Understanding Hospice Care
How is Care Paid For?
Most of our patients are eligible for Medicare—and almost all of them are surprised to discover this simple fact:
Medicare will pay for all expenses incurred in hospice care related to the patient’s terminal diagnosis.
If you are surprised to learn this, you’re not alone: A recent survey found that less than 10 percent of Americans over the age of 45 are aware of this remarkable, all-inclusive benefit. Though it has been in effect since 1983, this lack of awareness keeps many families from ever considering hospice care.
This amazing benefit is part of Medicare Part A, or hospital insurance. It covers all expenses involved in hospice care, including the use of durable medical equipment.
Tell me more about the Medicare Hospice Benefit.
Other Options
Most private insurance or prepaid health plans also provide coverage for hospice care. Hospice care is a fraction of the cost of hospital and nursing care. You should call your insurance company to learn more about your hospice coverage.
No one who needs our services is turned away because they have no insurance or cannot afford to pay for their care.
Click on these topics to learn more about the Medicare Hospice Benefit:
Who is Eligible for the Medicare Hospice Benefit?
Medicare beneficiaries must meet the following criteria to qualify:
- You must have Medicare Part A.
- Your doctor and the hospice medical director must certify that you have a life-limiting illness with a probable prognosis of six months or less if the disease runs its normal course.
- You must sign a statement certifying this change in services related to your life-limiting illness: You elect hospice care and the Medicare Hospice Benefit instead of curative treatment and standard Medicare benefits. (We will provide you with this election statement.)
Please note: This change only affects services related to your life-limiting illness: Coverage for services unrelated to that illness remains unchanged.
- You have to enroll in a Medicare-approved hospice program such as CompassionCare Hospice.
How the Benefit Works
The Medicare Hospice Benefit pays for services, medications, and treatments required to manage your life-limiting illness. However, to be covered, those services, medications, and treatments must be approved by CompassionCare Hospice as part of your individual Plan of Care.
4 Common Misconceptions about the Medicare Hospice Benefit
If I sign up for hospice care, I will lose my Medicare coverage.
Not true. Under the Medicare Hospice Benefit, Medicare will not pay for any curative services directed at your life-limiting illness. But coverage for services unrelated to your life-limiting illness remains unchanged—there is no loss of coverage.
I have to change doctors to receive hospice care.
Not true. The CompassionCare Hospice team works with your physician to provide hospice care.
Once I sign up, I’m locked in.
Not true. Whenever you choose, for example if your condition improves, you can simply cancel hospice care and return to regular Medicare coverage without penalty—there is no loss of coverage or service days. You simply sign a form and go back to receiving all benefits.
You can re-elect the Medicare Hospice Benefit again, provided you meet the eligibility criteria.
A Medicare hospice certification is a death sentence.
Not true. No doctor can unfailingly predict the course of a life-limiting illness. In fact, receiving expert palliative care—relieving pain, managing symptoms, and reducing stress—can make a huge difference that sometimes produces the side benefit that a patient lives longer.
There is no limit on the number of days a patient can receive hospice care. After six months, you can continue to receive CompassionCare Hospice care as long as the physician re-certifies you for hospice care based on the eligibility criteria.
What Costs are Covered?
As long as they relate to your life-limiting diagnosis, the following services are generally included in the Hospice Plan of Care—and thus are covered by the Medicare Hospice Benefit.
- Nurses who are specially trained in pain and symptom management who make routine and emergency visits to the patient as needed.
- Regular visits by Certified Nursing Assistants (CNA) /Home Health Aides (HHA) to provide personal care.
- Social work and counseling services to provide emotional support to the patient and family.
- Chaplain services for you and your family.
- Visits by trained volunteers.
- Temporary respite care at the CompassionCare Hospice inpatient facility or other approved facilities.
- 24-hour on-call medical services.
- Dietary counseling.
- Durable medical equipment (for example: bedside commode, hospital bed, walker, wheelchair)
Medical supplies (for example: wound care supplies, incontinence supplies). - Medication (specified in your Plan of Care).
- Physical, occupational and speech therapy.
- Bereavement support for grieving loved ones
More Answers
Shouldn’t I wait until the last possible minute to elect hospice care?
No. Why postpone access to such a comprehensive list of services available at no charge? The earlier you enter our program, the greater benefit you will receive from the medical and psychosocial services we offer.
Remember, you are never “locked in.” You can always opt out of hospice care without penalty. We would much prefer that you sign up and change your mind than wait until the very last minute and miss out on the benefits from the many services we provide.
What if I become ill and need to be moved to a different setting for care?
The Medicare Hospice Benefit pays for inpatient hospice care in a hospice, hospital, or skilled nursing facility. The CompassionCare Hospice team will work with you and your family to determine the best setting for you to receive inpatient care.
What if I am in a nursing home or an assisted living facility?
The CompassionCare Hospice team and the nursing facility collaborate on your care. You will have the benefit of experts in long-term care working with experts in pain and symptom management as well as counseling. It adds up to the highest level of quality care for you and your family.
How can I learn more about this benefit?
You can find more information from the Institute for the Future of Aging Services (IFAS) at www.futureofaging.org or by calling (202)508-1208.
