Hospice g. Individuals whose permanent residence and principal work location are outside the State of Minnesota and outside of the service areas of the health plans participating in Advantage. If these individuals use the plan administrator’s national preferred provider organization in their area, services will be covered at Benefit Level Two. If a national preferred provider is not available in their area, services will be covered at Benefit Level Two through any other provider available in their area. If the national preferred provider organization is available but not used, benefits will be paid at the POS level described in paragraph “i” below. All terms and conditions outlined in the Summary of Benefits will apply.
Hospice. A Provider which provides palliative and supportive care for terminally Ill or terminally Injured people. It must carry out its stated purpose under all relevant state and local laws, and it must either:
Hospice. Hospice care is not covered under the Hoosier Healthwise program; however, terminally ill members may qualify for hospice care under the fee-for-service Medicaid program once they are disenrolled from Hoosier Healthwise. The hospice provider can submit a hospice election form for the member to the IHCP Prior Authorization Unit. The IHCP Prior Authorization Unit will then initiate the disenrollment of the member from managed care and facilitate hospice coverage. The Contractor must coordinate care for its members that are transitioning into hospice by providing to an IHCP hospice provider any information required to complete the hospice election form for the Contractor’s terminally ill members desiring hospice, as described in the IHCP Hospice Provider Manual.
Hospice. Enrollees who elect to enroll in the Medicare Hospice program while enrolled in MSHO are not required to disenroll from the MCO’s MSHO product.
Hospice a Facility Provider, licensed by the state which, for compensation from its patients, is primarily engaged in providing palliative care to terminally ill individuals.
Hospice. Shall be defined as a coordinated plan of home and/or Inpatient Services, which treats a Terminally III patient and his or her family as a unit, focusing on providing comfort rather than on curing an illness. The plan provides Services to meet the special needs of the family unit during the final stages of a Terminal Illness and during bereavement. These services may include physical care, counseling, drugs, equipment and supplies for the terminal illness and related condition(s). Services are provided by a team made up of trained medical personnel, homemakers and counselors. The team acts under an independent hospice administration and helps the family unit cope with physical, psychological, spiritual, social and economic stress. Hospice is generally provided in the home, is not limited to people with cancer, and must be approved as meeting established standards, including but not limited to compliance with any licensing requirements of Guam, and the benefit period begins on the date the attending physician certifies that a covered member is terminally ill.
Hospice. A Provider which provides care for terminally ill patients and their families, either directly or on a consulting basis with the patient’s Physician. It must be licensed by the appropriate state agency. Hospice Care Program A coordinated, interdisciplinary program designed to meet the special physical, psychological, spiritual and social needs of the terminally ill Member and his or her covered family members, by providing palliative and supportive medical, nursing and other services through at- home or Inpatient care. The Hospice must be licensed by the appropriate state agency and must be funded as a Hospice as defined by those laws. It must provide a program of treatment for at least two unrelated individuals who have been medically diagnosed as having no reasonable prospect of cure for their illnesses. Hospital An institution licensed by the appropriate state agency, which is primarily engaged in providing diagnostic and therapeutic facilities on an Inpatient basis for the surgical and medical diagnosis, treatment and care of injured and sick persons by or under the supervision of a staff of Physicians duly licensed to practice medicine, and which continuously provides 24-hour-a-day nursing services by registered graduate nurses physically present and on duty. “Hospital” does not mean other than incidentally: • An extended care facility; nursing home; place for rest; facility for care of the aged; • A custodial or domiciliary institution which has as its primary purpose the furnishing of food, shelter, training or non-medical personal services; or • An institution for exceptional or disabled children. Identification Card The latest card given to You showing Your name, covered Dependents, Your ID numbers, the type of coverage You have the claim submission address, and phone numbers for Client Services, Prior Authorizations and Pharmacy Help Line. Incapacitated Dependent A Dependent in which the subscriber or the subscriber’s spouse is the court-appointed legal guardian; and the dependent is mentally or physically incapable of earning a living as determined by the Georgia Department of Human Resources, and the dependent is chiefly dependent upon the Subscriber for support and maintenance, provided that the onset of such incapacity occurred before the dependent was 26.
Hospice. The term "Hospice" means a facility that is licensed, accredited or approved by the proper authority to provide a Hospice Care Program and which admits individuals who have no reasonable prospect of a cure and have a life expectancy of six months or less.
Hospice. Enrollees who elect to enroll in the Hospice program while enrolled are not required to disenroll from the MCO’s SNBC SNP product.
Hospice. Hospice care is not covered under the Hoosier Healthwise program; however, terminally ill members may qualify for hospice care under the fee-for-service Medicaid program once they are disenrolled from Hoosier Healthwise. Hospice care is a special way of caring for people who are terminally ill, and for their family. This care includes physical care and counseling. Hospice care is covered under Hospital Insurance (see also: 42 CFR § 418.3). The hospice provider can submit a hospice election form for the member to the IHCP Prior Authorization Unit. The IHCP Prior Authorization Unit will then initiate the disenrollment of the member from managed care and facilitate hospice coverage. The Contractor must coordinate care for its members that are transitioning into hospice by providing to an IHCP hospice provider any information required to complete the hospice election form for the Contractor’s terminally ill members desiring hospice, as described in the IHCP Hospice Provider Manual.
