FAQ - Bluebird Hospice

Category 01 · 6 questions

Eligibility & decisions

Who qualifies for hospice care?

A patient qualifies for hospice when they are facing a life limiting illness with a life expectancy of 6 months or less if the disease were to run its normal course without aggressive intervention.

That doesn't mean you run out of hospice benefit at the 6 month mark. If your loved one continues to meet hospice criteria, they can stay on service for longer periods.

Most chronic, advanced illnesses qualify — cancer, heart failure, COPD, dementia, kidney disease, ALS, and many others. We can do a free evaluation visit if you're not sure whether your loved one qualifies.

Does choosing hospice mean we're "giving up"?

No. Hospice is choosing where the next chapter happens — not stopping the story. It means shifting the goal of care from cure to comfort, often after curative treatment has stopped working.

Many families describe the weeks or months in hospice as more meaningful than what came before, because the focus changes from procedures to people.

Can we change our minds after starting hospice?

Yes. You can leave hospice at any time, for any reason — and you can return later if it makes sense. Hospice is not a binding contract. Some families pause hospice when their loved one stabilizes and resume later. Some leave to try a new treatment and come back. Decisions stay with your family, always.

What's the difference between hospice and palliative care?

Hospice is comfort-only care for a life expectancy of six months or less. Curative treatment is paused; care focuses entirely on comfort and symptom management.

Palliative care is comfort-focused care available at any stage of a serious illness — alongside treatments like chemo, dialysis, or surgery. No prognosis required.

See our Palliative Care page for a full side-by-side comparison.

Do I need a referral from a doctor?

Not to start the conversation. You can call us first. We'll do a free evaluation visit and, if it makes sense to enroll, we'll work with your physician to get the orders signed. Most physicians are familiar with the process.

Can my loved one stay at home, or do they have to move?

Most patients stay exactly where they are — at home, in their assisted-living suite, or in their nursing facility room. Hospice travels to them. The team comes to you.

The only time a move happens is when the family chooses an inpatient hospice setting for short-term symptom control or respite, and even those are usually temporary.

Category 02 · 6 questions

Cost & coverage

Does hospice cost anything out of pocket?

For most families: no. The Medicare hospice benefit covers everything related to the terminal diagnosis at 100% — visits, equipment, medications, supplies, and 24/7 nurse access. Most private and Medicare Advantage plans follow the same model.

We verify your specific benefits before any care begins, so there are no surprises.

What does Medicare cover, exactly?

Skilled nursing visits, certified aide visits, social work, chaplain visits, medical equipment (hospital bed, oxygen, supplies), all medications related to the terminal diagnosis and comfort, the 24/7 nurse line, volunteer companionship, and 13 months of bereavement support after a loss.

See our Services page for a full visual breakdown.

What if my insurance is private (not Medicare)?

Most private and Medicare Advantage plans cover hospice the same way Medicare does — at 100% for hospice services. We verify benefits with your specific plan before any visits, and we handle prior authorizations.

If anything wouldn't be covered, we tell you in writing before you commit.

Are medications covered?

Yes — all medications related to the terminal diagnosis are covered at 100% under the Medicare hospice benefit. That includes pain meds, anti-nausea, anti-anxiety, breathing meds, and any others the care team prescribes.

Medications for unrelated conditions (like a long-standing high blood pressure prescription) may continue to be billed under the patient's regular drug plan, but we coordinate this carefully and tell you what to expect.

Is medical equipment covered?

Yes. Hospital bed, oxygen, wheelchair, walker, commode, wound supplies, oxygen concentrator, and any other equipment needed for comfort and care — delivered to your home (or facility room) at no cost. We coordinate setup, restocking, and pickup when no longer needed.

What's NOT covered by hospice?

Hospice doesn't cover treatments aimed at curing the terminal illness (like ongoing chemotherapy or dialysis when the goal is cure rather than comfort). It also doesn't cover room-and-board if your loved one lives in an assisted-living or skilled-nursing facility — that's billed separately to the facility, as it would be without hospice.

Care unrelated to the terminal diagnosis (a new broken arm, for instance) goes through regular Medicare, not the hospice benefit.

Category 03 · 6 questions

Care & services

How quickly can hospice start?

Often the same day. We aim for an evaluation visit within 4–8 hours of your first call, equipment delivery within 24 hours, and the first scheduled care visit within 24–36 hours. Same-day admissions are routine for us. There's no waitlist.

Who comes to my home and how often?

The hospice team is made up of the registered nurse, a certified nursing aide, a social worker, a chaplain, the hospice medical director, the hospice nurse practitioner and an optional volunteer. The frequencies of these visits are developed on admission to meet your families needs. They range anywhere from monthly to daily, depending on what the patient’s needs.

Is there really a 24/7 nurse line?

Yes. Call (248) 264-3704 any hour, any day. During business hours, a Bluebird Hospice nurse answers the telephone. After hours, our specially trained answering service answers and messages the registered nurse immediately so she can return your call within minutes.

Same-day admissions — really?

Really. When clinically indicated, we can admit a patient the same day a referral comes in, including evenings and weekends. We've done admissions on Christmas Eve. The wireframe target is 4–8 hours from call to evaluation visit, and most days we beat it.

Can hospice care continue if my loved one is in a facility?

Yes. We partner with assisted living, memory care, and skilled nursing facilities. Hospice augments — never replaces — what the facility already provides. Your loved one keeps every routine, every familiar face. We layer in. More on facility-based care.

What happens during the first 48 hours?

Hour 0–2: a real person calls you back. Hour 4–8: a nurse visits to evaluate. Hour 12–24: equipment delivered. Hour 24–36: first scheduled care visit. Hour 36–48: medication review and pain plan finalized.

See the full 48-hour timeline.

Category 04 · 6 questions

Medications & comfort

Will my loved one be over-medicated?

The honest answer: no, and we monitor closely to make sure of it. Hospice pain meds are titrated to comfort, not knockout. Our weekly clinical pharmacy reviews exist specifically to prevent over-medication. We aim for the lowest effective dose that keeps your loved one comfortable and present.

Won't my loved one become addicted to pain meds?

Addiction is a clinical concern in chronic non-cancer pain over years. In end-of-life care it's a different equation: the goal is comfort, the timeline is finite, and the meds are matched to the medical need. We follow opioid stewardship guidelines, but the calculus around dependence changes when someone's prognosis is months. We have these conversations openly with every family.

Will the meds make them lose their personality?

This is the worry families voice most often, and it's the one we work hardest on. Comfort and lucidity aren't opposites. We adjust the regimen if your loved one is too sleepy, too foggy, or too "not themselves." There's almost always a middle path between pain and sedation — our job is to find it.

What if a medication isn't working?

Call the 24/7 nurse line. Don't wait for the next visit, don't tough it out, don't guess at home. The plan is meant to evolve daily. A nurse can authorize a dose change, switch to a different med, or dispatch a same-night visit if needed.

Will I have to give injections?

Almost never. Most hospice meds are oral, sublingual (under the tongue), or transdermal (patch). When something more is needed, our nurses do it during a visit. Family caregivers should never feel out of their depth. We teach what's needed, we do the rest.

Are there side effects to worry about?

Yes — and we monitor every one of them. The most common are constipation (we anticipate and prevent it), drowsiness (we adjust dosing), and dry mouth (we have practical fixes). Side effects are part of the conversation, not the consequence of it. Tell us, and we'll address it.

Category 05 · 5 questions

Family support

Will hospice support my caregiver too — or just the patient?

Both. When one person is in hospice, the whole family is. Bluebird's social workers, chaplains, and bereavement coordinators are explicitly there for caregivers, not just patients. Caregiver Resources has downloads, support groups, and guides written specifically for the family caregiver.

What's respite care, and how do I use it?

Respite care is up to 5 consecutive days of inpatient care for the patient, paid for by Medicare, so the family caregiver can rest. Take a weekend off. Attend a wedding. Sleep eight hours. We also offer in-home volunteer respite for shorter breaks. Full respite details here.

What is the 13-month bereavement program?

After a loss, Bluebird stays in touch with the family for 13 months. Phone calls, mailings at key grief milestones, support groups, and one-on-one counseling — all free, all part of the Medicare hospice benefit. More on our bereavement program.

Can children visit during hospice care?

Of course. Children, grandchildren, great-grandchildren — all are welcome. Our social workers and chaplains can help families think through how to involve kids, what to say, and what to let kids decide for themselves. Most families find that including children in this season is healing for everyone.

How do I support my own grief during all this?

Anticipatory grief — grief that begins before a loss — is real and normal. Talk to our social worker. Consider a caregiver support group. Use respite when you need it. Skip what doesn't help. Grief doesn't run on a schedule, and there's no "right way" to do it. Read our essay on understanding grief.

Every question we hear in the first week. Answered.

Eligibility & decisions

Cost & coverage

Care & services

Medications & comfort

Family support

Don't see your question?