If you or someone you know is preparing for hospice care, it’s essential to understand what Medicare covers. It’s available for eligible beneficiaries with terminal illnesses with a life expectancy of six months or less.
Hospice is a specialized type of healthcare that focuses on improving the quality of life of people facing a life-limiting illness. Hospice aims to provide physical, emotional, and spiritual support to patients and their families as they cope with the end-of-life process.
Here’s how hospice care typically works:
Referral: A patient or their family can request hospice care, or a healthcare provider can refer them to a hospice agency.
Evaluation: The hospice team will evaluate the patient’s medical condition and needs to determine if they meet the criteria for hospice care.
Care plan: The hospice team will develop a care plan that outlines the patient’s treatment, medication, and support needs. The care plan is regularly reviewed and updated to meet the patient’s changing needs.
Care delivery: The hospice team provides care based on the care plan, including medical care, pain and symptom management, emotional and spiritual support, and assistance with daily living activities.
Care coordination: The hospice team coordinates care with the patient’s healthcare providers and family members to ensure that the patient’s needs are met.
Bereavement support: Hospice supports the patient’s family and loved ones during and after the patient’s death.
Hospice care can be provided in various settings, including the patient’s home, hospice facilities, hospitals, and nursing homes. The hospice team includes doctors, nurses, social workers, chaplains, and other professionals who work together to provide holistic care to patients and their families.
Hospice care is covered by Medicare, Medicaid, and many private insurance plans, making it accessible to those who need it.
What Does Medicare Cover in Regards to Hospice Care?
Doctor and nursing services: Medicare covers the services of doctors and nurses specially trained in hospice care.
Medical equipment and supplies: Medicare covers the cost of medical equipment and supplies necessary to manage the patient’s symptoms, such as oxygen equipment, hospital beds, and wheelchairs.
Prescription drugs: Medicare covers prescription drugs necessary to manage the patient’s symptoms.
Home health aide and homemaker services: Medicare covers the services of a home health aide or homemaker who can assist with activities of daily living, such as bathing and dressing.
Spiritual and emotional support: Medicare covers the services of a chaplain, social worker, or counselor who can provide emotional and spiritual support to the patient and their family.
Respite care: Medicare covers up to five days of respite care for the patient, which allows the caregiver to take a break.
Let’s break down Medicare coverage for hospice care even more.
Medicare Part A and Hospice Care
Here are the hospice services that Medicare Part A covers:
Doctor and nursing services: Medicare Part A covers the services of doctors and nurses specially trained in hospice care.
Medical equipment and supplies: Medicare Part A covers the cost of medical equipment and supplies necessary to manage the patient’s symptoms, such as oxygen equipment, hospital beds, and wheelchairs.
Prescription drugs: Medicare Part A covers prescription drugs necessary to manage the patient’s symptoms.
Home health aide and homemaker services: Medicare Part A covers the services of a home health aide or homemaker who can assist with activities of daily living, such as bathing and dressing.
Spiritual and emotional support: Medicare Part A covers the services of a chaplain, social worker, or counselor who can provide emotional and spiritual support to the patient and their family.
Respite care: Medicare Part A covers up to five days of respite care for the patient, which allows the caregiver to take a break.
It’s important to note that while the patient receives hospice care, Medicare Part A does not cover curative treatments for the terminal illness. However, if the patient’s condition improves and they no longer meet the hospice criteria, they can resume traditional Medicare coverage for their condition.
Medicare Part B and Hospice Care
Medicare Part B covers certain hospice-related services not covered under Medicare Part A. Here are the hospice services that Medicare Part B covers:
Medical services: Medicare Part B covers medical services unrelated to the terminal illness, such as treatment for a cold or flu.
Outpatient services: Medicare Part B covers outpatient services like physical and occupational therapy.
Medical equipment and supplies: Medicare Part B covers specific medical equipment and supplies not covered under Medicare Part A, such as walkers and wheelchairs.
Prescription drugs: Medicare Part B covers prescription drugs unrelated to the terminal illness, such as medication for high blood pressure or diabetes.
It’s important to note that if a patient receives hospice care, Medicare Part B may not cover some services typically covered under the plan. For example, suppose a patient is receiving hospice care. In that case, Medicare Part B will not cover routine physical exams, preventive care, or screenings for conditions unrelated to the terminal illness. However, these services may be covered if the patient stops receiving hospice care.
Work With a Trusted Medicare Insurance Agent
Hospice care can be very valuable in comforting someone at the end stages of life. While not everything is covered through Medicare Part A and B, many things are. I work with individuals with various needs when it comes to Medicare and finding the best options. Contact me today to discuss how Medicare can help you or your loved ones who need hospice care.