Medicare, Medicaid, managed care programs and in some instances commercial insurance programs provide coverage for hospice care.
Medicare
Most of our patients are eligible for Medicare coverage. Odyssey accepts the Medicare hospice benefit payment for 100 percent of a patient’s hospice care, that is, hospice services are fully reimbursable by Medicare. Odyssey requires no patient co-payments for our services. In states that offer Medicaid hospice benefits, Odyssey also accepts the Medicaid benefit as complete payment for our services.
Medicare Eligibility
Patients are eligible for Medicare hospice benefits if:
- they are eligible for Medicare Part
A (also called the hospital insurance portion of Medicare),
- the patient’s doctor and Odyssey’s
medical director certify the patient is terminally ill,
- the patient chooses to end
treatments aimed at attempting to cure the disease or condition and
elects treatment that eases pain and discomfort,
- and a Medicare-certified hospice
program, such as Odyssey HealthCare, provides the care.
Under the Medicare Hospice benefit, beneficiaries elect to receive what is called palliative treatment - treatment that helps ease pain and discomforting symptoms, rather than trying to cure a disease. By accepting the hospice benefit of Medicare, the patient waives Medicare coverage for treatment of the terminal illness. However, the patient may continue to access standard Medicare benefits for treatment of conditions unrelated to the terminal illness.
What does Medicare cover?
Hospice benefits, which are paid in total by Medicare, include:
- Doctor services related to the
terminal illness
- Regular home care visits by a
nurse
- Visits by a home healthcare aide
for such services as dressing and bathing
- Chaplain services for the patient
and the family, if desired
- Social work and counseling
services
- Bereavement counseling
- Medical equipment such as a
hospital bed, wheelchair, or walker
- Medical supplies such as bandages
or catheter
- Drugs to control symptoms and
relieve pain
- Physical, speech and occupational
therapy
- Dietary counseling
- Short-term hospital care, including
respite care for caregivers
Odyssey’s hospice services are available to patients at their own home or in nursing homes, hospitals, or other long-term care or assisted living facilities. In some cities, Odyssey also has freestanding in-patient hospice facilities. The Medicare benefit for hospice care does not cover expenses for room and board at nursing homes or long-term care and assisted living facilities. Medicaid and some personal insurance plans, however, cover these room and board expenses.
For patient evaluation, referrals or inquiries and the location of Odyssey’s hospices, please visit our Odyssey Locations page.
Medicaid
In states that offer a Medicaid Hospice benefit, Odyssey accepts that benefit for 100 percent of the charges associated with our services. The services provided by Odyssey under the Medicaid Hospice benefit are the same as those provided under Medicare. For patient evaluation, referrals and inquiries and the location of Odyssey’s hospices, please visit our Odyssey Locations page.
Managed Care/HMO
Odyssey will work with you to maximize any hospice benefits available. Managed care organizations must allow patients or their families to choose from all Medicare-certified hospices, such as Odyssey. For patient evaluation, referrals and inquiries and the location of Odyssey’s hospices, please visit our Odyssey Locations page.
Private Insurance
Odyssey will work with you to maximize any hospice benefits available under your private insurance coverage. For patient evaluation, referrals and inquiries, please visit our Odyssey Locations page.
Medigap
Patients in the Original Medicare program may have a Medicare Supplemental Insurance or Medigap policy. Medigap will assist in covering the treatment and care costs of health problems not related to a patient’s terminal illness.
