#how much does hospice care cost
Frequently Asked Questions
Hospice care is for people with a life-limiting illness who want comfort care rather than curative treatment. A physician must certify that the person’s life expectancy is six months or less, but that time frame is flexible. Services can be extended beyond six months. Some people go on and off hospice care as their conditions change. Some people “graduate” from hospice because they get better.
It is time to consider hospice care when one or more of these circumstances apply: loss of function or physical decline; increase in hospitalizations; dependence in most activities of daily living; multiple diseases or conditions; increase in emergency room visits, and continuing weight loss.
In addition, each disease has its own criteria indicating hospice eligibility. For example, dementia or Alzheimer’s disease is a terminal illness that can run its course over a decade. Hospice eligibility occurs when the person with dementia exhibits one or more of the following: unable to walk without assistance, incontinence, speech limited to a few words, difficulty swallowing or eating, and continuing weight loss.
Anyone can contact Hospice of the Valley for help to decide whether hospice care is appropriate. Click here to contact us.
We provide services to those who:
- Have a life-limiting illness, as confirmed by a physician.
- Agree that hospice care is appropriate.
- Reside in or near Maricopa County or Pinal County (including winter visitors).
Hospice care is an established part of the healthcare system. Services are covered by Medicare, most insurance plans, and some AHCCCS plans (the Arizona Health Care Cost Containment System, which pays for health care for low-income people). Hospice of the Valley, a not-for-profit agency, provides the same high quality of care to everyone regardless of insurance or financial means.
Those who elect to use the Medicare Hospice Benefit for their serious illness choose “the hospice plan of care,” which means they are no longer seeking aggressive treatments to cure their illness. However, Hospice of the Valley will pay for many valuable treatments that provide comfort and care, including radiation therapy, limited chemotherapy, intravenous fluids and antibiotics, intravenous or stomach tube feedings, and specialized pain management technologies.
If the patient has chosen the Medicare Hospice Benefit, and then has an illness that is not related to the “terminal” diagnosis, traditional Medicare will pay for that treatment. For example, if a patient with lung cancer falls and breaks his hip, he will get surgery for the fractured hip through traditional Medicare. If a patient on hospice chooses aggressive treatment such as cardiopulmonary resuscitation (CPR) or brain surgery, they are free to sign off their Medicare Hospice Benefit and return to their traditional Medicare insurance while pursuing a cure.
The Hospice Medicare Benefit covers all services related to the terminal diagnosis: medical and nursing care, social services and counseling, chaplain services, certified nursing assistants for personal care in the home, medications delivered to the home, medical equipment and supplies, and care in specialized inpatient hospice homes for acute symptom management. If the patient is taking medications for an unrelated diagnosis (for example, if the patient is on hospice for lung disease but also has an unrelated thyroid condition), the patient and/or their usual insurance will pay for those medications.
The Hospice Medicare Benefit covers room, board, and all care in a hospice palliative care unit or inpatient hospice home – a short-stay facility staffed by Hospice of the Valley for patients with acute symptoms such as pain, nausea or shortness of breath. The Hospice Medicare Benefit does not cover room and board in a group home, assisted living facility, or nursing home under most circumstances, except for brief nursing home stays of a few days for acute symptom management.
For more information, view the U.S. Government Web site: www.medicare.gov or call the Medicare Customer Representative: 1.800.633.4227.
Hospice services are covered by Medicare, most insurance plans and some AHCCCS plans (Arizona’s healthcare plan for the poor). Because Hospice of the Valley is not-for-profit, no one is ever denied care because of financial need.