Hospice Care: Arranging For Hospice Care

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Arranging for Hospice Care

Once you have decided to pursue hospice care, you will need to:

1. Complete documents to determine your eligibility and insurance coverage and to outline your treatment preferences. These documents include:
   • Health care agent or medical power of attorney. For more information, see the topic Choosing a Health Care Agent.
   • Living will. For more information, see the topic Writing an Advance Directive.
   • Insurance forms. Hospice services are covered by Medicare, by Medicaid in most states, and by many private insurance plans. If you plan to receive Medicare hospice benefits, you and your doctor will need to complete forms. Check with your employer or your health insurance plan for information about what services your plan covers. Many hospices will also help people who cannot pay by applying for money from other sources.
   • Legal documents related to finances, property, and other matters.
2. Decide what kinds of hospice services you want.
   • Each hospice program has its own guidelines and admission rules, such as whether the program will provide artificial (tube or IV) nutrition and fluids. Ask about the guidelines for the programs in your area and how flexible they may be: For example, if they don't provide a particular service, will they work with another provider who does? You need to be clear about what you want before entering a hospice program. Use a checklist (What is a PDF document?) to record what is important to you in a hospice program.
   • All hospice programs should provide written materials that describe their services, including who provides the services; who is eligible; costs and payment processes; and the program's insurance and liability information. Ask for this information, and read it carefully.
3. Identify hospice programs in your area. People and organizations that can help you find hospice programs in your area include:
   • Your doctor or hospital.
   • The medical social worker at your hospital or nursing home.
   • Your state or local agency on aging.
   • State health department.
   • Your insurance provider.
   • The phone book (look in the yellow pages under "home care" or "hospice").
   • Your state hospice organization.
   • National organizations such as the National Association for Home Care, the National Hospice and Palliative Care Organization, and the Hospice Association of America. For contact information, see the Other Places to Get Help section of this topic.
4. Choose a hospice program. Start by calling some of the programs in your area. Choose the program that best fits your needs by asking questions based on your checklist (What is a PDF document?).

After you have begun the hospice program, you will want to:

• Get all billing arrangements, including costs and payment arrangements, in writing, and keep a copy.
• Be sure that your family knows what services you are to receive from the program and the schedule.
• Be sure that everyone in your family knows the names and phone numbers of important contact people at the hospice. Post this information near your telephone.
• Ensure that your family will get the support they need after you die. Choose one person who will be responsible for notifying family and friends about support group meetings, bereavement counseling opportunities, and other services that the hospice program may provide after a loved one dies.

If you or a loved one has a disease such as emphysema or Alzheimer's disease that may be entering a terminal stage, hospice care can provide comfort and support. If a hospice program tells you that you or your loved one is not eligible, ask your doctor or case manager to help you find a hospice program that will accept and care for you or your loved one.

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Last updated:	March 14, 2006
Author:	Colleen Cronin
Reviewed By:	Adam Husney, MD - Family Medicine, Ira Byock, MD - Palliative Care
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman