Hospice care is care given to a person with a terminal condition, to keep them comfortable during their final days. The plan is put together by a special team.
They decide what services you will receive and which ones will not be offered. Things that will likely be provided are:
• Nursing care
• Physician care
• Wheelchairs and walkers
• Prescription drugs for pain relief
• Sometimes medication for symptom control
• Bandages and other needed medical supplies
• Homemaker services
• Help worker
• Social worker
• Grief counselor
This type of care, means you are forgoing care to cure your condition. It is used in cases of terminal cancer and other conditions that do not have a possibility of improvement. Once you start the plan, you will not receive benefits like:
• Treatment that may cure you of your disease of condition
• Prescription drugs to cure you
• Room and board (most care is done in the patient’s home)
• Emergency room care
Who Can Get Coverage Under Medicare?
You need to have Medicare Part A which is Hospital Insurance to get the Medicare Hospice Benefit. Your doctor must certify that you are terminally ill. This means you are expected to live 6 months or less. You must sign a form selecting this special care instead of regular Medicare coverage. You must accept care for comfort instead of care to cure you. There is no cost for the care, except you may need to pay a copayment of $5 for prescription drugs for pain and symptom control.
Other Things You Should Know About the Medicare Hospice Benefit
You will have an end of life doctor on your team. You may include your regular doctor of the nurse as well. There is a nurse and doctor on call around the clock if your doctor is not available. If you need in-hospital care during your program, your hospice provider must set up arrangements. In-hospital care should not be more than 20 percent of your total care costs. Your hospital care will be covered, but paid to your specific provider.
If you go to the hospital without arrangements with your provider, you may have to pay the entire cost of care. Your end of life provider must be approved of by Medicare. A Medicare plan can help you find a provider in your area. Your personal physician should be able to help you find an approved provider also. When you start your plan, you can still get covered by Medicare for conditions that are unrelated to your terminal illness. You will still have to pay the coinsurance and deductibles that apply and continue to pay your monthly premiums.
How Long Can You Receive Care?
Typically, you are certified for six months. If you live longer, your team doctor will need to re-certify that you are terminally ill. Care can be given in two 90-day periods, followed by an unlimited number of 60-day periods.
Can You Stop the Care Program?
If your condition improves or you go into remission, you can stop your care. You will have to sign a form to stop the care. Do this only at the time you decide to stop it. When you stop care, you will continue to receive the Medicare benefits you had before hospice began. If your condition deteriorates, you can go back on the plan at any time. So, care is available to terminally ill patients you have Medicare Part A.
Once a patient goes on a care plan, Medicare will no longer pay for medical care to potentially cure them. Patients have the option to go off the care plan any time they wish to. They can go back on it if their condition deteriorates again. The plan is provided so that physicians can offer care and patients can get coverage for care during the last months of their lives. It provides in-home care that is not available through regular Medicare plans. It allows the patient to stay with their families and receive care at home.