How to Find the Best Hospice Provider?

Last Updated: October 19, 2020

Written by the Open Caregiving Team. Editorial review by Joyce O. Murphy RN, MSN.

Who pays for hospice care?

Best Bet: Medicare

Many hospice patients have their care covered by the Medicare Part A Hospice Benefit which covers 100% of home hospice care and services for eligible beneficiaries.

To be eligible for Medicare covered hospice care, your loved one must:

  • Be enrolled in Medicare Part A.
  • Have certification of terminal illness by a hospice physician and a primary physician.
  • Legally state that they are choosing palliative care for comfort instead of seeking more treatment.
  • Elect the hospice benefit with a specific hospice provider. Your family will be able to switch providers if needed.

For those who prefer hospice care in a facility or dedicated hospice center, Medicare will cover all hospice costs other than room and board. While hospice has no deductible, Medicare covered respite care for families of hospice patients has a 5% deductible.

Learn more about the Medicare Part A Hospice Benefit.

Medicaid

For those who are not eligible for Medicare Part A but are ready for hospice care, Medicaid offers a similar benefit that covers nearly all hospice costs. Even though eligibility differs by state, the general Medicaid rules follow the above Medicare requirements.

Unlike the Medicare Hospice Benefit, Medicaid will cover the cost of room and board if your loved one’s hospice care is in a Medicaid approved long-term-care facility like a nursing home.

Veterans Affairs

The VA covers 100% of hospice care costs for all veterans who are enrolled in VA Healthcare Benefits and meet the hospice eligibility requirements. To learn more about the VA Hospice Benefit visit their online Geriatrics and Extended Care center.

Private Insurance

Most private insurance programs provided by companies cover the full costs of hospice care as part of their benefits. Most follow similar eligibility and coverage requirements as Medicare. It’s best to call your private insurance provider to confirm the exact requirements and coverage.

Charity Hospice Care

Provides hospice to individuals who need hospice care but are not insured by Medicare, Medicaid or a private policy. Some hospice organizations offer free hospice care for patients with no other option. The funds to pay for charity hospice are provided by donations, community grants, or the hospice themselves.

How do I find the best hospice provider near me?

Some places to turn for hospice recommendations include:

  • Your loved one’s medical team including their physician or a hospital discharge planner.
  • The Centers for Medicare and Medicaid Services offer Hospice Compare to help you search for the hospice providers near you.
  • Your friends and family may recommend hospice providers based on their own experience.
  • Your religious community may recommend hospice providers that align with your religious belief.

Questions to ask when choosing a hospice provider

  1. Is the hospice Medicare-certified? Without a Medicare certification, Medicare will not pay for hospice care.
  2. Is the hospice for-profit or not-for-profit? For-profit doesn’t mean the quality of hospice care is reduced. Research the history of the hospice company to assure their mission aligns with the care for want for your loved one.
  3. How long has the hospice been a care provider? It is important to know the quality of the facility. One way to find out about this is to look into the hospice or management team’s years of experience. Then inquire if there is a sound track record.
  4. Is the hospice accredited by JCAHO or CHAP? Accreditation confirms that a hospice is committed to quality care and third-party approval of the care that is offered. It is best to do more research if you are looking at a hospice that is not accredited.
  5. State License/Survey: Is the hospice state licensed or have they been surveyed by the state in the last 5 years? What were the survey findings and have they corrected any issues?
  6. Management Team: Is the management team local and available for support? If they are not local, are they still available to talk with and address questions and concerns?
  7. Family Expectations: Every hospice will have different expectations in terms of family involvement. It is helpful to learn about these before committing to a specific hospice.
  8. Doctor/Nurse Certification: Are all or most of the doctors and nurses hospice-certified or palliative care-certified?
  9. 24/7 Emergency Medical Service: Is it actually 24/7 and how quickly do they respond?
  10. Costs: Are there any hospice costs not covered by insurance or Medicare? Are there any out of-pocket-expenses that the family should know about?
  11. Volunteers: What is the screening process and training for volunteers? What services do they typically help with?
  12. Additional Services: What additional services does the hospice offer and are there extra costs for these?
  13. Bereavement Services: What supportive services are offered for families before and after their loved one passes?
  14. Family Evaluation of Hospice Care: Many hospices will ask families to evaluate the hospice service after their loved one passes. Is the most recent data available?

In addition to the questions above, it can be informative to talk with families who have previously used the hospice providers you are considering. Ask each hospice provider for referrals or try to find them online.

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Related Topics To Learn About

What Is Hospice?

Hospice care allows people with terminal illnesses and their families to live as comfortably as possible during the last stages of life.

When to Consider Hospice?

In the past, hospice was viewed as care for the very last days of life. Recently more people have seen the benefits of beginning hospice care earlier rather than later.

How to Have End-of-Life Conversations?

Learn why end-of-life conversations matter. You’ll gain insights on how to proceed, whom to include, and steps for planning your loved one’s remaining time.

How to Prepare for Hospice?

Learn about changes you may need to make to your home, what to expect from the hospice team, and how you can be there for your loved one.

Respite Care

Respite care offers primary caregivers a temporary break from the demanding day to day of caring for a family member who is disabled, ill, or aging.