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TRICARE Provides Deductible-Free Hospice Benefit


FALLS CHURCH, Va. – May 12, 2010 The final stages of life can be difficult for patients and their families. To make these last days easier, TRICARE’s hospice care benefit is a service focused on patients to give them the supportive services they need near the end of life.

Hospice is a zero-deductible benefit and it gives TRICARE beneficiaries access to personal care and home health aide assistance. It initially provides two 90-day periods of care, followed by an unlimited number of 60-day periods. Each period requires prior authorization from the regional health care contractor.

Not all care is covered by the hospice benefit. Individual hospices may charge for some items, such as outpatient medications or inpatient respite care. Charges for medical care not related to the terminal illness fall under the beneficiary’s basic TRICARE benefit. Other items not covered include room and board for hospice care received at home; room and board related to custodial care; and any treatments to cure the terminal illness.

Hospice benefits can be initiated by a patient, their family or the patient’s primary care manager (PCM). Before hospice can begin, four requirements must be met. First, the patient’s the eligibility information must be current. The patient also needs to obtain a referral for hospice from their PCM and get prior authorization from their regional health care contractor. Finally, a certification of terminal illness must be obtained.

There are four levels of hospice care to meet the varying needs of each patient: routine home care, continuous home care, inpatient respite care, and general hospice. If necessary, patients can switch between the four levels of care.

For more information about the hospice benefit, visit www.tricare.mil, contact TRICARE For Life, the regional managed care support contractor or TRICARE Area Office.

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