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The Hospice Benefit covers 100% of Reasonable and Customary Charges for the services outlined in the following chart up to a lifetime maximum shown in the Schedule of Benefits.

To be eligible for hospice benefits, the hospice care must be rendered as part of a Hospice Care Program by a licensed Hospice Care Agency. Before a covered individual enrolls in a Hospice Care Program, they should contact the Fund Office to verify that services will be covered under this benefit.

Schedule of Benefits for Hospice Services

Home Hospice Care - Allows patient to receive care in his or her own home.

Services and equipment covered at 100% include:

  • Physician services,
     
  • Physical, respiratory and occupational therapies,
     
  • Drugs, medications and medical supplies when provided under the Hospice Care Program through Hospice Care Agency,
     
  • Private duty nursing services by a Registered Nurse or Licensed Practical Nurse, if certified by a Physician,
     
  • Rental of Durable Medical Equipment (DME), as described in Appendix A, and
     
  • Oxygen and rental of related equipment.

Outpatient Hospice Care – Care that you receive in a licensed medical facility. After you receive treatment, you return to your home.

Services covered at 100% include:

  • Physician services,
     
  • Laboratory, x-ray and diagnostic testing, and
     
  • Ambulance service or alternative types of transportation.

Inpatient Hospice Care – Care received while you are an admitted patient in a Hospital or Hospice facility.

Services covered at 100% include:

  • Room and board for you which may include overnight accompaniment by family,
     
  • Nursing services,
     
  • All other related Hospital expenses,
     
  • Physician services, and
     
  • Ambulance service or alternative types of transportation.
 

Other Services – In addition to the services outlined above, certain other services for you and your family are also covered.

Services covered at 100% include:

  • Visits by a licensed social worker to evaluate the social, psychological and family problems related to the terminal illness. In addition, this professional will help develop a plan to assist in resolving these problems;
     
  • Emotional support services to help relieve stress, cope with the anticipated loss, complete unfinished family business and maintain the patient in the most appropriate environment;
     
  • Special incidental services for the patient, such as special dietary requirements, transportation between home and other sites of care; and
     
  • Bereavement counseling for the immediate family following the death of the Hospice patient. (Coverage is limited to six visits.)