Hospice is a specialized type of service for those facing a terminal illness. Hospice addresses the patient’s physical, emotional, social and spiritual needs and is provided to those with a life expectancy of six months or less. The goal of hospice care is to make their remaining time as comfortable and meaningful as possible while providing dignity in the process.
One of the most common questions we encounter here at McCortney Family Hospice is, “what is covered and how much will I need to pay?” In today’s blog, we’ll be sharing some information on eligibility and what the Medicare hospice benefit provides in this underutilized program.
Who’s eligible for the hospice benefit?
As we mentioned, patients facing terminal illness with a life expectancy of six months or less and no longer seeking curative treatment and are eligible for hospice care. Your physician or nurse practitioner will certify that you’re terminally ill and refer you to a hospice of your choice.
How does the Medicare hospice benefit work?
Once you’ve been certified by the doctor or nurse practitioner and have enrolled, you and your family will work with a hospice provider to create a plan of care that meets your needs. You will also be working with a supportive team of skilled nurses, social workers, counselors, pharmacists, hospice aides and volunteers. And if needed, hospice may also include resources like physical and occupational therapists, speech-language pathologists and dietary counselors.
A hospice nurse will be on-call 24/7 to provide emergency care when you need it. You may also choose to include your regular doctor as the attending professional who supervises your care. One of the greatest benefits of hospice is that it allows you and your family to stay together in the comfort of your home – or can make the necessary arrangements if you require additional care or nursing home placement.
What does Medicare cover?
Once you’ve created a care plan and your hospice benefit starts, original Medicare Part A will cover everything related to your terminal illness. But, the care you receive must be from a Medicare-approved hospice provider.
If your caregiver or family member needs rest, you can receive respite care in a Medicare-approved center like a hospice inpatient facility or nursing home. Your hospice provider will arrange this for you, and you can stay up to five days each time you receive respite care. It covers durable medical equipment such as hospital beds and oxygen. It also covers medications related to the hospice diagnosis that assist in symptom control and pain relief.
What does the hospice benefit not cover?
Once you’ve started hospice and stated you no longer want to pursue curative treatment (or your doctor has determined that the efforts to cure your illness aren’t working), be aware of the aspects Medicare will no longer cover.
- Treatment intended to cure your terminal illness.
- Care from a provider that wasn’t set up by the hospice medical team. However, you may choose to include your current doctor as the medical professional to supervise your health.
- Medicare doesn’t cover room and board in a nursing home or facility.
What will I pay for hospice care?
Medicare pays the hospice provider for your medical care under Medicare Part A. The cost is covered by the Medicare hospice benefit and anything related to your terminal illness or hospice diagnoses will be covered under Medicare Part B.
How long can you get hospice care?
If you live longer than six months, you can still receive hospice care as long as the medical director re-certifies that you’re terminally ill. To learn more about hospice and what your healthcare plan will cover, reach out to us at one of our two locations: (405) 360-2400 in Norman and (580) 332-6900 in Ada.
Wondering about the hospice services Medicare covers?
Our team at McCortney Family Hospice has created a free guide that illustrates the similarities and differences between hospice and palliative care – and what services are provided in each. Click here to access this free resource now!