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Payment for Hospice Services

Traditionally, hospice is an option for people whose life expectancy is six months or less, and involves palliative care (pain and symptom relief) rather than ongoing curative measures.  Some hospitals, nursing homes, and other health care facilities provide hospice care onsite, however, in most cases hospice is provided in the patient’s own home which provides a more familiar and comfortable environment. 

The Medicare hospice benefit, enacted by Congress in 1982, is the predominate source of payment for hospice care.  More than 88% (2012 NHPCO Facts & Figures) of patient days are covered by Medicare. Other payment sources include Managed Care or Private Insurance, Medicaid (same reimbursement as Medicare), self-pay (private pay), and uncompensated or charity care.  There must be a life expectance of six months or less (if the disease runs normal course) and there must be physician certification of limited life expectancy. 

If a person does not have coverage through Medicare, Medicaid or a private insurance company, hospice usually works with the person and their family to ensure needed services can be provided.

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