For participating Anthem commercial ASO plans, we have expanded our hospice benefit to align with our previous expansion for commercial fully insured members. These expanded hospice benefits allow members with a life expectancy of up to 12 months (increased from 6 months) and allow disease modifying treatments to continue alongside hospice services. If you have a patient with an advanced illness and life expectancy of less than 12 months, now is the time to talk about hospice. Hospice is a powerful support resource for patients that can work in tandem with their treatment.


Provider benefits:

  • Improved communication: By removing obstacles to hospice care, providers can introduce hospice benefits earlier while empowering patients to express their goals, values and care preferences.


  • Centralized care: The treating physician remains at the center of the patient’s overall treatment plan – supported by the entire hospice team. Patients get the benefit of expert medical care, pain management, and emotional and spiritual support all working together.


  • Planning resource: Hospice professionals are a useful resource for physicians to help aid in discussions with patients and families related to: caregiver stress, fears of the future, end-of-life discussions and bereavement planning.


Patient benefits:

  • More patient and caregiver support, earlier: Relaxing the previous benefit life expectancy maximum and treatment limitations will help patients with advanced illnesses access hospice services earlier, ultimately choosing the care that fits their personal needs.

  • Coordinated team: Patients will have a dedicated hospice team that coordinates access to medication, medical supplies, and equipment. Patients can depend on hospice services for their care needs rather than emergency room and intensive care professionals who are unfamiliar with their histories, goals, and preferences.


  • Improved quality of life: Patients receive help sooner, manage their pain and symptom relief better, and families are able to discuss planning of personal needs more effectively.


Note: This update does not apply to Federal Employee Program® (FEP®), Medicare and

Medicaid. Providers should continue to verify eligibility and benefits for all Anthem members prior to rendering services or referring members for hospice care.




Featured In:
December 2020 Anthem Provider News and Important Updates -- Nevada