What is Hospice Care?
The term hospice refers to treatment, services, and care for people who have a terminal illness and are expected to live for no more than six months.
The objective of hospice is to provide patients with peace of mind, while also ensuring they get a high quality of life for those who are near death. Many hospice providers put an emphasis on addressing the physical, emotional, and spiritual needs of the terminally ill patient, rather than offering curative treatment. According to reports, if a senior who is chronically ill is found to be eligible for Medicare, their end-of-life care will likely get covered.
Making decisions about hospice care, whether for yourself or for someone you care about, is difficult. Getting direct answers about how much hospice costs and how you can pay for it may help you make a difficult decision.
Does Medicare Cover Hospice – Pay for Hospice
Original Medicare (Medicare Parts A and B) covers hospice care as long as your hospice provider is enrolled in the program and accepts Medicare. Hospice care is also covered by a Medicare Advantage (Part C) plan.
If you’re looking for specific answers about which hospice facilities, providers, and services are covered by Medicare, this article can help.
Once a medical doctor certifies that you have an illness that makes it unlikely that you will live longer than 6 months, Medicare will help pay for hospice care.
Medicare Coverage Requirements for Hospice Care
Medicare is made up of numerous components. Each section covers a different set of items and services. The following is a breakdown of the role that each component of Medicare may play in covering your hospice care:
Part A of Medicare.
- Part A covers hospital expenses if you need to be admitted to a care facility for your symptoms or to give your caregivers a break.
Part B of Medicare.
- Outpatient medical and nursing services, medical equipment, and other treatment services are all covered by Part B.
Part C of Medicare.
- If you have a Medicare Advantage plan, it will continue to cover you as long as you pay your premiums, but it will not cover your hospice expenses. Those are covered by original Medicare. Your Medicare Part C plans can still be used to pay for treatments that aren’t related to the terminal illness or that aren’t covered by original Medicare (Medigap). Medigap policies can assist with costs that are unrelated to the terminal illness. Because hospice expenses are covered by original Medicare, you won’t need these benefits to help cover them.
Part D of Medicare.
- Your Part D prescription drug coverage will remain in effect to assist you in paying for medications unrelated to the terminal illness. Otherwise, medications used to treat symptoms or manage pain associated with a terminal illness are covered under your original Medicare hospice benefit.
Hospice Services Covered by Medicare
Both the patient and their family members get benefit from the range of services provided by hospice providers. To make sure the patient understands, it is important to be aware that services like these could be included in the patient’s overall plan of care and are at least partially covered by Medicare.
Original Medicare covers a wide range of services, supplies, and prescriptions related to the illness that prompted you to seek hospice care, such as:
- Doctor and nursing services.
- Physical, occupational, and speech therapy services
- Medical equipment, such as walkers and hospital beds
- Durable medical equipment (e.g., wheelchairs, walkers)
- Medical supplies (e.g., bandages, catheters)
- Nutrition counseling
- Prescription medications needed to relieve symptoms or control pain.
- Aide and homemaker services
- Grief and loss counseling for both the patient and their family
- Short-term inpatient care for pain and symptom management
- Social work services
- Short-term respite care (up to 5 days at a time) to give your caregiver a break if you are being cared for at home.
If you are receiving hospice care, Medicare Part A will continue to cover any other non-terminal illnesses or conditions you may have. You can also keep your Medicare Advantage plan while receiving hospice care if you want to continue receiving additional coverage.
Hospice Respite Care for Family Caregivers
The considerable physical and emotional effort involved in caring for a seriously ill loved one, especially someone who is approaching the end of their life, is significant. Short-term inpatient respite care, a hospice service provided by Medicare Part A, is an extremely valuable resource for people who are feeling distressed. This service provides terminally ill individuals the opportunity to continue receiving hospice care while they are receiving hospice services in a Medicare-approved hospice house, skilled nursing facility, or hospital. Their family caregiver may rest and recuperate while this is happening. The respite that an inpatient receives may last up to five days, and they may have to pay a small fee for their room and board while they are in the hospital. It is not unusual for patients and their families to request respite more than once, but the service can only be provided on an infrequent basis.
What Medicare Does NOT cover for Hospice Patients
- The final stages of treatment are meant to cure a terminal illness.
When a senior chooses to receive curative treatment for an illness that will inevitably lead to death, they no longer qualify for hospice care. Patients have the right to discontinue medical palliative care at any time. However, they can return to receiving treatment at any time, provided they still meet all of the eligibility requirements
- Palliative prescription medications to aid in the final stages of the disease.
Medicare’s hospice benefit does not cover any pain medications or treatments unless they are for the relief of pain and the treatment of symptoms.
- You should go to any hospice provider other than the hospice medical team arranged the hospice visit.
It is critical that all of the patient’s care be delivered or arranged by a single hospice medical team of the patient’s choice. Changing your Medicare-approved hospice provider will not allow you to receive the same type of hospice care you had before, since a senior is only eligible for one provider. In the case of in-home hospice care, a patient’s regular doctor or nurse practitioner is there to provide oversight, but they may still see their regular doctor or nurse practitioner if they have been appointed to supervise the patient’s hospice care.
- Included is room and board.
With respect to patients who receive hospice care while living at home, in nursing homes, in assisted living facilities, or in inpatient hospice houses, Medicare does not cover room and board. You will only be responsible for room and board during a short-term inpatient or respite stay.
- Patient care during a medical emergency
To qualify for Medicare’s hospice benefit, one must be enrolled in a hospice program that the patient designates and receive care from the medical team in that program. However, care received in an emergency room, or ambulance service, and care received in a hospital, regardless of the facility where care is received, are not covered.
What can Oasis Hospice Care do for the health of your Loved one?
Hospice doctor care is an extra layer of treatment for your loved one at home or in a care center, provided in collaboration with your family and their doctors. When a patient enters hospice care, they are surrounded by a team of people who can help start them with their physical, mental, and spiritual needs. The treatment for the patient’s terminal disease, as well as all medical equipment and supplies related to this condition, are given at no cost to the patient or his or her family.
Nurses and aides are available from Oasis Hospice & Palliative Care to help with health and personal care needs. Our social workers will assist the family in locating additional services (like grief support) and preparing for the end of life. Chaplains provide spiritual guidance and grief support. Volunteers step in and offer companionship visits to your loved one while allowing family members to relax. For those who need additional assistance, bereavement counselors are available. Contact us to find out how to start this care right away for your loved one.