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Please fax this form to the Coroner or Medical Examiner for the county of the expected death. FAX NUMBER: (612) 321-3556 DATE: / COUNTY: Hennepin, Dakota and Scott / HOSPICE PRE-REGISTRATION FORM.

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Eligibility Requirements The Patient Is Diagnosed with Life-Limiting Condition. ... Frequent Hospital Visits Within the Last 6 Months. ... Consistent Weight Loss. ... Increase Of Weakness & Fatigue.

The hospice benefit is available to recipients who have been certified by a physician as terminally ill. A recipient is considered to be terminally ill if he or she has a medical prognosis with life expectancy of six months or less when the disease runs its normal course. Hospice may be in effect greater than 6 months.

Hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course. It's important for a patient to discuss hospice care options with their doctor.

In general, hospice care services are covered by usual forms of payment for medical services: Medicare, Medical Assistance, MinnesotaCare and private insurance. If you decide on a hospice program, be sure to ask about how services will be billed and if you qualify for any or all of the coverage options described below.

Hospice services are paid for by Medicare, Medical Assistance, MinnesotaCare, most private health insurance companies, or you may pay privately. Veterans' benefits are also available. Your hospice program works with you and your family to identify ways to pay for services.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232