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Community Hospice Care

How are services paid for?

Insurance typically covers the cost: Community Hospice care is covered through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private health insurance plans. In fact, over 83% of people enrolled in a program of care from Community Hospice have their services paid for through Medicare.

Coverage for those unable to pay: As a nonprofit organization, Community Hospice is committed to improving the end-of-life experience for everyone in Northeast Florida. Through Community Hospice Foundation, we receive generous contributions from supporters throughout the community that allows us to care for those who are unable to pay.

More on the Medicare Hospice Benefit: Every person over 65 enrolled in Medicare has essentially "paid" for hospice services throughout their working life through Medicare payroll deductions. There are typically no additional costs. As a result, the financial burdens that can be associated with caring for a terminally ill patient are eliminated.

The Medicare Hospice Benefit is for all patients with the Medicare Part A benefit and a life expectancy of six months or less if the terminal illness or disease runs its normal course. The patient, of course, must choose to elect hospice and the patient's eligibility must be certified by a physician (most often the patient's personal physician or a referring physician from the hospital). Hospice care can be extended beyond the six-month period when re-certified by a doctor.

The Medicare Hospice Benefit covers costs related to the terminal illness, including the services of the Community Hospice team, medications, medical equipment and supplies. Recognizing that patients sometimes need a higher level of medical attention, the Medicare Hospice Benefit reimburses for each of the four different categories of care. Covered services include:

• Physician services
• Nursing care
• Emotional and spiritual support from social service professionals and chaplains
• Personal care services provided by certified nursing assistants
• Medications for pain relief and symptom control
• Medical equipment (like beds, wheelchairs, walkers)
• Medical supplies (like bandages and catheters)
• Routine home care in the comfort of your own home
• Short-term inpatient care in one of our facilities or a hospice contracted hospital
• Continuous home care when needed to manage a patient's medical crisis
• Respite care through a long-term care facility to provide rest and comfort to the primary caregiver
• Bereavement support for up to 13 months following the patient's death
• Ambulance transport

What you might expect to pay out-of-pocket: While there are typically few, if any, out-of-pocket costs for most Community Hospice patients, some instances where the patient is responsible for costs associated with their care are as follows:

• All co-payments and/or deductibles assessed through their private insurance plans.
• All medications not related to the life-limiting illness and not covered by Medicare, Medicaid or some other insurance plan.
• Any treatments or services related to the life-limiting illness but received without the approval of hospice or outside the hospice care plan.
• Room and board at the Hadlow Center of $165.00 a day for residential patients. This is not covered by the Medicare Hospice Benefit.
• Room and board in a long-term care facility if the patient is not Medicaid eligible.
• For those patients in a long-term care facility under the Institutional Care Medicaid Program, he or she will be responsible for continuing to pay the client's responsibility. The amount is assessed by the Department of Children and Families (DCF) based on the patient's income.

Find out more:

• Detailed information on the Medicare and Medicaid Hospice Benefits sites.
• For other insurance coverage, please contact your health insurance provider for information on specific hospice services covered and any costs for which you may be responsible.
• At any time, you can call Community Hospice at 904.268.5200 (800.274.6614 toll-free) and we can assist you in better understanding your coverage options. Our goal is to ensure that no one is denied hospice care due to an inability to pay.

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More in this section:

• What kind of care and support does Community Hospice provide?
• What services are offered and what are the benefits of receiving this type of care?
• What are the options for where I can live when receiving care?
• What are the different categories of care that are provided?
• Who makes up the team of Community Hospice caregivers?
• Who is eligible for care and when should we involve Community Hospice?
• How are services paid for?
• What are some of the misconceptions about hospice care that I should understand?
• How do I sign up for Community Hospice care?

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Call 904.268.5200 for general information or 904.596.6500 for referral and admissions information.
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