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 and circumstances and depends on the availability of clinicians in your area. There are generally three possible types of referrals: full-service hospice agencies, palliative care practices, and independent providers. Each provides a different model of care and uses different models for payment, preparations, and attendance on the aid-in-dying day.
PLEASE NOTE: Medicare does not provide any coverage for aid-in-dying care. Aid in dying is legal as a state program in 10 states plus Washington, DC, but Medicare is a federal program. For this and other reasons, Medicare does not cover any aid-in-dying services nor the aid-in-dying medications (which cost around $700). As well, most insurance policies do not cover medical aid in dying. You should, of course, check with your insurance company, but in our experience, it is very difficult and uncommon to have coverage or receive reimbursement for costs related to aid in dying.
Hospice agencies that provide a full range of 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. There are 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 an end-of-life discussion, though the medications may not be covered. 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 make home visits and charge one set fee. These private practice doctors 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.