Hospice – One of Medicare’s Best Benefits
Courtesy Pikes Peak Hospice & Palliative Care, Colorado Springs LIVING WELL Magazine
With the skyrocketing cost of healthcare, many people are concerned about how to access and pay for medical services. Even with the Affordable Care Act unfolding, it is a common misconception that quality end-of-life care is expensive or unaffordable.
Hospice care is one of Medicare’s best benefits. It is paid for through the Medicare Hospice Benefit. The Medicaid Hospice Benefit (offered by the state of Colorado) and many private insurance plans also cover the costs of hospice care. Many hospice providers, including Pikes Peak Hospice & Palliative Care, work with patients and families to provide needed services even when they do not have a payor source.
You are eligible for the Hospice Medicare Benefit if you meet all of the following conditions:
You are eligible for Medicare Part A (hospital insurance).
Your doctor and the hospice medical director certify that you have a life-limiting illness and, if the disease runs its normal course, death is expected in six months or less.
Your goals of care are focused on relief of symptoms and comfort measures, not on curative therapies.
You receive care from a Medicare-Certified hospice program.
As a Medicare recipient you have options:
You do have the right to choose any Medicare-Certified hospice agency providing service in your community. But, not all hospices are the same. You can contact hospice agencies directly to get information about eligibility and services. Be sure to ask about additional programs and therapies that they offer.
You may remain in your Medicare private health plan while you get hospice care, and you may continue to see your regular doctors for curative treatment of all illnesses and injuries unrelated to the terminal diagnosis.
Medicare-Certified hospice providers must have all core services. But not all services are needed by all patients. Your hospice team will develop a care plan appropriate to meet your specific needs. The plan is continually reviewed and adjusted as needed.
Medicare beneficiaries who choose hospice care are eligible to receive a full range of medical and support services for their life-limiting illness. Virtually all aspects
of hospice care are covered under the Hospice Medicare Benefit, including a variety of services for family and loved ones. There are no co-pays for hospice services. However, depending on which hospice provider you choose there may be some out-of-pocket expenses.
Medications not directly related to your hospice diagnosis are not covered under the Medicare Hospice Benefit. Your hospice team will let you know which drugs and medications are covered and which are not.
Most individuals prefer to receive hospice care at home. If a patient receives hospice care in a long-term care or assisted living facility, the cost to live in these settings may not be covered by your insurance. Special circumstances may allow for inpatient hospice care, including symptom management, which cannot be accomplished in another care setting, or for short periods of time.
Often patients and clinicians fail to realize that hospice is not just for those on the brink of death. For many people death is months, not days, away. Get to know hospice providers in your community. Ask them specific questions about services and costs. They can help determine your Medicare/Medicaid eligibility and review your personal insurance benefits with you. If you or a loved one are living with life-limiting illness, paying for hospice should be your last concern.
For more information about Pikes Peak Hospice & Palliative Care, please visit our website at www.pikespeakhospice.org or call 719-633-3400. You can also find us on Facebook.