A hospice election checklist for Alzheimer's caregivers confirms eligibility, records the hospice choice, and shifts care to comfort. Hospice election is the signed Medicare statement that chooses palliative care instead of curative treatment for the terminal illness. Use it when decline is steady despite good care. The checklist helps you gather certifications, sign correctly, secure services, and keep control after enrollment.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Does your person qualify now?
- What must the election statement include?
- How do benefit periods and recertification work?
- What help, drugs, and costs should you expect?
- How do you avoid bills and protect comfort wishes?
Does your person qualify now?
Medicare patients qualify only with Part A entitlement plus physician certification of terminal illness. The certified life expectancy is 6 months or less if the disease follows its normal course, according to the Centers for Medicare & Medicaid Services in Medicare hospice information. For Alzheimer's and related dementias, Medicare guidance points to FAST stage 7 or beyond.
Supporting evidence includes progressive decline plus weight loss, infections, dysphagia, or repeated ER visits. Ask the doctor what supports the prognosis in plain words. Note recent weights, swallowing problems, fevers, antibiotics, falls, and hospital visits to bring to evaluation.
What must the election statement include?
The signed statement must identify the chosen hospice and the attending physician selected by the patient or representative. It must acknowledge palliative rather than curative care and waive Medicare payment for curative treatment of the terminal condition, under Code of Federal Regulations Title 42 Part 418 in federal hospice election rules.
Check these items before you sign: Keep a copy with advance directives, medication lists, and contact numbers. An incomplete form can delay admission or billing.
- correct hospice name, attending physician name, and effective date
- clear statement that care is palliative for comfort
- signatures from the patient or authorized representative and a hospice representative
How do benefit periods and recertification work?
Hospice coverage runs as two 90-day benefit periods followed by unlimited 60-day periods. Each period requires recertification, with a required face-to-face visit by a hospice physician or nurse practitioner before the third period. Put recertification dates on a calendar.
If the person stabilizes, the hospice may discharge; if decline resumes, the person can be re-evaluated. You may change hospices once per benefit period. You may also revoke at any time with a signed statement to resume curative Medicare coverage.
What help, drugs, and costs should you expect?
The interdisciplinary team provides nursing, aide, physician, social work, counseling, chaplain, and volunteer services. It also covers drugs for symptom control, equipment, short-term respite, and bereavement support for families under a written plan of care, described by Medicare.gov in Medicare hospice coverage guide. Families pay nothing for covered hospice services.
They may owe up to $5 per outpatient drug for symptom relief and 5% of the Medicare-approved amount for inpatient respite; room and board at home or in a facility is not covered. Ask which symptoms each drug targets and who to call day or night. Confirm delivery times for equipment such as a hospital bed, oxygen, or commode.
How do you avoid bills and protect comfort wishes?
Request the written list of conditions, drugs, and services deemed unrelated to the terminal illness within 3-5 days. You must call the hospice before ER, hospital, or outside-provider care, or you risk full payment liability. Complete advance directives early while the person can express wishes.
Choose comfort-focused care and DNR or out-of-hospital orders, then share copies with the hospice, attending physician, and family. Post the hospice number on the refrigerator and in phones. Call first, even in a crisis, so the nurse can direct care and preserve coverage.
