Who Pays for Hospice?

Why Pays for Hospice?

When Hospice of New York is on your side, you’re never alone, and you don’t have to shoulder the financial burden yourself either.. Financial coverage is available through the Hospice Medicare Benefit, managed care organizations and private insurance companies. Patients who qualify for and are approved for New York State Medicaid may have their care covered under this benefit. 

The Hospice Medicare Benefit covers all fees for the services of the Hospice team, plus the cost of all medications, medical equipment, ancillary therapies and supplies related to the symptom management of their hospice diagnosis.

There are no co-payments or deductibles and Hospice of New York bills Medicare directly for everything that is covered under the Medicare Hospice Benefit.

Hospice of New York is a preferred provider for most managed care organizations and insurance companies in New York.

Uninsured patients are provided comprehensive hospice services by Hospice of New York without discrimination.

Hospice of New York is a participating provider in the New York State Aids Drug Assistance Program (ADAP).
A Medicare beneficiary may elect to receive Hospice care for two 90-day benefit periods, followed by an undetermined number of 60-day benefit periods. The benefit periods may be used consecutively or at intervals. Regardless of whether the benefit periods are used consecutively or at different times, a Hospice Medical Director must certify the patient as appropriate for Hospice services at the beginning of each benefit period.

If a patient chooses Hospice services and later changes his or her mind, that patient can easily revoke the Hospice service election and resume care under the Standard Medicare Benefits. Hospice services may be re-elected at any time in the future with the required certification.

Benefit Payments

Medicare pays Hospice directly on a per diem basis at a specified daily rate depending on the level of care provided. Hospices are, in turn, responsible for paying all costs related to the terminal condition.

There are no co-payments, exclusions, add-on costs or denials and the patient will not receive a bill from Hospice. For questions or clarification about the Medicare Hospice Benefit, please call the Hospice office.
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