Your TRICARE Hospice Benefit

If you or a loved one is faced with a terminal illness, hospice care is available from TRICARE. Hospice is a concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments. The goal of hospice is to enable patients to continue an alert, pain-free life and to manage other symptoms so that their last days may be spent with dignity and quality, surrounded by their loved ones.

All TRICARE beneficiaries are eligible for this benefit.

Initiating Hospice Care

The patient, their Primary Care Manager (PCM), or a family member can initiate care as long as the patient's DEERS information is current. There is no paperwork for the beneficiary to complete to obtain hospice services. It is the hospice provider's responsibility to submit the documentation necessary to obtain authorization for care.

Coverage and OHI

Hospice care is provided in three benefit periods; each period requires a separate authorization. The hospice provider will submit the necessary forms to TriWest.

First 90-day period
Second 90-day
Unlimited number of 60-day periods

Medicare patients do not need an authorization for hospice services and they are not processed through TriWest.

Costs

Copayments, deductibles, cost-shares and catastrophic cap do not apply for services provided under the hospice benefit. TRICARE pays the full cost of all covered services, except for small cost-share amounts that may be collected by the hospice.

Additional Questions?

If you need further information on the hospice benefit, please click here, visit www.triwest.com/beneficiary or call 1-888-TRIWEST (874-9378). Additional resources are available through http://www.hospicenet.org/.

Published Date: 05/19/2009