Can I pay out of pocket?

Check benefits before deciding to self-pay

Tell the team about every policy the patient has, even if you are unsure it will help. Medicare has a hospice benefit for eligible patients, and Medicaid has a hospice benefit subject to eligibility and program rules. Checking these possibilities can help you make an informed decision before using savings. Paying privately does not replace a clinical assessment of which care is appropriate.

Request a written good faith estimate

For people who are uninsured or are not using insurance, federal rules generally require a good faith estimate when care is requested or scheduled within the applicable time frames. Ask for one in writing. It describes expected charges; it is not a bill, and unexpected care may change the final amount. Request separate estimates from other providers or facilities involved.

Make the estimate practical for your family

Explain where care will take place, what help is already available, and which tasks worry you most. Ask the team to describe how charges are calculated and what could change them. Compare written descriptions of care rather than comparing a daily or monthly number alone. A lower headline price may describe a different set of services.

• Included care: Which visits, medications, supplies, equipment, and support services are included in this estimate?
• Separate expenses: Who bills for facility living costs, outside clinicians, transportation, or additional paid caregivers?
• Changes over time: How will the estimate be updated if needs change, and who will explain the new charges before we agree?

Keep estimates and bills together

Save the written estimate and any updated versions. If a bill is unexpected, ask for an itemized explanation and compare it with what was discussed. For eligible uninsured or self-pay bills, a federal dispute process may be available when one provider’s charges are at least $400 above that provider’s estimate. The request generally must begin within 120 days of the initial bill.

Tell us what you need to understand

It is okay to say, “We need to know our likely financial responsibility before making this decision.” Ask who can explain the payment agreement, when payments would be due, and how to raise a concern. If a cost is beyond your family’s means, say so early and ask about other coverage or community resources. Ask for details rather than assuming assistance is available.