Electing & Revoking Hospice Care: Frequently Asked Questions (FAQ)
As a Hospice and Elder Law Attorney, I am often asked questions about hospice care and end-of-life planning. As a result, I decided to create a list of the most frequently asked questions (with answers) about hospice care when advising my clients. I hope you find this information helpful. Below, I have listed many of my clients’ frequently asked questions, along with my answers, which you may find helpful. Of course, if you have a different question or would like to meet, you can contact our office at (732) 863-9900 or email Fredrick P. Niemann, Esq. personally at fniemann@hnlawfirm.com. I am always available to discuss your questions in person, via video conference, or by phone.
In my practice, I have worked with thousands of hospice patients and their families over many years. Hospice can be a difficult subject, but it plays an important role in end-of-life planning. When I speak with clients and members of the public, I often explain that “hospice planning is my most effective asset protection planning,” and understanding how hospice works helps explain why.
Hospice is a structured plan of care focused on comfort, dignity, and support for individuals who are terminally ill. Most hospice care is provided in the patient’s home, a family member’s home, or in a nursing home. In New Jersey, hospice services may also be provided in hospice residences or hospital-based hospice units, depending on availability and the patient’s needs.
The concept of hospice dates back to the Middle Ages, when it referred to a waystation for travelers and the dying. Today, hospice care in the United States is most often designed to allow patients to remain at home whenever possible, surrounded by family during their final months and days.
How do I qualify for hospice care?
A patient will qualify for hospice care if two doctors sign a document stating that the patient is terminally ill and is expected to live less than six months. One of these doctors is the patient’s own physician; the other is the hospice medical director. This is the sole medical requirement for admission to hospice.
The patient must sign an election to receive hospice care, in which the patient says he or she is no longer seeking curative treatment and instead seeks care for comfort. Under appropriate circumstances, a legally appointed guardian or health care decision maker can elect hospice care if the patient is incapacitated.
Payment for hospice care can be made in many ways. About two-thirds of New Jersey hospice patients receive hospice care through Medicare Part A. Hospice may also be covered by Medicaid, private insurance, or private pay. A NJ hospice attorney can help you understand coverage options.
The importance of discussing death. I know it’s a tough subject.
One of the purposes of hospice care is to prepare the patient and family for the patient’s death. Another is to provide comfort and dignity at the end of life. Hospice staff are skilled at balancing those goals.
If I elect hospice, will I die soon?
To be admitted, two physicians must certify that a life expectancy of six months or less exists. However, some patients live well beyond this prognosis and may remain in hospice if recertified.
Can I still see my doctor for my terminal prognosis?
Yes, you may keep your doctor. Hospice will coordinate care with your physician.
Can I still see my doctors for my other diseases?
Yes. Let your hospice team know so care can be coordinated.
Can I choose to stop receiving hospice care? What if I change my mind about hospice?
Yes. You may revoke hospice at any time.
Hospice also has the right to discharge a patient. Some reasons might be that:
- The patient’s condition has stabilized
- The home environment is unsafe
- The patient moves outside the service area
- The patient refuses the plan of care
How do I pick the best hospice care provider?
Hospices are licensed by the State of New Jersey and certified by Medicare. Families should verify licensing and certification before enrolling.
If I don’t like my hospice agency, can I choose another?
Yes. Patients have the right to transfer hospice providers.
If I live longer than six months, can I still receive hospice care?
Yes. Patients may remain in hospice if they continue to meet eligibility requirements upon recertification.
I’m still walking – I can’t be eligible for hospice!
You can still qualify. There is no requirement that a patient be bedridden.
I don’t think I’m close enough to death. Am I ready for hospice?
Hospice is appropriate when a patient meets medical criteria and chooses comfort care over curative treatment.
When should I contact hospice?
It is best to contact hospice early in a serious illness to understand available services.
Can anyone who is elderly or in poor health receive hospice services?
Yes, as long as medical eligibility requirements are met.
Is hospice good for any kind of illness?
Hospice is available for many terminal illnesses, not just cancer.
Who will know I am receiving hospice care?
Hospice maintains confidentiality and shares information only with authorized individuals.
Will a nurse come every day?
Not usually. Visits depend on patient needs.
How many hours a day can I get from aides?
Aide services depend on the patient’s needs and the hospice assessment.
Why can’t the aide be here when I want her here?
Aide schedules are based on multiple patient needs and travel constraints.
Do family members need to be in the house 24/7?
No. Hospice provides respite and support options.
What is respite care?
Respite care provides temporary inpatient care to give family caregivers a break.
Do I have to use a hospital bed instead of my own?
No. Comfort decisions are patient-centered.
What happens if I suddenly get a lot of pain?
Contact hospice immediately for guidance and medication management.
What is a “pain kit”?
A pre-approved set of medications is kept in the home for symptom management.
Why won’t hospice pay for all my medications?
Hospice only covers medications related to the terminal illness, with limited copay requirements under Medicare rules.
Can you help me die – by giving me the “little black pill”?
No. Hospice provides comfort care and does not hasten death.
Won’t hospice give extra morphine to hasten death?
No. Hospice uses medications to relieve pain in accordance with accepted medical standards.
What if I want to travel?
Hospice care can be coordinated across locations with advanced planning.
If I need to go to the hospital, what happens?
Hospitalization for curative treatment may affect hospice eligibility and coverage.
What if I live alone?
Hospice evaluates whether a safe care environment exists.
Will somebody hold my hand when I die?
Hospice staff and family often provide companionship at the end of life.
Will the nurse come in the middle of the night?
Hospice provides on-call nursing support.
Will Hospice help me with funeral arrangements?
Yes, hospice staff can guide families through the planning process.
Hospice, Medicaid, and Insurance Coverage
Is hospice care covered by Medicare or Medicaid?
Yes. Hospice care is typically covered by Medicare Part A and is also available through New Jersey Medicaid and many private insurance plans.
What does Medicare hospice coverage include?
Medicare hospice benefits generally cover physician services related to hospice care, nursing care, medications for the terminal illness, medical equipment and supplies, and support services such as social work and counseling.
What is not covered by hospice benefits?
Hospice does not cover curative treatments intended to reverse the terminal illness. In addition, hospice generally does not cover room and board in a nursing home or assisted living facility unless Medicaid or another program provides that coverage.
Does Medicaid pay for hospice care and facility costs?
Yes. New Jersey Medicaid may cover hospice services and, in some cases, may also help cover room and board in a nursing home setting for eligible patients.
Are there any costs for hospice care?
Most patients pay little or nothing out of pocket. Medicare and Medicaid generally cover hospice services in full, although small copayments may apply for certain medications under federal guidelines (typically a small percentage or nominal copay).
Do I have to pay a deductible for hospice care?
No separate deductible is typically required for the Medicare hospice benefit once eligibility is established.
What if I have private insurance instead of Medicare or Medicaid?
Many private insurance plans also cover hospice care. Coverage levels vary by policy, but most plans include hospice services when medical eligibility requirements are met.
What if I don’t have insurance or government benefits?
Hospice providers may offer care through private payment arrangements or other financial assistance programs, depending on the agency and circumstances.
Who pays for hospice care in a nursing home?
Hospice covers medical and supportive hospice services, but room and board in a nursing home is generally paid separately through Medicaid, private pay, or long-term care insurance.
Can veterans receive hospice benefits?
Yes. Veterans may receive hospice care through Medicare, Medicaid, private insurance, or VA-related benefits, depending on eligibility.
Hospice and Estate Planning / Asset Protection
Does entering hospice affect my estate plan?
Hospice itself does not change your estate plan, but it is often a time to review wills, trusts, and beneficiary designations to ensure they reflect your current wishes.
Should I update my estate planning documents when entering hospice?
Yes. Many patients review or update powers of attorney, health care directives, and wills when beginning hospice care to ensure that decision-making authority is clear and up to date.
How does hospice relate to Medicaid planning or asset protection?
Hospice care often intersects with Medicaid eligibility and long-term care planning. While hospice focuses on comfort care, Medicaid rules may still affect how long-term care costs are handled and how remaining assets are treated.
Will hospice planning protect my assets?
Hospice planning itself is not an asset-protection tool, but it often prompts families to address estate planning issues, beneficiary designations, and Medicaid-related planning strategies when appropriate.
If I decide I need to go to the hospital, what do I do?
If you think you need to go to the hospital, contact your hospice team first for guidance.
Are hospice agencies licensed by the State?
Yes. Hospices are licensed by the State of New Jersey and certified by Medicare before they can provide services.
Fredrick P. Niemann Esq.
NJ Hospice Care & Legal Planning
Compassionate Guidance During Life’s Most Difficult Transitions
When hospice becomes part of your family’s journey, it is also an important time to ensure legal and financial matters are in order. Clear planning protects assets, clarifies authority, and allows families to focus on comfort and meaningful time together.
At Hanlon Niemann & Wright, we help New Jersey families navigate hospice-related legal planning with clarity, sensitivity, and experience.
If you would like to speak with our Hospice Planning lawyers, contact Fredrick P. Niemann, Esq. at (732) 863-9900 or email him at fniemann@hnlawfirm.com to schedule a consultation to discuss your particular needs.
Written by Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a New Jersey Hospice Care Attorney serving these New Jersey Counties:
Monmouth County, Ocean County, Essex County, Cape May County, Camden County, Mercer County, Middlesex County, Bergen County, Morris County, Burlington County, Union County, Somerset County, Hudson County, Passaic County
Hospice | Medicaid NJ | Hospice Lawyer | Probate | Hospice Attorney New Jersey Hospice and Medicaid