Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations.
How is hospice paid for?
Hospice is paid for through the Medicare Hospice Benefit, Medicaid Hospice Benefit, and most private insurers. (link to “FAQ” page under What is Hospice) If a person does not have coverage through Medicare, Medicaid or a private insurance company, hospices will work with the person and their family to ensure needed services can be provided.
More than 90% of hospices in the United States are certified by Medicare. Medicare defines a set of hospice core services, which means that hospices are required to provide these set of services to each person they serve, regardless of the persons insurance.
Eighty percent of people who use hospice care are over the age of 65, and are thus entitled to the services offered by the Medicare Hospice Benefit. This benefit covers virtually all aspects of hospice care associated with the hospice diagnosis with little out-of-pocket expense to the patient or family. As a result, the financial burdens usually associated with caring for a terminally ill patient are virtually nonexistent. In addition, most private health plans and Medicaid in 47 States and the District of Columbia cover hospice services.
Sometimes a terminally ill patient’s health improves or their illness goes into remission. If that happens, your doctor may feel that you no longer need hospice care and won’t recertify you at that time. Also, as a hospice patient, you always have the right to stop getting hospice care, for any reason. If you stop your hospice care, you will receive the type of Medicare coverage that you had before electing hospice. If you are eligible, you can go back to hospice care at any time.
If you have a question that isn’t addressed above, email Caring Connections.
How does hospice work?
Hospice care is for any person who has a life-threatening or terminal illness. Most reimbursement sources require a prognosis of six months or less if the illness runs its normal course. Patients with both cancer and non-cancer illnesses are eligible to receive hospice care. All hospices consider the patient and family together as the unit of care.
The majority of hospice patients are cared for in their own homes or the home of a loved one. “Home” may also be broadly construed to include services provided in nursing homes, hospitals, assisted living facilities, shelters and prisons.
Typically, a family member serves as the primary caregiver and, when appropriate, helps make decisions for the terminally ill individual. Members of the hospice staff make regular visits to assess the patient and provide additional care or other services. Hospice staff is on-call 24 hours a day, seven days a week.
Who is the hospice team?
Hospice care is a family-centered approach that includes, at a minimum, a team of doctors, nurses, social workers, counselors, and trained volunteers. They work together focusing on the dying patient’s needs; physical, psychological, or spiritual. The goal is to help keep the patient as pain-free as possible, with loved ones nearby until death. The hospice team develops a care plan that meets each patient's individual needs for pain management and symptom control.
It is important to find out what the role of the patient's primary doctor will be once the patient begins receiving hospice care. Most often, hospice patients can choose to have their personal doctor involved in the medical care. Both the patient's physician and the hospice medical director may work together to coordinate the patient's medical care, especially when symptoms are difficult to manage. Regardless, a physician's involvement is important to ensure quality hospice care. The hospice medical director is also available to answer questions you or the patient may have regarding hospice medical care.
The team usually consists of:
- The patient' s personal physician
- Hospice physician (or medical director)
- Nurses
- Home health aides
- Medical social workers
- Spiritual support staff
- Bereavement
- Trained volunteers
- Complementary therapies such as music, art and pet therapies
Click here to read more about these and other services.
What services does the hospice team provide?
Among its major responsibilities, the interdisciplinary hospice team:
- Manages the patient’s pain and symptoms
- Assists the patient with the emotional, psychosocial ,and spiritual aspects of dying
- Provides needed medications, medical supplies, and equipment
- Coaches the family on caring for the patient
- Delivers special services like speech and physical therapy when needed
- Makes short-term inpatient care available when pain or symptoms become too difficult to manage at home, or the caregiver needs respite time
- Provides bereavement care and counseling to surviving family and friends.
In many cases, family members or loved ones are the patient's primary caregivers. Additionally, hospice recognizes that loved ones have their own special needs for support. As a relationship with the hospice begins, hospice staff will want to know about the primary caregiver's priorities. They will also want to know how best to support the patient and family. Support can take many different forms, including visits with the patient and family members; telephone calls to loved ones, including family members who live at a distance; and the provision of volunteers to assist with patient and family needs.
Counseling services for the patient and loved ones are an important part of hospice care. After the patient's death, bereavement support is offered to families for at least one year. These services can take a variety of forms, including telephone calls, visits, written materials about grieving, and support groups. Individual counseling may be offered by the hospice or the hospice may make a referral to a community resource.
If you have a question that isn’t addressed above, email Caring Connections.
How do I begin receiving hospice?
Anyone can inquire about hospice services. You or your loved one may call a local hospice and request services. The hospice staff will then contact your physician to determine if a referral to hospice is appropriate. Another way to inquire about hospice is to talk with your physician, who can make a referral to hospice.
Hospice can begin as soon as a ‘referral’ is made by the person’s doctor. The hospice staff will then make contact to set up an initial meeting. At that time, hospice services are reviewed and necessary consent forms for care to begin are signed. Usually, care is ready to begin within a day or two of a referral. However, in urgent situations, service may begin sooner.
When is the Right Time to Ask about Hospice?
Now is the best time to learn more about hospice care and ask questions about what to expect. Although end-of-life care may be difficult to discuss, it is best for loved ones and family members to share their wishes long before it becomes a concern. This can greatly reduce stress when the time for hospice becomes apparent. By having these discussions in advance, uncomfortable situations can be avoided. Instead, educated decisions can be made that include the advice and input of loved ones.
Hospice checklist
Below is a list of things to think about as you consider contacting a Blue Ridge Hospice and how you can help to improve access to end-of-life care for your family, friends and in your community.
- Have an advance directive
 (PDF/23.6k) in place that authorizes a person of your choosing to make decisions if you become unable to do so for yourself
- Get the information you need about services provided by Blue Ridge Hospice
- Make sure you understand how hospice services are paid for
- Discuss your thoughts, concerns and choices with your family and friends
- Talk to your health care agent, family and doctor about your choices
- Draw up a living will of instructions (PDF/23.6k) to make known what you want done if, for example, you are seriously ill and the only way you can be kept alive is by artificial means
- Encourage your family and loved ones to complete their own advance directive (PDF/24k)
- Engage others in discussions about end-of-life care issues and encourage them to complete their own advance directives
- Seek out opportunities to help others who are dealing with end-of-life care issues such as volunteering with a local hospice or end-of-life care coalition
- If you’d like to make a donation in honor or memory of someone whose life has been touched by hospice, click here
For more information about how you can engage others, contact Caring Connections.
at (800) 658-8898 or email us at: caringinfo@nhpco.org.
|
