What will the patient/family have to pay for?
The answer will depend on whether the patient is covered under the Medicare
Hospice Benefit, insurance, private pay or charity.
Under the Medicare Hospice
Benefit, the patient most likely will not be held financially responsible for:
- Drugs/medicine that are related to the terminal illness
- Medical equipment that the hospice approves or orders
- Medical supplies that the hospice approves or orders
- Periodic visits by hospice staff - scheduled according to your plan of
care and
need
- Hospitalization, if determined by the hospice team to be necessary for symptom
control not possible at home and if it takes place at a hospital with which
Adventist Health/Hospice has a contract.
Under the Medicare Hospice Benefit, the patient will be held financially
responsible for:
- Drugs that are not related to the terminal illness, e.g., blood pressure
medication, thyroid pills, etc.
- Private duty aides or caregivers
Under Insurance, almost every policy is different. It is important for you and hospice to
work together to find out what your insurance policy will cover. If you are not
comfortable with your understanding of this important issue, call the Hospice
office at 503-251-6192.
- The patient may have to pay a yearly deductible amount
- The patient may also have a "co-payment" which means
that he/she has to pay a certain percentage of the bill (usually 5-25%) that the
insurance will not pay
- Medical equipment, supplies, hospitalizations, medications may or may not
be covered
Under Private Pay, the patient will be held financially responsible for:
- Services, supplies or treatments not related to Hospice diagnosis or on the plan
of care
- Any service, supplies or treatments not authorized by Hospice team or on the
plan of care
Under Charity Care, the patient will not have to pay for:
- Hospice billing office will issue a monthly statement of charges to
private pay patients and a statement of services provided to charity patients
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What if something happens at night?
This is perhaps one of the most worrisome fears of many patients and their
families. Adventist Health/Hospice has a nurse on call 24 hours a day, 7
days a week for this very reason. You can feel free at any time to call Hospice
at 503-251-6192. The phone will be answered by an operator and you
will receive a call from the nurse within 10 minutes. If he/she is unable to
help you over the phone, a nurse will come to your home.
We do not recommend that the paramedics be called. Once they are involved, they
often feel forced to take the patient to a hospital or give more treatment than
the patient or family wishes. (Also, the cost is not covered under the Medicare
Hospice Benefit.) Always call Hospice first!
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Can our doctor continue to care for the patient?
Yes! The hospice staff firmly believes that the patient's physician should
continue to be involved with the hospice patient. Visits can be made either in
the doctor's office or by a home visit. Charges for such visits should be
processed in the normal way. That is, the doctor should send his/her bill
directly to Medicare or insurance. Hospice does not handle these visits and
will not cover fees incurred by such visits. In some instances, Medicare or
insurance denies coverage for these visits and so we recommend checking with
them regarding coverage before scheduling any such visits.
The Medicare Hospice Benefit will provide a visit by the Hospice Medical
Director, if needed, in the absence of the attending physician, in lieu of the
attending physician or upon staff or family request. Our Medical Directors are
actively involved in your Hospice Plan of Care to assure the highest quality of
care is given to you.
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Can we try any further treatments if offered?
Of course. There may be some complications, however. Under Medicare, some
treatments are considered "curative" and disqualify a patient from being covered
under the Medicare Hospice Benefit. While we support the patient's right to seek
whatever treatment he/she wishes, we will most likely have to discharge the
patient during the time that such treatments are taking place in order to
conform to Medicare law. The patient could then re-enter the hospice after such
treatments were completed. This is another very complicated area, and we suggest
that if you have a specific question you call Hospice and talk to one of the
staff about it.
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Who orders supplies or drugs?
Only a physician can order drugs, so Hospice works closely with your doctor to
keep him/her informed about the patient's condition. The hospice nurse is
allowed to call a physician's order into a pharmacy. Upon admission, the Intake
Nurse will assess the need for supplies and will order them. From that
point on your Nurse Case Manager will monitor supply usage and will place orders
for re-fills and new supplies as needed.
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Who delivers or picks up the drugs?
Our Hospice team has a courier available when the patient or family is unable to
leave the patient alone; basically the family is responsible, just as they were
prior to being admitted to hospice.
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Can I use any pharmacy I want?
If the patient is covered by Medicare, Hospice is responsible for paying for
many of the symptom control drugs that may be needed. We have a contract with
Adventist Medical Center Pharmacy. They will send bills for covered
drugs directly to Hospice, and may be able to have our courier deliver the
medication to you. If the patient's hospice care is covered by an insurance
policy that includes pharmaceuticals, bills for medication should be processed
the same way as was handled prior to hospice services. All other medications,
not covered by Hospice will be obtained just as before.
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What do we do at the time of death?
Call Hospice at 503-251-6192. A hospice
nurse will assist you. It is often even more helpful to call when you think
death is approaching.
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Who will contact the funeral home?
The hospice nurse usually contacts the funeral home to make arrangements with
the funeral home.
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What about the coroner?
By law, any death that takes place at home must be reported to the county
coroner. This is usually done by the hospice nurse who has a good working
relationship with the various coroners in our area. The family is rarely
inconvenienced by this request.
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When and where do we get the death certificate?
The death certificate is issued by the county. Usually the funeral home will
arrange to get the information needed for the certificate and will file it with
the appropriate government offices. The funeral home will usually arrange to get
you as many copies of the certificate as you need.
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Who will arrange to get equipment picked up after a death?
The hospice staff will make the necessary calls for any equipment that the
hospice ordered. Arranging for equipment owned by the family is the family's
responsibility, but the hospice staff will be happy to assist when possible.
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What about memorials?
The income received as memorials plays a vital role in Hospice's well-being. We
appreciate a mention in obituaries, and as a consideration for memorials in lieu
of flowers. Any individuals sending memorials will receive a thank you from Hospice.
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SE Market St, Portland, OR 97216
503-257-2500
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