Medicare’s “Hospice Benefit” pays for hospice care for people who are terminally ill and have a life expectancy of six months or less, if the illness runs its normal course.
* Connecticut Hospice covers all costs of Arts services, which are not reimbursed to us by Medicare.
You must still pay your regular Medicare Part A and B premiums, and any other care that is unrelated to the terminal illness will continue to be covered.
At this time, patients must meet two important conditions to be deemed eligible for the Hospice Benefit by Medicare:
The patient has elected to cease curative treatment and chosen to focus only on comfort and quality of life.
As a Medicare-certified hospice, Connecticut Hospice and its programs qualify for Medicare Hospice Benefit.
Patients in our Stand By Me (SBM) home care program are eligible for home palliative care services, including physician or nurse practitioner consultation in the home to assist with symptom management and decision making in serious illness.
Medicare coverage for palliative home care is available under certain conditions, where skilled care is needed for patients who are homebound, as certified by their physician.
Regular Medicare covers inpatient palliative care for symptom management for our SBM patients. At this time, those with a Managed Medicare policy are excluded from palliative care admission to our Branford Inpatient facility.
Respite care is only available for Hospice patients for short-term (5 days or less) inpatient stay. Medicare and Medicaid Hospice cover Respite Care. Patients should check with their private insurance to see if this benefit is covered.
Learn more about Respite Care eligibility requirements.
The Connecticut Hospice is a Medicare/Medicaid certified hospice program, offering a comprehensive hospice benefit. Most of our patients are Medicare/Medicaid eligible. You do NOT have to be over 62 to qualify for Medicaid.
Hospice care services are paid for by Medicare, Medicaid, most commercial insurances and privately by the patient/family.
Once a diagnosis is given and a patient is determined eligible for hospice care, the hospice benefit can be elected. The hospice benefit pays for all medical care, medications and appropriate treatments that will provide comfort and alleviate symptoms and which are related to the diagnosis. Hospice cares for people wherever they live. Because of that, hospice care is provided in hospitals, nursing homes and assisted living communities as well as in private homes.
We know that health care payment can be complicated, the following is a guide to help you understand Medicare/Medicaid coverage. (If using commercial insurance, please check with the company.)
Hospice care is covered by Medicare and Medicaid, Part A, B and C.
In most cases, supplies, equipment and even medications can be delivered to the patient's residence. Medicare supplements may help pay for particular aspects of care not fully covered by Medicare.
Contact The Connecticut Hospice, 203-315-7500 ext. 540 to make sure you understand what your responsibilities are with regard to payment.
Unlike many medical treatments which vary in cost according to location or hospital system, the Medicare reimbursement for hospice care is fixed at a daily rate, regardless of the complexity of the care involved in assuring the patient's comfort. There are four hospice reimbursement rates, and they are linked to what are called the "four levels of care": routine home care, general inpatient care, respite care, and continuous care. For additional information about Medicare and Medicaid and the hospice benefit, please visit Medicare/Medicaid (http://medicare.gov/coverage/hospice-and-respite-care.html).
Most commercial insurers, such as those offered through an employer, also offer a hospice benefit. Because insurance plans vary, it is important to speak with your insurance provider (and supplemental insurance provider) as well as The Connecticut Hospice to fully understand your financial obligations.
Some palliative care or hospice patients are self-pay. While this is unusual, it may happen that private insurance coverage is inadequate, and they do not qualify for federal insurance programs. Rather than wait, the patient or family may choose to pay for some or all services directly. There are set fees for all services. Interest free payment plans can be arranged.
There may be special circumstances where The Connecticut Hospice patients and families need financial assistance. Circumstances such as:
A Social Worker is available to conduct a financial assessment and help answer questions regarding your options. For an appointment call: 203-315-7500 ext. 692. You and/or your family will be asked to provide documentation of financial need.
In order to cover unreimbursed services and continue serving patients regardless of ability to pay, The Connecticut Hospice relies on memorial gifts, private donations, community support and grants. We sincerely appreciate all gifts and pledge to use all donated funds in service to our patients and our communities.