When you are caring for someone with a serious illness, you need clear answers fast. Hospice in Texas is available when a doctor certifies a life expectancy of six months or less if the disease follows its usual course, and when the patient or representative elects hospice care. This guide turns complex rules into a short, practical checklist so you can move forward with confidence in Austin, Travis County, and surrounding communities. Key items include medical criteria, Medicare or Medicaid steps, Texas advance directive options, and what to gather before the first nurse visit.
What Makes Someone Eligible For Hospice?
You are likely eligible for hospice if the following are true:
- A physician certifies terminal illness. A medical doctor or doctor of osteopathy must certify that life expectancy is six months or less if the illness runs its normal course. Recertifications continue hospice when criteria are still met.
- You elect the hospice benefit. The patient or legal representative signs the election of hospice benefit and chooses a hospice provider. The plan of care is created with the interdisciplinary team and the family. Read more about how to choose hospice care in Austin Texas here.
- An initial nurse assessment is timely. After election, a hospice registered nurse completes an initial assessment within 48 hours unless you request sooner. A full comprehensive assessment is completed within five calendar days.
If you have Texas Medicaid, additional program rules apply. See the Medicaid notes in the checklist below.
Texas Family Checklist: Confirm Eligibility And Get Ready
Use this checklist to confirm hospice eligibility and to speed up the start of care. You do not need everything perfect to call. If your loved one is in pain or struggling, call us now at (737) 240-3003 and we will guide you step by step.
- Clinical Criteria
- Physician believes life expectancy is six months or less if the illness runs its natural course. If there is an attending physician, the hospice medical director and attending coordinate on the certification. Keep the most recent clinic or hospital notes handy.
- You agree that the focus is comfort, safety, and quality of life. Hospice can include medications, supplies, and equipment related to comfort and symptom control. The team creates an individualized plan of care with you.
- Physician believes life expectancy is six months or less if the illness runs its natural course. If there is an attending physician, the hospice medical director and attending coordinate on the certification. Keep the most recent clinic or hospital notes handy.
- Coverage and Benefit Election
- Medicare: Most adults qualify through Medicare Part A. Once you elect hospice, the hospice team manages care related to the terminal diagnosis and coordinates with your other clinicians.
- Texas Medicaid: Medicaid members may elect hospice when certified terminally ill. Some nursing facility arrangements require a Medicaid-contracted bed and coordination with the facility. Your hospice will help verify benefits.
- Other insurance: Many commercial plans follow Medicare rules. We can check your benefits during the first call.
- Medicare: Most adults qualify through Medicare Part A. Once you elect hospice, the hospice team manages care related to the terminal diagnosis and coordinates with your other clinicians.
- Paperwork That Helps Day One Feel Easier. Gather what you have. If something is missing, we will help you complete it.
- Photo ID and insurance cards.
- Contact list for key decision-makers and physicians.
- Medication list and allergies.
- Advance directives you already have, for example:
- Directive to Physicians and Family or Surrogates, sometimes called a living will.
- Medical Power of Attorney.
- Out-of-Hospital Do Not Resuscitate Order (OOH-DNR), if desired. Texas has a specific standard form. This is optional and can be discussed with the nurse or physician.
- Directive to Physicians and Family or Surrogates, sometimes called a living will.
- Home Set-Up And Safety
- Choose a quiet, accessible place for medications, supplies, and equipment.
- Clear walkways and remove loose rugs to reduce falls.
- Identify a comfortable space for a hospital bed or oxygen if recommended.
- Choose a quiet, accessible place for medications, supplies, and equipment.
- After You Elect Hospice: What To Expect In Texas
- A registered nurse completes the initial assessment within 48 hours, often sooner for urgent needs. The comprehensive assessment is finished within five days.
- Your individualized plan of care is created with the hospice physician, nurse, social worker, chaplain, you, and your caregiver. You will know how to reach the team 24 hours a day.
- A registered nurse completes the initial assessment within 48 hours, often sooner for urgent needs. The comprehensive assessment is finished within five days.
Texas Advance Directives and OOH-DNR: Optional Planning
Advance directives are not required to begin hospice, but many families find them helpful:
- Directive to Physicians and Family or Surrogates. States what treatments you want if you cannot speak for yourself. Texas provides state forms in English and Spanish.
- Medical Power of Attorney. Names someone to make health care decisions if you are unable.
- Out-of-Hospital Do Not Resuscitate (OOH-DNR). Tells EMTs and other clinicians to allow a natural death outside the hospital. Texas requires the state’s standard form or a properly issued bracelet or device. Your hospice nurse can review options with you.
If you need help completing any of these, ask your hospice social worker during the first visit.
Quick Self-Check: Do We Qualify Today?
- Has a doctor said that continued curative treatment is no longer helping or is no longer the goal?
- Would comfort, safety, and time together be the primary focus going forward?
- Has your loved one had more frequent ER visits, hospitalizations, infections, weight loss, falls, or declining function in the past six months?
- Are caregivers feeling stretched or worried about symptom changes at night?
If you answered yes to most of these, call us. A hospice nurse can review your situation and coordinate with your physician to confirm eligibility.
Frequently Asked Questions
- Do we need to stop all current medications to start hospice?
No. The team reviews each medication and continues those that support comfort and quality of life within the plan of care. Decisions are individualized. - How fast can hospice start?
After you elect hospice, the initial nurse assessment occurs within 48 hours unless you request sooner. Urgent situations are prioritized whenever possible. - Can we keep our own doctor?
Yes. If you have an attending physician, the hospice physician collaborates with your doctor when certifying eligibility and shaping the plan. - What if my loved one lives in a nursing facility?
Hospice can serve patients in nursing facilities. For Medicaid residents, certain facility and bed rules apply. Your hospice will coordinate the details with the facility.
How To Start Hospice In Austin And Nearby Counties
- Call Generations Health Care at (737) 240-3003.
- We verify benefits and speak with your physician to confirm eligibility.
- You sign the hospice election and we schedule your first nurse visit.
- We deliver needed medications, supplies, and equipment for comfort.
- Your plan of care begins with clear visit schedules and 24/7 support.
Service Areas
We care for families throughout Austin and Travis County, as well as Bastrop, Caldwell, Harris, Hays, and Williamson counties.
Talk to Our Hospice Team Now
If you believe your loved one may qualify, or if you are unsure, call us. We will walk with you from the first question. Call our care team at (737) 240-3003 or fill out this form to help you understand hospice eligibility and speed up confirmation. You may also check out our services here.