Understanding Hospice Eligibility
One of the most common questions families ask is: When is it time for hospice care? At Aspen Grove Hospice, we help you understand the eligibility guidelines so you can make the best decision for your loved one.
Hospice care is for individuals facing advanced illness who want comfort focused support rather than curative treatments. In most cases, eligibility is based on Medicare’s guidelines and a physician’s certification.
Medicare Hospice Eligibility Requirements
Medicare and most insurance plans cover hospice care when:
A physician certifies that the patient has a life expectancy of six months or less if the illness runs its normal course.
The focus of care shifts from cure to comfort, prioritizing quality of life and symptom management.
The patient and family choose hospice services instead of curative treatments.
Signs It May Be Time for Hospice
While every patient is unique, families often notice:
- Frequent hospital visits or emergency room trips
- Decline in physical ability (walking, eating, dressing, bathing)
- Significant weight loss or decreased appetite
- Increasing pain, shortness of breath, or need for medications
- Spending most of the day in bed or chair
- Withdrawal from social interaction
If you are noticing these changes, it may be time to discuss hospice care with your physician or our team.
Who Decides If Someone Is Eligible?
- Physician certification is required to begin hospice care. This can come from the patient’s primary doctor or a specialist.
- Our hospice team works closely with doctors to evaluate eligibility and create a personalized plan of care.
- Families can request an evaluation at any time to see if hospice may be appropriate.
Frequently Asked Questions
Is hospice only for the last days of life?
No. Hospice care can begin months earlier, giving families more time to receive comfort, support, and guidance.
Can eligibility change over time?
Yes. If a patient stabilizes or improves, hospice care can be paused. If needs increase again, hospice can resume.
Is hospice covered by Medicare?
Yes. Hospice care is 100% covered by Medicare, Medicaid, and most private insurance plans. This includes medications, equipment, supplies, and team support.
Can we request an eligibility evaluation directly?
Yes. Families do not need to wait for a doctor to suggest hospice. You can call Aspen Grove Hospice, and we’ll work with your physician to determine eligibility.
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Take the First Step Toward Comfort
If you’re unsure whether your loved one qualifies for hospice, let us guide you. Our team provides compassionate assessments and answers your questions clearly. Call us today at (720) 999-9854 to request a hospice eligibility evaluation in Aurora, Denver, and surrounding counties.