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What Is Hospice Care and Does Medicare Cover It?

Persons with a terminal illness have a poor prognosis. As a terminal illness cannot be cured, a person diagnosed with a terminal illness is expected to die from the illness.

The person who is suffering from a terminal illness often has to plan for end-of-life care. The person and his or her family have to choose the option that best meets the end-of-life care needs.

For people with a terminal illness, an option worth considering is hospice care. So what is hospice care? Will Medicare cover it? Here's all you need to know.

What Is Hospice Care?

Hospice care is a type of end-of-life care that focuses on quality of life. This type of special care can be provided to persons who have a terminal illness such as cancer, amyotrophic lateral sclerosis, and liver disease.

While health care providers who focus on hospice care cannot cure a terminal illness, they focus on providing compassionate care. Their goal is to make the patient as comfortable as possible during the final phase of their lives. If a patient is suffering from symptoms such as pain and difficulty breathing, the hospice care providers can focus on using interventions that provide relief.

Persons who receive hospice care are usually assigned a team made up of health care providers and other individuals who have the expertise and skills needed to meet the physical, emotional, and spiritual needs of the person. The individuals who are part of the team may include a physician, hospice care nurse, social worker, home health aide, and a chaplain if the person requests spiritual care.

Persons who are terminally ill are not the only ones who can benefit from hospice care. Caregivers get support as needed. Caregivers are also updated through family meetings.

Types of Hospice Care

Hospice care comes in levels. There are four levels of hospice care - routine home care, continuous home care, general inpatient care, and respite care.

Persons who are provided with routine home care are assigned health aide services for either the home or the nursing home. Continuous home care is provided to persons who need continuous care during a crisis.

General inpatient care is provided in a hospital. This level of hospice care is provided to persons who have pain and other symptoms that require treatment in a hospital setting. For persons who have a caregiver that needs a break, respite care is a possible option.

There is a level of care for each person diagnosed with a terminal illness. The hospice care team will help the patient and his or her family to select the level of hospice care that is the most appropriate.

How to Obtain Hospice Care

If you or your loved one has a terminal illness you need to start exploring if hospice care is an option. A physician is the one who is responsible for determining if the patient meets the criteria for hospice care. After the physician has reviewed for eligibility, the physician will make a referral for hospice care if the patient benefits from it.

Before making a decision, the patient and his or her loved ones must have a discussion with the physician about end-of-life care. While this may be a difficult conversation, it is one that needs to take place.

What Services Are Part of Hospice Care?

Once a person is in hospice care, the person and the caregiver will have a team that will work with them. The dedicated team of professionals will develop a special plan to ensure that the person's needs are met.

The team will check on the person and caregiver regularly. There will be a member of the team who will be on call 24 hours a day, 7 days a week via telephone. This member of the team will be available to answer questions and address concerns.

How Is Hospice Care Paid For?

One of the questions that many persons and family members have regarding hospice care is how will it be paid for. This is an important question. It can be difficult to navigate the whole process considering the complexity of the health care system.

Hospice care costs are a major concern. Medicare pays for hospice care. Original Medicare (comprised of Part A and B) pays for hospice care services as long as the hospice care provider is approved by Medicare. With this plan, the hospice care patient does not pay anything.

Various services, supplies, and prescriptions related to the illness diagnosed in the hospice care patient are part of the Medicare coverage. These include medical equipment such as a bed, social work services, and prescription medication for pain relief.

No deductibles are part of hospice care. Unfortunately, some medications may carry a copay of $5. Medicare does not cover hospice care services that have not been assigned by the hospice care team.

Because there are certain things that Original Medicare doesn't cover, Medicare offers a supplemental plan called Medicare Plan G. There are five things covered in Medicare Plan G. One of the things covered by Medicare Plan G is hospice care.

Making the Decision

When discussing end-of-life care, a common question that might come up is "What is hospice care?" Now that you know what hospice care is, you understand what this type of care is for. Hospice care is an ideal end-of-life care option for persons diagnosed with a terminal illness.

Under hospice care, a team of health care providers will provide the patient with compassionate care and meet all the patient's needs to ensure that patient is as comfortable as possible.

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