Hospice is comprehensive care in the last months of life. Hospice services
are provided by a coordinated team of doctors, nurses, social workers, grief
counselors, spiritual counselors, physical therapists, home health aides and
volunteers.
All services are provided at home, if at all possible.
Otherwise, inpatient care is available in hospice facilities, special units
in hospitals, and nursing homes.
Comprehensive Coverage with Minimum
out of Pocket Expenses
As a Medicare beneficiary, you are entitled
to the Medicare Hospice Benefit without additional premiums. If you are enrolled
in a managed care organization (MCO) you have access to this benefit, even
if the MCO does not cover hospice services.
The Medicare Hospice Benefit
covers the following hospice services in full:
- Skilled nursing services
- Volunteer Services
- Physician visits
- Skilled therapy
- Home health aide visits
- Medical social services
- Spiritual counseling
- Nutrition counseling
- Bereavement support for the family
The Medicare Hospice Benefit also covers 95% of the cost of the following
although most hospices do not collect the 5% co-payment:
- Drugs for pain and other symptoms
- Inpatient respite care to relieve the caregiving responsibilities of the
family
For services related to terminal illness, there are virtually no out-of-pocket
expenses, even for drugs, equipment and other high cost items that are often
needed in the last months of life. No other Medicare benefit offers such
financial protection.
The Medicare Hospice Benefit does not cover 24-hour
care, but during a medical crisis, continuous nursing and short-term inpatient
services are available. The Medicare Hospice Benefit also does not cover
personal services.
Maximum Choice
As a Medicare beneficiary,
you can choose any Medicare-certified hospice in any area of the country.
If you are in a managed care organization (MCO) you can select any hospice
- you are not restricted to the MCO's network of providers. You do not need
a referral or approval, nor do you have to disenroll from the MCO. Should
you need health services unrelated to the terminal illness, your MCO is obliged
to provide these services as long as you do not dis-enroll.
If you prefer
to be cared for by your own doctor, rather than the hospice physician, most
hospices will accommodate you. Ask in advance if that is an option. Your
doctor can be reimbursed by Medicare, even if he or she is not under contract
with the hospice.
Reduced Family Burden
The family's burden
is reduced by the financial relief that the Medicare Hospice Benefit provides,
and by volunteers that hospices offer in addition to the hospice staff. In
every Medicare-certified hospice, there are volunteers that lend a helping
hand to the family. They may do household chores, keep the patient company,
and generally respond to the family's need for support.
Bereavement
services are available to the family for about a year after the death, so
hospice patients can be reassured that support will continue well after they
are gone.
After the hospice admission, there is virtually no paperwork,
no bills, no claims, and no financial surprises.
Eligibility
To qualify for the Medicare Hospice Benefit:
- You must have Medicare Part A
- Your doctor and the hospice medical director must confirm that you have
a life expectancy of less than six months
- You must agree in writing not to pursue treatments for curing your illness
Some, though not all, hospices require that patients have a primary
caregiver. Ask in advance if this is an additional admission criterion.
Having access to the hospice and Medicare Hospice Benefit means that
comprehensive care at the end of life does not have to be expensive or burdensome
to your family.
You should be able to die in comfort and with dignity
in your own home, under the supervision of a coordinated team of hospice staff
and volunteers. Family members, too, will be supported in their caregiving
roles and in their grief.
by Naomi Naierman, President and CEO,
American
Hospice Foundation
For Additional Resources:
American Hospice
Foundation tel: 202-223-0204
Choice in Dying tel: 212-366-5540
Hospice
Association of America tel: 202-546-4759
Local hospices - look in the
telephone book
Medicare Rights Center, tel: 212-869-3850
National
Association of People with AIDS, tel: 202-898-0414
National Family Caregivers
Association, tel: 800-658-8898
National Hospice Organization, tel: 800-658-8898
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© 2001. American Hospice Foundation.
All Rights Reserved.
2120 L Street, NW ~ Suite 200 ~ Washington, DC 20037
Tel: 202-223-0204 ~ Fax: 202-223-0208 ~ E-mail: ahf@americanhospice.org
www.americanhospice.org
