The Academy is a non-profit (501c3) and our referral work is without charge. We do gratefully accept donations so that we can continue this service for as many as are in need, as well as our research and clinician education about medical aid in dying.
Once we receive your completed intake form, we may have several referral options for you to consider. The type of referral the Academy provides will vary with each patient’s individual needs, urgency, and circ*mstances and depends on the availability of clinicians in your area. Each provides a different model of care and likely timeframe, and requires a different model for payment. Some may be able to accommodate non-oral routes of self-administration if needed. There are generally three possible types of referrals: full-service hospice agencies, palliative care practices, and independent providers.
PLEASE NOTE: Medicare does not provide coverage for aid-in-dying care or medications. Aid-in-dying is legal as a state program in 10 states plus Washington, DC, but Medicare is a federally funded program. For this and other reasons, and others, Medicare does not cover any aid-in-dying services or medications (which cost around $700). Most insurance policies also do not cover medical aid-in-dying. You should, of course, check with your insurance company.
Hospice agencies that provide complete aid-in-dying care: If you are referred or agree to be transferred to a hospice that provides both the attending/prescribing physician and consulting/2nd-opinion doctor, the fees for these services are usually incorporated as part of that hospice’s care. In general, there is no cost to the patient or family for this care, though the medications will not be covered. Urgent cases, that require quick eligibility and access to aid-in-dying medications are typically not easily met. There other important details to ask about, such as what the hospice nursing staff can and can not do in regards to aid-in-dying care. Some hospices allow their staff to attend the aid-in-dying day but may not allow them to mix medications and may require them to leave the room during ingestion, which can be disruptive and anxiety-producing.
Palliative care physicians who work within medical organizations may provide aid-in-dying care as part of an office or telehealth visit. Insurance typically covers these visits as end-of-life discussions, though the medications are not covered. Also, urgent cases that require immediate eligibility and access to aid-in-dying medications may not be easily met. These physicians may or may not come to the home or attend the aid-in-dying day. They may have local referrals to volunteers or paid doulas who can come to the home to provide support for the aid-in-dying day.
Independent Aid-in-Dying Clinicians typically work rapidly, make home visits and charge one set fee. These private practice doctors can typically work most quickly help patient complete the eligiblity process, and provide prompt access to aid-in-dying care and medications. They put in extensive time and effort to provide attentive, personalized care. As such, they charge fees for this work, usually a one-time amount, and may be willing to use a sliding scale. Please bear in mind that these dedicated healthcare workers will need to be paid sufficiently so that they can continue to provide this care and offer pro-bono work for the truly indigent. Thank you for your understanding.
*If you believe you may need a non-oral route of administration, please be sure to discuss this critical detail before choosing a clinician.
