A-5000, Texas Medicaid Hospice Program

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Revision 18-1; Effective March 1, 2018

Persons eligible for full Medicaid benefits may elect to participate in the Texas Medicaid Hospice Program if they have a medical prognosis of six months or less to live. In order to enroll in the Texas Medicaid Hospice Program, the person or authorized representative signs and dates Form 3071, Individual Election/Cancellation/Update. This election remains in effect until another Form 3071 is completed canceling hospice election. Recipients electing hospice waive their rights to other Medicaid services related to treatment of the terminal illness(es). They do not waive their rights to Medicaid services that are not related to treatment of the terminal illness(es). Hospice services may be received at home, in a hospital or in a Medicaid-contracted long-term care facility.