Medicare, Medicaid and Other Insurance
Many of our hospice services are covered by Medicare, Medicaid and private insurance companies. When that is not possible – we’re here for you. Our services are available to anyone in our community regardless of ability to pay because of the generosity of our community.
|Medicare & Medicaid||Other Insurance|
|HopeWest is paid by day of care approximately $160 for all care and other purchased services in the residential setting.||X||Most|
|Registered Nurse||As needed – daily, after hours or weekly as patient needs||As needed – daily, after hours or weekly as patient needs|
|Social Worker/Counselor||Patient and family need determines||Patient and family need determines|
|Chaplain||Available at patient and family’s request||Available at patient and family’s request|
|Nursing Assistant||Based on patient need, typically 3 times per week||Based on patient need, typically 3 times per week|
|Doctor||As needed for symptom control||As needed for symptom control|
|Volunteer||Available for support to all patients||Available for support to all patients|
|Occupational Therapist||For patients who need help with walking or medical equipment||For patients who need help with walking or medical equipment|
|Speech/Physical Therapy & Dietary Counseling||As needed||As needed|
|24-hours/7 days per week, access to Registered Nurse by telephone and visit if needed||X||X|
|Medical Transportation & Ambulance||X||Varies by Insurance Carrier|
|Medical Equipment||X||Varies by Insurance Carrier|
|Oxygen / Lab Work / Xrays||X||Varies by Insurance Carrier|
|Medications related to diagnosis||X||Varies by Insurance Carrier|
|Hospitalization or care at the Hospice Care Center||X||Varies by Insurance Carrier|
|Tube Feeding when it is the sole source of food||X||Varies by Insurance Carrier|
Services not typically covered by the Hospice Benefit under Medicare or Medicaid.
These benefits may vary under other insurance providers:
- Curative therapies like radiation /chemotherapy with some exceptions
- Major surgeries
- Room and board in a hospice facility
Can I go back to regular Medicare or Medicaid after I elect Hospice?
Yes, you can decide to leave hospice care and return to other benefits in an instant. There are also times where HopeWest may discharge a patient because they no longer meet the prognosis criteria for Medicare or Medicaid, want to pursue curative therapies or pose a safety threat to themselves or staff.
When patients are discharged from hospice or decide to leave (revoke) they are offered a palliative care program to continue to meet their needs.
Forms and Notices for Medicare
Patients will sign a Hospice Election Form when they are admitted to Hospice and sign a Revocation Form when they decide to leave hospice. Patients will periodically receive a Medicare Summary Notice (see example) following hospice services.
People find the Medicare Summary Notice form extremely misleading. The notice from Medicare appears to reflect the charges and services rendered to the patient and what Medicare paid HopeWest.
However, the notice from Medicare only reflects the visits of some of the staff and medications covered by the hospice but no other services like the ones listed in the table on the previous page.
It appears as though HopeWest was paid thousands of dollars in a month for a few staff visits and a few medications, when often there are many other costs HopeWest covered as part of that period of time and those costs are not reflected on the Medicare notice.
Example of Medicare Summary Notice
Please call if you have questions or need further clarification. (866) 310-8900