Hospice care is designed to be a support for people who are facing a life-limiting illness. Hospice teams are comprised of experts who help patients and their families through the physical, spiritual, and psychosocial needs as they embark on this part of life’s journey. The goal of the hospice team is not to add days to someone’s life but add life into the days they have remaining.
If you or someone you love is living with a terminal illness and would like professional assistance to maintain your quality of life, it’s worth exploring how Medicare benefits for hospice care work. In understanding these benefits, eligible patients and their families can spend less time worrying about the details of caregiving, medication costs, and pain management issues and more time focusing on the things that matter most.
Who Is Eligible for Medicare’s Hospice Benefits?
Hospice care focuses on offering comfort care and support that is going to add to the quality of a person’s life. Individuals who choose hospice have the benefit of receiving medical care in their home. When someone chooses hospice services, they have decided they no longer wish to seek curative treatment. They do not want to go to the hospital or ER anymore; they prefer to have any symptoms they experience managed at home.
To be eligible for hospice, a person must have a life-limiting illness and a prognosis they will live six months or less if the disease process follows the normal progression. Medicare, Medicaid, and VA cover the hospice expense. Most insurances have a hospice benefit as well but the benefits vary per plan.
What Is Covered?
Hospice is a customized form of care that is tailored to meet the unique needs of each patient. Covered services may include the following (source):
- Physician services
- Nursing care
- Hospice aide and homemaker services
- Social work services
- Chaplain and bereavement services
- Hospice volunteer
- Medications related to the hospice diagnosis and medications for pain relief and symptom control
- Medical supplies and durable medical equipment
- Grief and loss counseling for the terminally ill patient and their family
- Other Medicare-covered services recommended by the hospice team for the management of pain and symptoms
It’s important to note that accepting hospice care is not final. Patients have the right to stop hospice care at any time, so if their disease goes into remission or their prognosis improves unexpectedly, they can opt to end hospice care.
What Costs Are Involved?
For patients with Medicare, Medicaid, and VA benefits, there is generally no charge for hospice services, but there may be copayments for certain things. For example, a copayment of no more than $5 may be required for covered prescription medications that are used to manage symptoms or pain. For respite care, patients may be requested to pay five percent of the Medicare-approved amount for inpatient respite care. These expectations vary between hospice agencies, so it is best to ask questions before services are started.
How Long Does Medicare’s Hospice Benefit Last?
While hospice care is intended for terminally ill patients with no more than six months to live, the benefit may extend past that time frame. As long as the patient is declining and changes are being seen, hospice can continue to care for him. Once a person has utilized hospice services for six months, a physician will visit them and do a face-to-face visit. After that visit, the physician will determine if the patient still meets hospice criteria. If the patient does not meet criteria, he will be discharged from services and can resume hospice services when his condition has declined enough to qualify for hospice services.
Hospice workers are committed to offering support to the terminally ill and their families. If you want to learn more about Medicare benefits for hospice care, take a look at what Phoenix Home Care & Hospice has to offer. We can accommodate for a number of services ranging from hospice to pediatric care to other home services, and we have licensed professionals across the country in Missouri, Illinois, Colorado, and Kansas. To get more information on what we can provide, get in touch with us at 855-881-7442, or visit us online. We look forward to connecting with you.