Is there a difference between Hospice and Nursing Home for insurance purposes?

I realize this is an old thread with a recent post bringing it back. I thought I'd comment as yesterday I met with a hospice dr seeing my mom. The purpose of the visit was for an extension of hospice care. Mid August my mom will hit the six month mark - if she makes it that far and the hospice people believe she will. So the purpose of the eval yesterday was to approve extending services another two months. The dr told me now that the six month mark will likely be exceeded, my mom will be reevaluated every two months to continue hospice care.

Disagree with pamstegma. How can anyone give "proof" that a patient will die within 6 months? Only God knows when that day will come (and He is not telling us). You only have to be considered terminally ill to stay in hospice for a longer period.

Does not sound like a Hospice case to me. Hospice now requires proof that the patient will die within 6 months. Hospice does not cover nursing home costs anyway. Insurance does not cover nursing home care either. Only Medicaid covers it.

If your mother stays in the nursing home the cost of the nursing home will continue as is, private pay, Medicaid etc. if her doctor decides she should be on hospice she can continue to live in the nursing home with visits from hospice staff and hospice medical attention. The extra cost of hospice is usually covered by Medicaid.

Amy, a doctor should advise you if your mother is eligible for hospice. I believe the primary factor is that death would be anticipated within 6 months, so a medical determination is involved. And that could change whether she stays where she is or whether she goes into hospice.

AmyGrace, your Mom is taking the very same path my Mom [98] had been taking. Too weak to walk, major fall risk, one day Mom would eat, next day not. One day looking alert, couple days later looked like it would be her last day. This waffled back and forth for almost 3 months.

For my Mom it was a doctor at the hospital who decided it is time to bring in Hospice. My Mom was moved from the rehab wing to the long-term-care section as a bed had opened up and I was glad Mom was now in that wing.

Medicare and secondary insurance didn't pay for any of the room/board at the nursing home because Mom was taken off the list for rehab because she failed to get better physically, so she became self-pay. It looked like maybe Medicare did pay for some of the Hospice related items, like the Geri recliner rental, Depends, the air mattress motor rental.... I can't be certain as the final bill hasn't come in from the nursing home.

Actually at one time it looked like my Mom was improving on Hospice. What I liked about Hospice was there were extra eyes on Mom, and extra attention. Mom did better being off of her prescription meds she had been taking for many years. Hospice does supply pain meds to make the patient comfortable.