When you or a loved one has a life-limiting illness, medical expenses are often a concern. Co-pays, deductibles and over-the-counter supplies can add up quickly. Hospice can help with not only the physical and emotional challenges families struggle to cope with when dealing with a serious illness, but the financial ones too.
The support of hospice is covered by Medicare, Medicaid, the Department of Veteran’s Affairs, and most private insurance companies. And, most hospices find a way to help those that are uninsured. Medicare continues to be the most common form of payment with almost 80% of hospice patients aged 65 or older.
What Expenses Are Covered by the Medicare Hospice Benefit?
The Medicare Hospice benefit covers everything a patient needs to manage the care for their life-limiting illness including:
- Physician care
- Nursing services
- Certified Nursing Assistants
- Medications related to the terminal diagnosis to help with pain and symptom control
- Medical equipment (hospital bed, walker, wheelchair)
- Medical supplies related to the terminal diagnosis
- Social work support
- Spiritual care
- Nutrition counseling
- Bereavement support for families
- Short-term respite care
A few exclusions to the benefit include:
- Treatments intended to cure the disease
- Medications and supplies not related to the terminal diagnosis
- Room and board in a nursing home
Many insurance programs follow the Medicare hospice guidelines for determining benefit coverage.
Hospice Eligibility for Medicare Patients
To be eligible to utilize the Medicare hospice benefit, the patient must:
- Be a recipient of or entitled to receive Part A of the Medicare benefit
- Be certified by a physician as terminally ill with a life expectancy of six months or less if the disease or illness follows its normal course
The hospice benefit can last six months or longer if the patient continues to meet the criteria outlined above. For certification purposes, the Medicare hospice benefit is made up of two 90-day benefit periods and an unlimited number of sixty-day benefit periods.
If you would like to read more, The Medicare Hospice Benefit is a publication that can be downloaded from the Centers for Medicare and Medicaid. For additional information about eligibility and benefits, call Halcyon Hospice at 855-328-1700 or visit our website at www.ExcellenceInHospice.com.