amounts for all Medicare-covered services. You must also continue to pay Medicare premiums, if necessary.
For more information about the Original Medicare Plan, Medicare Advantage Plans, Medigap and other Medicare Health Plans, look in your copy of the “Medicare and You” handbook mailed to every Medicare household in the fall. If you do not have that handbook, you can visit the Medicare website. You also may get a free copy by calling 1-800-MEDICARE (1-800-633-4227).
For more information about The Hospice Medicare Benefit, visit the National Hospice and Palliative Care Association or the Hospice Association of America websites or call 800-MEDICARE or (800) 633-4227. Text Telephone (TTY) users should call 1-877-486-2048.
Our staff is available to answer your questions about coverage. Call us at (855) 843-3935.
For more information, please call (855) 843-3935