PruittHealth Resource Center

Resource Center

Medicaid And Hospice Care

What does Hospice cover?
Hospice will cover all hospice related charges. Charges not covered by Hospice will be paid for by another payor source.

Do I have to apply for Medicaid if my family member is admitted to the skilled nursing facility as a Hospice patient?
If the Hospice patient is a new admit to the skilled nursing facility then a Medicaid application will have to be completed and sent to DFACS. The Medicaid approval process will be the same as if the patient was coming into the skilled nursing facility as a Medicaid patient.

What happens if my family member does not get approved for Medicaid?
The payor source will be changed from Hospice to Private Pay Hospice and the patient/responsible party will be billed accordingly from date of admission.

How much will the Hospice patient have to pay if approved for Medicaid?
If approved for Medicaid, the Hospice patient will own the liability portion as determined by DFACS. This amount will be clearly stated on the Summary Notification Letter.

Who should be referred for Hospice Care?
When the hospice movement in the United States began nearly 30 years ago, it was viewed primarily as care for end-stage cancer patients. But the types of illnesses in patients served by hospice have evolved over the years along with the criteria for admission to our program.

Today, slightly fewer than half of our patients do have cancer, but we care for and have expertise in the care of patients with many life-limiting illnesses and conditions. In addition to cancer, this list includes:
  • AIDS
  • Alzheimer’s Disease
  • ALS, also known as “Lou Gehrig’s Disease”
  • Cardiomyopahty
  • Congestive Heart Failure
  • Chronic Obstructive Pulmonary Disease
  • Emphysema
  • Heart Disease
  • Liver Disease
  • Stroke
  • Renal or respiratory/pulmonary disease (end stage)
Sometimes in the last months of life, people may simply lose weight and become weaker. Adult Failure to Thrive and Dementia are acceptable hospice diagnoses.

What Makes Hospice Special?
Hospice concentrates on care - not cure. The patient’s physical and emotional comfort is the most important goal of the hospice team. Patients are encouraged to maintain their quality of life, and to be as active and to do as much as possible for themselves, for as long as they are able.
  • Hospice treats the whole family. When someone has a terminal illness, his or her loved ones feel pain too.
  • Hospice can provide relief to exhausted and emotionally stressed caregivers.
  • Whenever possible, care is provided in the comfortable surroundings of home. Being at home with the people one cherishes is truly the best gift you can give to a loved one.
  • Hospice staff visit regularly and are accessible to answer questions and provide support.
  • Hospice helps prepare family and friends for the loss of a loved one, and helps them deal with their grief through counseling and bereavement support groups.​
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