What is Hospice?
The healthcare community is making a concerted effort to educate patients, their healthcare agents and families about the Medicare Hospice Benefit (MHB) so they can make an informed care decision that meets the wishes of the patient or loved one.
Hospice is appropriate when a patient seeks “comfort care" and is no longer interested in curative therapies (i.e. rehabilitation).
A specially-trained team, including doctors, nurses or nurse practitioners, pharmacists, physical & occupational therapists, speech language pathologists, social workers, counselors, chaplains, hospice aides and volunteers, provide care for the “whole person” including physical, social, emotional and spiritual needs.
Typical services include physical care, short-term inpatient care (pain & symptom management) short-term respite for the primary caregiver (up to 5 days), grief, loss and dietary counseling, medications, durable medical equipment (DME), such as hospital beds, wheelchairs or walkers, oxygen and supplies (i.e. incontinence).
The hospice benefit does not cover (1) any treatments intended to cure a terminal illness, (2) prescription drugs (except for pain & symptom management), (3) care from any provider not set up by the selected hospice agency, (4) room and board (i.e. assisted living) and (5) hospital-level care such as emergency department visits, inpatient care or ambulance transportation (unless arranged by your hospice provider).
Eligibility for the hospice benefit includes: (1) having Medicare Part A (hospital insurance), (2) primary care physician (PCP) or nurse practicioner (NP) and hospice physician certify a terminal illness with 6 months or less to live, (3) patient or their agent accepts palliative care for comfort instead of care to cure the illness and (4) patient or their agent signs a statement choosing hospice over other Medicare options.
The first step to exploring the hospice option is to request a one-time hospice consultation with a Medicare-approved hospice provider. Hospitals usually provide a list of local hospice agencies for families to choose from. If the patient, agent or family decides that hospice is the right care option and eligibility is confirmed, the hospice agency will coordinate a plan of care following discharge from the hospital to a hospice inpatient facility, home or long-term care facility (assisted living).
Hospice care is provided in benefit periods. If a patient lives beyond 6 months, they can continue under hospice care if the hospice medical director re-certifies the terminal illness. More specifically, hospice care is approved initially for two 90-day benefit periods followed by an unlimited number of 60-day benefit periods. It’s important to know that a patient or their agent can change the hospice provider once during a given benefit period or choose to stop hospice care at any time.
In summary, hospice care is a wonderful Medicare benefit if your loved one wishes to be comfortable and seeks to live well in their final season of life.