Hospice Medicare Eligibility
This page lists the Medicare eligibility guidelines for the services we offer.
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Medicare Hospice Benefit
The Medicare Hospice Benefit, initiated in 1983, is covered under Medicare Part A. Medicare beneficiaries who choose hospice can receive a full scope of non-curative medical and support services for their terminal illness. Willowbrook Hospice is a Medicare certified agency.
Covered Hospice Services
• Physician Services
• Medical supplies, oxygen, and durable medical equipment related to the terminal illness
• Medication for symptom control and pain relief
• Visits by the hospice interdisciplinary team. (Physicians, nurses, social workers, hospice aides, spiritual
support counselors, and volunteers)
• Short-term inpatient and respite care
• Counseling to help families deal with grief and loss
Eligibility Requirements
Medicare has four key eligibility criteria:
• Terminal prognosis of 6 months or less, if the disease runs its normal course, as certified by the
patient’s attending physician and the hospice medical director
• The patient no longer seeks curative treatment and chooses to receive hospice care
• The patient is enrolled in a Medicare approved hospice program. (Most private insurance managed care
providers also cover Hospice care. Willowbrook Hospice will verify insurance benefits when a referral is
received.)
• Patient has a competent person in the home to help provide care
Payment for Hospice
Medicare reimburses the hospice program for virtually all medical expenses related to the patient’s terminal
illness.
Benefit Periods for Hospice Care under Medicare
Four benefit periods for hospice care are available:
• 1st period: 90 days (evaluation period)
• 2nd period: 90 days
• 3rd period: 60 days
• 4th period: unlimited 60 day period |
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