What is Hospice?
Medical treatment is focused on finding a cure for a patient. But, when a cure is no longer a prognosis, that is the time to consider hospice care.
The focus is on maintaining or improving the quality of life for a patient whose illness, disease, or condition is unlikely to be cured.
The patient’s care plan addresses the physical, emotional, and spiritual pain that comes with terminal illness. While hospice care is focused on the patient, the family and caregivers are also part of the process including grief support after the death. It is a blessing when medical intervention is no longer the best option and life prognosis is six months or less.
Hospice care is a family affair. The family comes together – each doing their part. The team offers support and education. It includes doctors, nurses, social workers, chaplains/spiritual advisers, and personal care aides. But, no one knows the patient as well as you and your input is critical to this process.
Medicare and Costs
Most patients opt for comfort at home and the Medicare Hospice Benefit can help with the cost burdens of care.
If the patient meets these conditions, they are eligible for the Medicare Hospice Benefit
- They are eligible for Medicare Part A. You can confirm eligibility at medicare.gov.
- The doctor and hospice physician agree that the patient’s life expectancy is six months or less.
- The patient agrees that they will only receive care for comfort – not treatments aimed at a cure.
Care can be stopped at any time and can always be reinstated as long as the above conditions still apply.
If the patient exceeds the life expectancy of six months, services will continue without penalty.
How Do You Find a Care Provider?
All service providers are reimbursed in the same way. As such, providers do not compete based on cost but on the quality of service.
In searching for a program, make sure that the Medicare Hospice Benefit covers 100 percent of the services with no co-payments. The following should all be covered.
- All medications – prescribed or over-the-counter
- Medical equipment and supplies related to the patient’s illness that are required for enhanced comfort
- Lab and other diagnostic tests
- Inpatient care for symptoms and pain that cannot be managed at home
- Bereavement support for the family for at least one year after the patient’s death.
- Time and services of the care team, including visits to the patient’s location by the physician, nurse, medical social worker, home-health aide and chaplain/spiritual adviser
- Physical, speech, and occupational therapy related to the terminal illness
- Dietary counseling
What’s not covered by the Medicare Hospice Benefit?
- Room and board in a nursing home or residential facility
- Treatment or medication intended to cure the patient’s illness
- Emergency room visits, inpatient care, or ambulance services unless arranged by the hospice team
When choosing a provider, keep these questions in mind.
- Do they have a full-time medical staff dedicated to the patient and family?
- Do they have the resources and facilities to provide the most appropriate level of care?
- Are there systems in place to assure that they are responsive to the patient and family’s needs?