C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-43, subsec. 144-101-II-43.02

Current through 2024-51, December 18, 2024

Subsection 144-101-II-43.02 - MEMBER ELIGIBILITY FOR CARE

A member is eligible for covered hospice services if he or she meets both the General MaineCare financial eligibility requirements and the Hospice Services Eligibility Requirements, with the exception of the following: those members deemed eligible for coverage under Medicare hospice benefits shall not be eligible for services which would be duplicative under this Section.

43.02-1General MaineCare Eligibility Requirements

Individuals must meet the financial eligibility criteria set forth in the MaineCare Eligibility Manual. Some members may have restrictions on the type and amount of services they are eligible to receive.

43.02-2Hospice Services Eligibility Requirements

A. A member must be certified by a physician as having a terminal illness as set forth in Section 43.03-1, Certification of Terminal Illness; and

B. The member or his or her Representative must elect hospice benefits in lieu of other MaineCare covered services as specified in Section 43.03-2 by completing an election statement as set forth in that section. Members under age 21 making said election do not waive any MaineCare covered services that are related to the treatment of the child's condition for which a diagnosis of terminal illness has been made.

C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-43, subsec. 144-101-II-43.02