Both Medicare and Medicaid have a hospice benefit. Medicare and Medicaid together pay for more than 90 percent of all hospice care provided in Michigan. Hospice care is also fully reimbursed by many other types of health plans, including health maintenance organizations (HMOs), preferred provider organizations (PPOs), Blue Cross & Blue Shield of Michigan, and other private insurance plans. If you have insurance other than Medicare (Part A) or Medicaid, your hospice program will help you determine your coverage by contacting your insurance company for you.

Eligibility for hospice care is described well in the regulations that were developed for the hospice Medicare benefit. Many of the rules that apply for Medicare coverage also apply for Medicaid and various private insurance plans.

Generally, hospice care insurance pays for everything related to the terminal illness. Since it is the hospice philosophy to provide access to all who choose this type of care, regardless of ability to pay, most hospice programs also provide care for those who have no source of hospice benefit coverage. Most hospice programs conduct fund-raising events in their communities to help support free care.

Both Medicare and Medicaid regulations require the hospice program to provide everything needed for care until death comes. The services are comprehensive and include the cost of the many staff members who are involved in the patient's care, medications and drug therapies, medical equipment, and other services. The following services are paid by both Medicare and Medicaid for hospice patients in Michigan:

• Physician services (both the hospice medical director and the patient's own physician for services related to the terminal illness).
• Nursing care.
• Medical equipment (designed to providing comfort to the patient).
• Medical supplies.
• Outpatient drugs for symptom management and pain relief.
• Short-term inpatient care, including hospitalization if needed, and respite care.
• Home health aide and homemaker services.
• Physical, occupational, and other therapies.
• Medical social services.
• Spiritual counseling.
• Bereavement programs.
• Services by trained volunteers.
• Dietary and other counseling.
• Care of the body after death.
• Counseling.

Most health plans offer services that are similar to those provided under Medicare. However, individuals in need of care who are covered by a private plan are advised to check that plan for exact coverage.

The means of payment for hospice is taken care of during the admission process, when the patient chooses hospice care. To ease both the patient and family's concerns, the hospice admissions staff and social workers try to ensure that payment issues are handled in a quick and uncomplicated manner. The hospice philosophy is that payment for services should not be a concern at this time of life.