{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3418.11.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3418.11.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3418.11.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3418.11.html"}],"law_id":87414,"edition_id":1,"section_id":87414,"structure_id":14324,"section_number":"38.2-3418.11","catch_line":"Coverage for hospice care","history":"1999, c. 858.","full_text":"A\n\nNotwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services shall provide coverage for hospice services under such policy, contract or plan delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1999.B\n\nAs used in this section:\n\t\t\t“Hospice services” shall mean a coordinated program of home and inpatient care provided directly or under the direction of a hospice licensed under Article 7 (§ 32.1-162.1 et seq.) of Chapter 5 of Title 32.1, and shall include palliative and supportive physical, psychological, psychosocial and other health services to individuals with a terminal illness utilizing a medically directed interdisciplinary team.\n\t\t\t“Individuals with a terminal illness” shall mean individuals whose condition has been diagnosed as terminal by a licensed physician, whose medical prognosis is death within six months, and who elect to receive palliative rather than curative care.\n\t\t\t“Medicare” shall mean Title XVIII of the Social Security Act.\n\t\t\t“Palliative care” shall mean treatment directed at controlling pain, relieving other symptoms, and focusing on the special needs of the patient as he experiences the stress of the dying process, rather than treatment aimed at investigation and intervention for the purpose of cure or prolongation of life.C\n\nFor the purposes of this section, documentation requirements shall be no greater than those required for the same services under Medicare.D\n\nNothing in this section shall prohibit an insurer, corporation, or health maintenance organization from offering or providing coverage for hospice services when it cannot be demonstrated that the illness is terminal or for individuals with life expectancies of longer than six months.E\n\nThe provisions of this section shall not apply to short-term travel, accident only, short-term nonrenewable policies of not more than six months’ duration, or to policies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal governmental plans.","order_by":null,"text":{"0":{"id":312960,"text":"Notwithstanding the provisions of § 38.2-3419, each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services shall provide coverage for hospice services under such policy, contract or plan delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1999.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":312961,"text":"As used in this section:\n\t\t\t“Hospice services” shall mean a coordinated program of home and inpatient care provided directly or under the direction of a hospice licensed under Article 7 (§ 32.1-162.1 et seq.) of Chapter 5 of Title 32.1, and shall include palliative and supportive physical, psychological, psychosocial and other health services to individuals with a terminal illness utilizing a medically directed interdisciplinary team.\n\t\t\t“Individuals with a terminal illness” shall mean individuals whose condition has been diagnosed as terminal by a licensed physician, whose medical prognosis is death within six months, and who elect to receive palliative rather than curative care.\n\t\t\t“Medicare” shall mean Title XVIII of the Social Security Act.\n\t\t\t“Palliative care” shall mean treatment directed at controlling pain, relieving other symptoms, and focusing on the special needs of the patient as he experiences the stress of the dying process, rather than treatment aimed at investigation and intervention for the purpose of cure or prolongation of life.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":312962,"text":"For the purposes of this section, documentation requirements shall be no greater than those required for the same services under Medicare.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":312963,"text":"Nothing in this section shall prohibit an insurer, corporation, or health maintenance organization from offering or providing coverage for hospice services when it cannot be demonstrated that the illness is terminal or for individuals with life expectancies of longer than six months.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":312964,"text":"The provisions of this section shall not apply to short-term travel, accident only, short-term nonrenewable policies of not more than six months’ duration, or to policies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal governmental plans.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D"}},"ancestry":[{"id":14324,"edition_id":1,"name":"Mandated Benefits","identifier":"2","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:47:45","date_modified":"2026-06-26 03:47:45","permalink":{"id":215143,"object_type":"structure","relational_id":14324,"identifier":"2","token":"38.2\/34\/2","url":"\/38.2\/34\/2\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness 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physicians","url":"\/38.2-3408\/","token":"38.2\/34\/2\/38.2-3408","metadata":false},{"id":55621,"structure_id":14324,"section_number":"38.2-3409","catch_line":"Coverage of dependent children","url":"\/38.2-3409\/","token":"38.2\/34\/2\/38.2-3409","metadata":false},{"id":68501,"structure_id":14324,"section_number":"38.2-3410","catch_line":"Construction of policy generally; words \"physician\" and \"doctor\" to include dentist","url":"\/38.2-3410\/","token":"38.2\/34\/2\/38.2-3410","metadata":false},{"id":76551,"structure_id":14324,"section_number":"38.2-3411","catch_line":"Coverage of newborn children required","url":"\/38.2-3411\/","token":"38.2\/34\/2\/38.2-3411","metadata":false},{"id":71629,"structure_id":14324,"section_number":"38.2-3411.1","catch_line":"Coverage for child health supervision services","url":"\/38.2-3411.1\/","token":"38.2\/34\/2\/38.2-3411.1","metadata":false},{"id":70694,"structure_id":14324,"section_number":"38.2-3411.2","catch_line":"Coverage of adopted children required","url":"\/38.2-3411.2\/","token":"38.2\/34\/2\/38.2-3411.2","metadata":false},{"id":77817,"structure_id":14324,"section_number":"38.2-3411.3","catch_line":"Coverage for childhood immunizations","url":"\/38.2-3411.3\/","token":"38.2\/34\/2\/38.2-3411.3","metadata":false},{"id":86598,"structure_id":14324,"section_number":"38.2-3411.4","catch_line":"Coverage for infant hearing screening and related diagnostics","url":"\/38.2-3411.4\/","token":"38.2\/34\/2\/38.2-3411.4","metadata":false},{"id":63024,"structure_id":14324,"section_number":"38.2-3412","catch_line":"Repealed","url":"\/38.2-3412\/","token":"38.2\/34\/2\/38.2-3412","metadata":false},{"id":84153,"structure_id":14324,"section_number":"38.2-3412.1","catch_line":"Coverage for mental health and substance use 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diabetes","url":"\/38.2-3418.10\/","token":"38.2\/34\/2\/38.2-3418.10","metadata":false},{"id":87414,"structure_id":14324,"section_number":"38.2-3418.11","catch_line":"Coverage for hospice care","url":"\/38.2-3418.11\/","token":"38.2\/34\/2\/38.2-3418.11","metadata":false},{"id":81464,"structure_id":14324,"section_number":"38.2-3418.12","catch_line":"Coverage for hospitalization and anesthesia for dental procedures","url":"\/38.2-3418.12\/","token":"38.2\/34\/2\/38.2-3418.12","metadata":false},{"id":82972,"structure_id":14324,"section_number":"38.2-3418.13","catch_line":"Coverage for the treatment of morbid obesity","url":"\/38.2-3418.13\/","token":"38.2\/34\/2\/38.2-3418.13","metadata":false},{"id":85731,"structure_id":14324,"section_number":"38.2-3418.14","catch_line":"Coverage for lymphedema","url":"\/38.2-3418.14\/","token":"38.2\/34\/2\/38.2-3418.14","metadata":false},{"id":71964,"structure_id":14324,"section_number":"38.2-3418.15","catch_line":"Coverage for prosthetic devices and components","url":"\/38.2-3418.15\/","token":"38.2\/34\/2\/38.2-3418.15","metadata":false},{"id":57543,"structure_id":14324,"section_number":"38.2-3418.15:1","catch_line":"Coverage for prosthetic devices and components","url":"\/38.2-3418.15_1\/","token":"38.2\/34\/2\/38.2-3418.15_1","metadata":false},{"id":61286,"structure_id":14324,"section_number":"38.2-3418.16","catch_line":"Coverage for telemedicine services","url":"\/38.2-3418.16\/","token":"38.2\/34\/2\/38.2-3418.16","metadata":false},{"id":81144,"structure_id":14324,"section_number":"38.2-3418.17","catch_line":"Coverage for autism spectrum disorder","url":"\/38.2-3418.17\/","token":"38.2\/34\/2\/38.2-3418.17","metadata":false},{"id":60567,"structure_id":14324,"section_number":"38.2-3418.18","catch_line":"Coverage for formula and enteral nutrition products as 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holder","url":"\/38.2-3419\/","token":"38.2\/34\/2\/38.2-3419","metadata":false},{"id":57559,"structure_id":14324,"section_number":"38.2-3419.1","catch_line":"Report of costs and utilization of mandated benefits","url":"\/38.2-3419.1\/","token":"38.2\/34\/2\/38.2-3419.1","metadata":false}],"previous_section":{"id":86304,"structure_id":14324,"section_number":"38.2-3418.10","catch_line":"Coverage for diabetes","url":"\/38.2-3418.10\/","token":"38.2\/34\/2\/38.2-3418.10","metadata":false},"next_section":{"id":81464,"structure_id":14324,"section_number":"38.2-3418.12","catch_line":"Coverage for hospitalization and anesthesia for dental procedures","url":"\/38.2-3418.12\/","token":"38.2\/34\/2\/38.2-3418.12","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3418.11\/","history_text":"

This law was first created in 1999. The record of its establishment is cataloged in chapter 858<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year.<\/p>","references":false,"refers_to":[{"id":77748,"section_number":"32.1-162.1","catch_line":"Definitions","order_by":null,"url":"\/32.1-162.1\/"},{"id":66144,"section_number":"38.2-3419","catch_line":"Additional mandated coverage made optional to group policy or contract holder","order_by":null,"url":"\/38.2-3419\/"}],"permalink":{"id":215225,"object_type":"law","relational_id":87414,"identifier":"38.2-3418.11","token":"38.2\/34\/2\/38.2-3418.11","url":"\/38.2-3418.11\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3418.11\/","token":"38.2\/34\/2\/38.2-3418.11","dublin_core":{"Title":"Coverage for hospice care","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3418.11","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Notwithstanding the provisions of § 38.2-3419<\/a>, each insurer<\/span> proposing to issue<\/span> individual or group accident and sickness insurance policies<\/span> providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts<\/span>; and each health maintenance organization providing a health care plan for health care services shall provide coverage for hospice services<\/span> under such policy, contract<\/span> or plan delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1999. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> As used in this section:\n\t\t\t“Hospice services<\/span>” shall mean a coordinated program of home and inpatient care provided directly or under the direction of a hospice licensed under Article 7 (§ 32.1-162.1<\/a> et seq.) of Chapter 5 of Title 32.1, and shall include palliative and supportive physical, psychological, psychosocial and other health services to individuals with a terminal illness<\/span> utilizing a medically directed interdisciplinary team.\n\t\t\t“Individuals with a terminal illness<\/span>” shall mean individuals whose condition has been diagnosed as terminal by a licensed physician, whose medical prognosis is death within six months, and who elect to receive palliative rather than curative care.\n\t\t\t“Medicare<\/span>” shall mean Title XVIII of the Social Security Act.\n\t\t\t“Palliative care<\/span>” shall mean treatment directed at controlling pain, relieving other symptoms, and focusing on the special needs of the patient as he experiences the stress of the dying process, rather than treatment aimed at investigation and intervention for the purpose of cure or prolongation of life. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> For the purposes of this section, documentation requirements shall be no greater than those required for the same services under Medicare<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> Nothing in this section shall prohibit an insurer<\/span>, corporation, or health maintenance organization from offering or providing coverage for hospice services<\/span> when it cannot be demonstrated that the illness is terminal or for individuals with life expectancies of longer than six months. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> The provisions of this section shall not apply to short-term travel, accident only, short-term nonrenewable policies of not more than six months’ duration, or to policies or contracts<\/span> designed for issuance to persons<\/span> eligible for coverage under Title XVIII of the Social Security Act, known as Medicare<\/span>, or any other similar coverage under state<\/span> or federal governmental plans. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nCOVERAGE FOR HOSPICE CARE (\u00a7 38.2-3418.11)\n\nA. Notwithstanding the provisions of § 38.2-3419, each insurer proposing to\nissue individual or group accident and sickness insurance policies providing\nhospital, medical and surgical, or major medical coverage on an expense-incurred\nbasis; each corporation providing individual or group accident and sickness\nsubscription contracts; and each health maintenance organization providing a\nhealth care plan for health care services shall provide coverage for hospice\nservices under such policy, contract or plan delivered, issued for delivery or\nrenewed in this Commonwealth on and after July 1, 1999.\n\nB. As used in this section:\n\t\t\t“Hospice services” shall mean a coordinated program of home and\ninpatient care provided directly or under the direction of a hospice licensed\nunder Article 7 (§ 32.1-162.1 et seq.) of Chapter 5 of Title 32.1, and\nshall include palliative and supportive physical, psychological, psychosocial\nand other health services to individuals with a terminal illness utilizing a\nmedically directed interdisciplinary team.\n\t\t\t“Individuals with a terminal illness” shall mean individuals\nwhose condition has been diagnosed as terminal by a licensed physician, whose\nmedical prognosis is death within six months, and who elect to receive\npalliative rather than curative care.\n\t\t\t“Medicare” shall mean Title XVIII of the Social Security Act.\n\t\t\t“Palliative care” shall mean treatment directed at controlling\npain, relieving other symptoms, and focusing on the special needs of the patient\nas he experiences the stress of the dying process, rather than treatment aimed\nat investigation and intervention for the purpose of cure or prolongation of\nlife.\n\nC. For the purposes of this section, documentation requirements shall be no\ngreater than those required for the same services under Medicare.\n\nD. Nothing in this section shall prohibit an insurer, corporation, or health\nmaintenance organization from offering or providing coverage for hospice\nservices when it cannot be demonstrated that the illness is terminal or for\nindividuals with life expectancies of longer than six months.\n\nE. The provisions of this section shall not apply to short-term travel, accident\nonly, short-term nonrenewable policies of not more than six months’\nduration, or to policies or contracts designed for issuance to persons eligible\nfor coverage under Title XVIII of the Social Security Act, known as Medicare, or\nany other similar coverage under state or federal governmental plans.\n\nHISTORY: 1999, c. 858.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}