Does My Medicare HMO Choose My Home Health or Hospice Provider?
Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director
Ramona Visiting Nurse Association and Hospice
Question: I recently changed insurance plans from regular Medicare to a Medicare HMO. If I need Home Health or Hospice Services will I be allowed to choose, or will the HMO select the provider?
Answer: Although the HMO has the right to select the provider for Home Health services, by Federal Law, Medicare Regulations give you the right to select the Medicare Certified Hospice of your choice, even if you are enrolled in a Medicare HMO plan.
In the same way that Hospitals differ in the quality and variety of services that they provide, Home Health and Hospice Agencies differ in the quality and variety of services they provide. As our name suggests, Ramona VNA (Visiting Nurse Association) and Hospice is affiliated with the Visiting Nurse Association of America; but not all VNA providers are the same.
When you are selecting a Home Health or Hospice provider it is important that you carefully research your choices to ensure that you are selecting the agency that best meets your needs. Although your HMO may have a contract with a preferred Home Health Agency, the choice of Hospice providers remains in the hands of the patient. Although all Medicare Certified Hospice Programs are required to provide a basic set of services, Hospice programs vary widely in the extra services which they provide. Medicare does not require that a Hospice retain a full time physician or that the physician have any specialty training in Hospice and Palliative Medicine. Nor does Medicare require that Hospice Staff be certified in Hospice and Palliative care.
Ramona VNA & Hospice’s service to the community would not be possible without the generous support of The Hemet Hospice Volunteer Foundation. Hemet Hospice Volunteers have provided over $250,000 in support thus far this year. Because we are a community based non-profit agency we don’t need to generate a profit for investors, and with the added support of Hemet Hospice Volunteers we are able to provide additional services to our patients above and beyond what Medicare requires. For example, we are the only area Hospice with two full time physicians who are Board Certified in Hospice and Palliative Medicine and who regularly make housecalls to our patients. Other Ramona distinctives include the services of a full time Licensed Massage Therapist.
Ramona VNA & Hospice places a strong emphasis on providing advanced training for our staff. Currently, 84% of our Hospice staff has received additional certification in Hospice and palliative care. Remember that you have the right to choose your Hospice; for more information visit us on the web at www.ramonavna.org or if you need help with any general health related issue contact our HELP line at 1-888-983-5337; or visit us on the web at www.help4elders.info. If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.
