HOSPICE CARE SERVICES. The Plan provides Benefits for Hospice Care to Members diagnosed as having a terminal illness by a Provider with a life expectancy of less than twelve months. The Hospice plan of care will focus on palliative rather than curative treatment for the terminally ill Member. The care approach is holistic and interdisciplinary. Your Provider and hospice medical director must certify that you are terminally ill and likely have less than twelve months to live. Your Provider must agree to care by the hospice Provider and must be consulted in the development of the care plan. The hospice Provider must keep a written care plan and provide it to Health Options upon request.
HOSPICE CARE SERVICES. Services rendered by a Home Health Care Agency or a Hospital program for Hospice Care for which benefits are available as follows:
HOSPICE CARE SERVICES. See the Prior Authorization Amendment for Covered Services that may require prior authorization.
HOSPICE CARE SERVICES. See Section 15, Utilization Management, for Covered Services that require prior authorization.
HOSPICE CARE SERVICES. Hospice Care Services are for terminally ill Members. If a Plan Physician diagnoses you with a terminal illness and determines that your life expectancy is six (6) months or less, you can choose hospice Services through home or inpatient care instead of traditional Services otherwise provided for your illness. We cover Hospice Care Services in the home if a Plan Physician determines that it is feasible to maintain effective supervision and control of your care in your home. We cover Hospice Care Services within our Service Area and only when provided by a Plan Provider. Hospice Services include the following:
HOSPICE CARE SERVICES. For the purpose of this Benefit, "hospice care services" means the following items and services provided to a terminally ill Covered Person by, or by others under arrangement made by a Hospice Program under a written plan (for providing such care to such Covered Person) established and periodically reviewed by the Covered Person's attending Physician and by the Medical Director.
HOSPICE CARE SERVICES. If You become Terminally Ill and You receive care provided by a Hospice, We will pay:
HOSPICE CARE SERVICES. WHERE CAREFIRST BLUECHOICE PROVIDES MEMBER PAYS As an inpatient or outpatient of a Qualified Hospice Care Program. Coverage for the services listed below. The coverage is subject to the limitations, if any, listed below or stated in the Schedule of Benefits. Deductible, Copayments or Coinsurance, if any, required under the Member's coverage as stated in the Schedule of Benefits. HOSPICE CARE SERVICES MUST BE AUTHORIZED OR APPROVED BY CAREFIRST BLUECHOICE 5.1 Covered Hospice Care Services. Services are covered when provided by a Qualified Hospice Care Program. CareFirst BlueChoice will monitor the care for ongoing appropriateness. Benefits are provided for inpatient and outpatient care and include the following:
HOSPICE CARE SERVICES. Hospice benefits cover inpatient and outpatient services for patients certified by a Physician as terminally ill. Your Contract provides Covered Services for inpatient and outpatient Hospice care under certain conditions as stated in the Summary of Benefits and Coverage’s. The Hospice treatment program must: • Be recognized as an approved Hospice program by Alliant; • Include support services to help covered family members deal with the patient’s death; and • Be directed by a Physician and coordinated by an RN with a treatment plan that: o Provides an organized system of home care; o Uses a Hospice team; and o Has around-the-clock care available. The following conditions apply: • To qualify for Hospice care, the attending Physician must certify that the patient is not expected to live more than six months. • The Physician must design and recommend a Hospice Care Program; and • The Physician’s statement and recommended program should be Pre-Certified.
HOSPICE CARE SERVICES. The Plan provides Benefits for Hospice Care to Members diagnosed as hav ing a terminal illness by a Provider with a life expectancy of less than twelve months. The Hospice plan of care will focus on palliative rather than curative treatment for the terminally ill Member. The care approach is holistic and interdisciplinary. Yo ur Provider and hospice medical director must certify that you are terminally ill and likely have less than twelve months to live. Your Provider must agree to care by the hospice Provider and must be consulted in the development of the care plan. The hos pice Provider must keep a written care plan and provide it to Health Options upon request.
