Date

Participants who are eligible for both Medicare and MO HealthNet at the time of hospice election must simultaneously elect the hospice benefit for both programs. Electing both Medicare and MO HealthNet Hospice benefits enables MO HealthNet to avoid duplication of payments for services covered under the Medicare Hospice benefit.

If a participant’s MO HealthNet eligibility begins, or the Hospice becomes aware of the participant’s MO HealthNet eligibility after Medicare hospice benefits have been elected, providers must complete the informational portion of the MO HealthNet Hospice Election Statement and attach a copy of the Medicare election form indicating the original election date. The signature(s) and dates on the Medicare election may be used as verification of the participant’s election date, and consent to use Hospice benefits when attached to the MO HealthNet Hospice Election Statement. The Hospice must submit these forms to MHD.

For more information on MO HealthNet’s Hospice program, providers can reference Section 13 of the Mo HealthNet hospice manual and MO HealthNet Hospice Election Statement.