Hospice care
Hospice care is a community-centered, patient- and family-focused, cost-effective way of caring for a terminally ill patient at home or in a home-like setting. Hospice care focuses on pain control and symptom management and emphasizes comfort measures and counseling to provide support to the dying patient and his or her family.
Hospice care is provided by a team of professionals and trained volunteers who are experienced in caring for a person whose illness cannot be cured. The team brings together physicians, nurses, social workers, chaplains, and volunteers to help ensure complete care for the patient and family.
Who is eligible to receive this benefit?
Any person who is covered by the Trust group health plan is eligible to receive hospice care benefits provided that:
- We have authorized hospice care services in advance.
- A physician has verified that the patient is terminally ill.
- The patient has chosen to seek palliative care rather than curative care.
- The provider is licensed by the State of Wisconsin to be a hospice provider. We’ll cover out-of-state hospice providers, but they must provide us with written proof of hospice licensure in the state in which they are operating.
What hospice services will be preauthorized?
Depending on the patient’s specific circumstances, we may preauthorize hospice services:
- Provided in the patient’s home.
- Rendered at a free-standing hospice facility.
- Delivered in a hospital facility when the patient needs acute care.
- Provided in a skilled nursing facility. In this case, we limit our reimbursement to the hospice per diem rate.
The following are some of the services included in our hospice per diem rate:
- Room and board at a hospice facility.
- Services to relieve pain and other symptoms.
- Therapy services.
- Rental of necessary durable medical equipment, including oxygen.
- Services of a medical social worker.
- Counseling services (pastoral, bereavement, or other).
- Medical appliances and supplies.
- Physician and nursing care.
- Home health care services.
- Prescription and nonprescription medications provided by the hospice care agency, organization, or facility.
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