Hospice Care & Eligibility

Who is eligible for hospice care?
The hospice benefit is available to anyone, of any age, who has made the decision to seek palliative (comfort) care rather than curative care. In order to be eligible to receive hospice services, a patient's physician or the hospice medical director must certify that the patient has a life-limiting illness with a prognosis of six months or less. This can be very difficult to predict, even for skilled medical professionals. There are times when a patient's condition stabilizes to the point where s/he may be discharged from hospice. Similarly, if a patient lives beyond the six-month prognosis, s/he can continue to receive hospice services as long as their doctor re-certifies that the patient is still terminally ill.

What other requirements are there for eligibility?
There are no further conditions or restrictions, beyond the stated eligibility requirements. Hospice By The Bay's services are available to patients of any age, race, national origin, religion, or sexual orientation. We believe there should be no barriers to high quality end-of-life care. Hospice By The Bay's patients retain control of their care and are encouraged to participate in making choices.

Who does Hospice By The Bay serve?

• Hospice care is available to persons diagnosed with a life limiting condition or illness whose physician estimates life expectancy to be six months or less and who choose comfort care rather than aggressive treatment for their illness.
• Residents of Marin, San Francisco, Northern San Mateo, and Sonoma counties.
• Grief and loss services are available to anyone who resides in communities Hospice By The Bay serves and who has suffered the loss of a loved one.

Where is care provided?
Hospice By The Bay provides care and support to patients living in many different situations. Many are in their own home, but a growing number reside in residential care facilities, retirement communities or skilled nursing facilities. We also provide care to patients in local hospitals.

How is the care paid for?

• Medicare Hospice Benefit: Medicare provides beneficiaries with a hospice benefit that covers most aspects of care, with little or no out-of-pocket expense to the patient or family. Medicare beneficiaries use Medicare Part A (Hospital Insurance) for hospice services.
• Medi-Cal Hospice Benefit: Medi-Cal offers a comparable, inclusive benefit to the Medicare Hospice Benefit, see above.
• Private Insurance, including Kaiser: Private insurance companies offer similar hospice benefits. A small co-payment for services may be required depending on the insurance provider. Upon referral, our Admissions Team will verify insurance benefits to determine what is covered.
• Underinsured or Uninsured: Supplemental funding from Hospice By The Bay Foundation allows Hospice By The Bay to provide services, regardless of one's ability to pay. This is made possible through the generous financial support of the communities we serve.