Texas Hospice Care FAQ
What is hospice care?
Hospice Care is Not Limited to Six-months of Service.
- The Medicare Hospice Benefit requires that a terminally-ill patient have a prognosis of six months or less: There is not a six-month limit to hospice care services.
- Hospice eligibility requirements should not be confused with length of service.
- A patient in the final phase of life may receive hospice care for as long as necessary when a physician certifies that he or she continues to meet eligibility requirements.
- Under the Medicare Hospice Benefit, two 90-day periods of care (a total of six months) are followed by an unlimited number of 60-day periods.
What Services Does Hospice Provide?
Where is Hospice Care Provided?
We provide hospice care in patients’ homes, hospital beds, nursing homes and assisted living communities/residential care facilities—wherever people can benefit from comfort care. The goal is to support patients and manage their care in the setting they consider home.
When is the Right Time to Ask About Hospice Care?
One of the challenges for family members and caregivers of people who are near the end of life is knowing when it is time to consider hospice. In making this decision, consider these questions:
- Despite good medical care, have our loved one’s condition and symptoms progressed to the point that they cannot be adequately controlled?
- Has our loved one endured multiple hospitalizations, emergency department visits or repeated use of other healthcare services?
- Has the attending physician or specialist said there is nothing more that can be done to slow or cure the condition?
- Has our loved one indicated that the side effects of medical treatments outweigh the benefits?
Your loved one’s physician can play a key role in determining, from a medical standpoint, if the patient is clinically appropriate for hospice. Using a variety of medical criteria and guidelines—which vary according to specific illness—the physician can determine whether hospice is a viable choice. Alternatively, you or your loved one can call a hospice provider for a free evaluation of hospice eligibility. If the patient is hospice appropriate, the hospice provider can help you have the conversation with your physician.
What does the hospice admission process involve?
Typically, hospice care starts as soon as a formal request or "referral" is made by the patient's physician. Often a hospice program representative will make an effort to visit the patient within 48 hours of that referral, provided the visit meets the needs and schedule of the patient and family/primary caregiver. Usually, hospice care is ready to begin within a day or two of referral. However, in urgent situations hospice services may begin sooner.
Who pays for hospice?
Hospice is covered 100% under Medicare, Medicaid, most private insurance plans, HMO's and managed care organizations. Arrangement for private pay is available for those that qualify for hospice care.
Who is eligible for Hospice care?
Any individual whose focus is on physical, emotional and spiritual comfort can apply for hospice care. Diagnosis commonly associated with hospice care includes:
- Congestive Heart Disease
- Chronic Lung Disease
- End-Stage Liver and Kidney Diseases
- ALS (Lou Gehrig's Disease)
- Parkinson's Diesease
- Multi-System Breakdown
- Multiple Sclerosis