eligibility_for_services

Eligibility for Services

Eligibility for Adult Palliative Care Services

For adults, when palliative care is provided outside of hospice services, there are no restrictions regarding life expectancy. Your doctor should provide a referral for palliative care services. Consult your insurance provider for eligibility.

Eligibility for Pediatric Palliative Care Services

From Massachusetts Department of Public Health Pediatric Palliative Care Network Operational Program Standards 11.24.09

All children less than 19 years old, who are determined by a physician to have a potentially life-limiting illness, are eligible for the program.

  • Prenatal to 19 years of age with a life-limiting diagnosis.
  • All life-limiting diagnoses are included. Pediatric Palliative Care Network (PPCN) providers retain on file a DPH-approved form, completed and signed by the referring licensed Massachusetts physician, dated by the physician, including identifying information about the child, including birth date, and documentation of the child’s life-limiting condition. Transfer by consent to the hospice of physician records containing the same information may substitute for the form. Documentation should be on file within 2 weeks of referral.
  • The child must be a resident of Massachusetts.
  • When considering the appropriateness of a referral, discernment is given to recent medical crises and activity, i.e., hospitalizations, ER visits, frequency and severity of respiratory events, more advanced stage of illness, etc. Families of children who are medically fragile are also socially fragile. Efforts should be made to identify those children at highest risk.
  • There are no restrictions as to the life expectancy of the child.
  • Children in the PPCN program may continue to receive care directed at cure.
  • Admission to PPCN does not preclude the child and family from treatment choices or hopeful, supportive therapies.
  • Children are admitted to the program without regard for diagnosis, gender, race, creed, age or ability to pay.