Frequently Asked Questions

Hospice care is a type of care that focuses on the quality of life for individuals who are experiencing advanced illness. Its goal is to provide comfort and support for the patient and their family, rather than a cure for the illness.

Hospice care is available to individuals who have been diagnosed with a life-limiting illness and have a life expectancy of six months or less. This includes individuals with cancer, heart disease, lung disease, and other terminal illnesses.

Hospice care provides a range of services, including pain and symptom management, emotional and spiritual support, medication management, medical equipment and supplies, and bereavement support for the patient and their family.

In California, hospice services are typically covered by Medicare, Medi-Cal (California's Medicaid program), and private insurance companies. Here's a breakdown of the main sources of payment for hospice services in California:

1. Medicare: Medicare Part A covers hospice care for beneficiaries who meet the eligibility criteria. To qualify for Medicare hospice coverage, a person must be entitled to Medicare Part A and be certified by a physician as having a life-limiting illness with a life expectancy of six months or less. Medicare covers a range of hospice services, including nursing care, medical supplies, medications related to the terminal illness, counseling, and respite care.
2. Medi-Cal: Medi-Cal provides coverage for hospice services to eligible low-income residents in California. Like Medicare, the individual must meet certain eligibility criteria related to the terminal illness and life expectancy.
3. Private Insurance: Many private insurance plans also offer coverage for hospice care. The extent of coverage and specific requirements may vary depending on the insurance provider and policy. It's essential to check with the insurance company to understand the terms and conditions related to hospice coverage.
4. Medicaid Managed Care Plans: Some individuals may receive their Medi-Cal benefits through managed care plans, which may also provide hospice coverage.
5. Veterans' Administration: For veterans, the Veterans' Administration (VA) may cover hospice services for those who are eligible and enrolled in VA healthcare.
6. Private Pay: If an individual does not qualify for government assistance or does not have private insurance coverage, they may have to pay for hospice services out of pocket. However, many hospice providers have sliding fee scales or other financial assistance programs to help those without sufficient resources.

1. Research Local Hospices: Start by researching hospices in your area. Look for hospices that are certified and accredited by recognized organizations, such as The Joint Commission or the National Hospice and Palliative Care Organization (NHPCO).
2. Check Reviews and Recommendations: Read online reviews and seek recommendations from healthcare professionals, friends, or family members who have experience with hospice care. Personal experiences can offer valuable insights into the quality of care provided by different hospice agencies.
3. Evaluate Services Offered: Make sure the hospice provides the specific services your loved one needs. Hospice care typically includes medical, nursing, emotional, and spiritual support. Confirm that the hospice offers a comprehensive care plan tailored to the patient's unique needs.
4. Assess Staff Expertise: Hospice care requires a multidisciplinary team, including doctors, nurses, social workers, chaplains, and volunteers. Inquire about the qualifications and experience of the staff to ensure they can provide the level of care required.
5. Consider Location: The location of the hospice is essential for ease of access and family visits. Choose a hospice that is convenient for you and your family members.
6. Review Medicare Certification: If your loved one is on Medicare, ensure that the hospice is Medicare-certified. This certification is essential for Medicare to cover hospice services.
7. Compare Quality Ratings: Check the hospice's quality ratings on the Centers for Medicare & Medicaid Services (CMS) Hospice Compare website. This can give you an idea of how well the hospice performs in various quality measures.
8. Visit the Hospice: Arrange a visit to the hospice facilities if possible. This will give you an opportunity to see the environment, meet the staff, and ask any questions you may have about their services.
9. Assess Communication and Support: Pay attention to how the hospice communicates with you and your family. A good hospice should be transparent, supportive, and responsive to your needs and concerns.
10. Discuss Financial Matters: Clarify the hospice's billing and payment policies. Ensure you understand the costs involved and how they will be covered, whether through Medicare, private insurance, or other means.
11. Trust Your Instincts: Ultimately, trust your gut feeling about the hospice. Choose a hospice that makes you feel comfortable and confident in the care they will provide.

Remember that the correct hospice choice can significantly impact the quality of life of your loved one during this sensitive time. Take your time to research and ask questions before making your decision. If possible, involve the patient and other family members in the decision-making process to ensure their preferences and needs are considered.