Hospice

Hospice is traditionally for people with advanced illnesses whose life expectancy is six months or less. The decision to enroll in this service can be very difficult for patients or their family. It means not using curative measures for the terminal illness.

This type of specialized health care is designed to provide support to patients suffering with a terminal illness and his/her loved ones. The goal is to relieve suffering and improve the quality of life for people with an advanced illness or those near the end of life.  It focuses on comfort and quality of life, rather than cure. This service affirms life and views death as a natural process.

Compassionate care and knowledgeable guidance is provided every step of the journey. A coordinated team of professionals, assisted by volunteers, works to meet the patient’s and family’s emotional and spiritual needs, as well as the patient’s physical needs. The experienced interdisciplinary team can provide information on where the services can be provided, whether in the patient’s home or in a facility like an assisted living facility or a nursing home.

The interdisciplinary team may consist of any of the following disciplines or all of them depending on the needs of the patient and/or the family.

The emphasis is on controlling pain and symptoms through the most advanced techniques available and on emotional and spiritual support tailored to the needs of the patient and family.

A terminal illness affects the entire family as well as the person who is ill and sometimes, it’s the family members who need the emotional and spiritual services and support more that the patient.  

Eligibility

Patients who have chosen to focus on comfort and relief from pain and symptoms may elect to receive these services, however, these services may not be appropriate if you are seeking treatments intended to cure your illness.

Some of the more common diagnoses associated with hospice care include cancer and other end-stage diseases such as:

• Cardiovascular Disease                             
• Aids/HIV
• Alzheimers Disease                                    
• Chronic/End-Stage Respiratory Disease
• Neurological Disease                                
• Major Stroke
• Liver/Renal Disease (ESRD)                                 
• Terminal Cancer

If you or a loved one is suffering from symptoms of a disease or disorder, be sure to ask your primary care physician for a referral to a licensed and certified agency.

Who Pays?

When you elect to have the services of hospice care, all your needed health care services should be covered under your Medicare/Medicare Advantage/Medicaid Plan. It is also covered by many private insurance companies.

If you are covered by a Medicare Advantage Plan that covers other services not covered by traditional Medicare such as dental or vision, those services will continue uninterrupted as long as you stay enrolled in that Plan.

If you choose to obtain health services that aren't part of your terminal illness, you may be required to pay the deductible and coinsurance amounts for all Medicare covered services.

How Long Can I Receive Hospice Care?

Many people don't receive end of life care until the final weeks or even days of life, possibly missing out on months of quality time. This may be out of fear that it would mean losing out on a chance for a cure. Sometimes doctors fear that their patients will feel abandoned if they suggest hospice. Early referrals help patients and their family receive the maximum benefit that the health plan allows.

Patients can continue treatments that are maintaining or improving their quality of life as long as they continue to meet criteria. No patient that is appropriate for hospice will be dismissed at six months but rather, the patient will remain on service as long as the services are needed.

If the illness improves, a patient can discontinue the services at any time and return if and when they choose to. That is their right under the law.

What To Do Next?

Once you've decided that you want/need hospice care, you need to notify your primary care physician and let him/her know that you are considering those services. Only your doctor can certify that you have a terminal condition and have a life expectancy of 6 months or less. Once your doctor has made that determination, a referral will be made to the provider agency of your choice, or if you agree, to a provider chosen by your doctor. Ultimately, it is your right to select the agency of your choice.

Here are some factors to consider in selecting an agency. You may want to do a search on the internet or call the agency directly and speak to someone in intake or administration. Some questions to ask:

• Is the agency licensed and Medicare/Medicaid certified to provide these services?
• Does the agency provide training for the caregivers who will be providing your care.
• Will your doctor work with the doctor from the hospice provider?
• Will the staff meet regularly with you and your family to discuss the plan of care?
• Are there after hour services for emergencies and how would I access them?
• What services do the volunteers perform and are they trained?   

The provider you choose must be Medicare-approved to get Medicare payment. To find out if a certain provider agency is Medicare-approved, ask your doctor, the agency you've selected, your state hospice organization, or your state health department.