Hospice is paid through a benefit, and the benefit covers the items and services its rules name. Everything else in the house can still be bought, and nothing announces when those purchases have started to add up. The drift usually looks like a few small receipts a week, none large enough to stop you.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Know what the benefit does not list
Before the first month closes, ask the hospice business office for a written list of what the hospice covers and what it does not. Ask for it in plain categories: equipment, supplies, visits, and items the hospice will not pay for. Medicare's hospice rules are the starting point, and the Sources page shows where to read them. Ask the office to show you on paper where a common item falls.
Keep one monthly sheet
Use one page with columns for the date, the store, the item, the amount, and whether the hospice covers it. Keep the receipts in one envelope. Common items include disposable gloves, underpads, wipes, extra linens, bottled water, food for helpers, parking, and gas for trips to appointments. At the end of each month, total each category. The category that grew from one month to the next is the one to ask about. Do not wait for a statement with a large total.
Check each bill against the sheet
When a bill arrives from any provider, match each line to the sheet. A line you cannot find is a question for the provider, not a reason to pay in silence. Ask what the charge is for, which dates it covers, and who authorized it. If the answer does not match what you were told, write down the name and the date and ask for a correction in writing.
Ask what the hospice can supply
Some items you buy may already be available through the hospice if you ask, and some may be available through a standing order. Ask the nurse or the aide's supervisor which supplies the team keeps on hand and how the ordering works. Write the answer on the sheet beside the item it would replace.
When the total keeps climbing
If the monthly total keeps rising and you are no longer sure what it pays for, that is information about the plan, not about your skill with a checkbook. Raise it with the social worker on the team, who can walk through what the family is carrying and what might be shared or changed.