Who Pays for Hospice?
During this difficult time, determining a payment method for hospice care may be the furthest thing from your mind. Rainbow Hospice and Palliative Care can help you explore your payment options.
Hospice services are covered by Medicare, Medicaid and most private health insurance.
Rainbow has never turned away a patient in need for being uninsured or underinsured.
Medicare is the most common form of insurance for patients receiving hospice services. Beneficiaries who are covered under Medicare Part A are eligible to access the Medicare Hospice Benefit.
This benefit covers the costs of hospice care, including medications and medical equipment related to the diagnosis. All Medicare billing and paperwork is handled by Rainbow.
Patients who are accessing the Medicare Hospice Benefit are still covered under Medicare Part B for any services that are not related to their terminal illness.
U.S. citizens and many legal residents are eligible for Medicare at the age of 65. Those under the age of 65 who have End-Stage Renal Disease (ESRD) or who have received Social Security Disability Income payments for 24 months (or for one month for patients with ALS) are also eligible for Medicare.
Medicaid is a state-funded program that provides medical coverage for individuals who have limited financial means.
The Medicaid Hospice Benefit covers the costs of hospice care including medications and medical equipment related to the diagnosis. All Medicaid billing and paperwork is handled by Rainbow. If a patient’s income is slightly higher than the amount for Medicaid eligibility, “spend-down” amounts must be satisfied in order to access maximum coverage this benefit. All Medicaid billing is handled by Rainbow.
*Medicare and Medicaid Hospice Benefits reimburse Rainbow at a daily rate for hospice services.
Medicare HMO Coverage for Hospice
The Medicare HMO transfers coverage to Medicare Part A for hospice benefits (see Medicare Hospice Benefit above). The benefit reimburses Rainbow at a daily rate for all services.
Hospice benefits vary widely among private health insurance plans. Rainbow will verify and negotiate benefits for individuals with commercial or private health insurance.
Coverage will be determined at the time of admission to hospice and the allowable benefits will be explained. In most situations, Rainbow negotiates a daily rate that provides coverage for hospice service. As with any healthcare benefit plan, deductibles and co-payments may be applied to the hospice benefit.
Coverage for the Uninsured
Rainbow Hospice and Palliative Care is a non-profit organization committed to serving the needs of its community. If a patient does not have health insurance coverage, we will provide services based on need, regardless of his or her ability to pay.
Discontinuation of Hospice Services
Patients have a right to choose at any time to discontinue hospice care. On occasion, individuals may choose to receive active treatment or alternative medical benefits instead of hospice care. With proper notification, this transition can be easily accomplished. Additionally, Medicare, Medicaid and most private health insurance plans allow for hospice benefits to be reactivated at a later date.
You have Choice
Medicare, Medicaid, Medicare HMO and most private insurance companies allow you to choose your hospice provider even if the hospice is outside of the HMO provider network. Ask for Rainbow by name.