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Benefits by Service: Hospice Care (October 2006) Definition/Notes
 
 
 
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Note: Totals include 50 states and D.C. "Benefits Covered" Totals "Benefits Not Covered" Totals
Is the benefit covered? 48 3
          Is there a co-payment requirement?
Yes: 0 No: 48




Alabama
Yes Yes Prospective rates based on Medicare methodology CN
Alaska
Yes Yes 210 days unless additional days certified by physician Prospective rates based on Medicare methodology CN
Arizona
Yes Coverage limited to ALTCS members - see state-specific FN Prospective rates based on Medicare methodology CN & MN
Arkansas
Yes Two 90-day periods with additional 60-day periods as necessary Prospective rate using Medicare wage index CN & MN
California
Yes Yes Services must generally comply with Medicare guidelines Prospective rates based on Medicare methodology CN & MN
Colorado
Yes Prospective rates based on Medicare methodology CN
Connecticut
No
Delaware
Yes Prospective rates based on Medicare methodology CN
District of Columbia
Yes Two 90-day periods and one 30-day period with additional 30-day periods as necessary Prospective rates based on Medicare methodology CN & MN
Florida
Yes Prospective rates based on Medicare methodology CN & MN
Georgia
Yes Two 90-day periods and one 60-day period with additional periods as necessary Prospective rates based on Medicare methodology CN
Hawaii
Yes Yes 210 days unless additional days certified by physician Prospective payment based on Medicare methodology and rates CN & MN
Idaho
Yes Services limited to Enhanced Plan and to 8 months of care by Medicare certified hospices only with 5 respite days/month - See state-specific FN Prospective rates based on Medicare methodology CN
Illinois
Yes Prospective rates based on Medicare methodology CN & MN
Indiana
Yes Yes Prospective rates based on Medicare methodology CN
Iowa
Yes Prospective rates based on Medicare methodology CN & MN
Kansas
Yes Prospective rates based on Medicare methodology CN & MN
Kentucky
Yes Limited to non-institutional care, two 90-day periods and one 30-day period with additional periods as necessary Prospective rates based on Medicare methodology A, B, C & D - See state-specific FN
Louisiana
Yes Two 90-day periods with additional 60-day periods as necessary Prospective rates based on Medicare methodology CN & MN
Maine
Yes Two 90-day periods and additional 60-day periods as necessary Prospective per diem or hourly rates based on Medicare methodology CN & MN
Maryland
Yes Two 90-day periods and one 30-day period with additional periods as necessary Prospective rates based on Medicare methodology CN & MN
Massachusetts
Yes Prospective rates based on Medicare methodology CN & MN
Michigan
Yes Prospective rates based on Medicare methodology CN & MN
Minnesota
Yes Two 90-day periods with additional 60-day periods as necessary Prospective rates based on Medicare methodology A & B - See state-specific FN
Mississippi
Yes Two 90-day periods with additional 60-day periods as necessary Prospective rates based on Medicare methodology CN
Missouri
Yes Two 90-day periods and one 30-day period with additional periods as necessary Prospective rates based on Medicare methodology CN & MN
Montana
Yes Prospective rates based on Medicare methodology A & B - See state-specific FN
Nebraska
Yes Initiation of care Prospective rates based on Medicare methodology CN & MN
Nevada
Yes Prospective rates based on Medicare methodology CN
New Hampshire
No
New Jersey
Yes Two 90-day periods and one 30-day period with additional periods as necessary, 24 therapeutic leave days per year Prospective rates based on Medicare methodology CN
New Mexico
Yes Yes Prospective rates based on Medicare methodology CN
New York
Yes Prospective rates based on Medicare methodology CN & MN
North Carolina
Yes Care must be elected for initial and ongoing periods Prospective rates based on Medicare methodology CN & MN
North Dakota
Yes Prospective rates based on Medicare methodology CN & MN
Ohio
Yes All-inclusive rate per day for applicable level of care CN
Oklahoma
No
Oregon
Yes Prospective rates based on Medicare methodology A & B - See state-specific FN
Pennsylvania
Yes Prospective rates based on Medicare methodology CN & MN
Rhode Island
Yes 210 day maximum coverage Prospective rates based on Medicare methodology CN & MN - see state-specific FN
South Carolina
Yes Two 90-day periods and one 30-day period with additional periods as necessary Prospective rates based on Medicare methodology CN
South Dakota
Yes Beneficiary must make an election statement Prospective rates based on Medicare methodology CN
Tennessee
Yes A & B - See state-specific FN
Texas
Yes One 6-month period with additional periods as necessary Prospective rates based on Medicare methodology CN
Utah
Yes B - respite care and services for convenience of beneficiary or family not covered Prospective rates based on Medicare methodology A, B & C - See state-specific FN
Vermont
Yes Prospective rates based on Medicare methodology A & B - See state-specific FN
Virginia
Yes Yes Prospective rates based on Medicare methodology CN & MN
Washington
Yes Prospective rates based on Medicare methodology, rates vary geographically CN & MN
West Virginia
Yes Prospective rates based on Medicare methodology CN & MN
Wisconsin
Yes Prospective rates based on Medicare methodology CN & MN
Wyoming
Yes Prospective rates based on Medicare methodology CN
American Samoa
No
Guam
No
Northern Mariana Islands
No
Puerto Rico
No - see territory-specific FN
Virgin Islands
No



Definition/Notes: Link to Hospice Care Footnote

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