There is no need to postpone hospice treatment because of financial worries. The Medicare Hospice Benefit, which covers up to 100 percent of hospice treatment, is available to the vast majority of hospice patients.The Medicare Hospice Benefit is an all-inclusive benefit that covers all services linked to terminal illness up to the full extent of Medicare Part A coverage.
Non-terminal disease care is still covered by Medicare Parts A and B, with all standard restrictions still in effect like co-payments, coverage guidelines, and deductibles.Hospice care includes visits from a nurse, physician, and other healthcare specialists, medication, and supplies.
The Following are The Requirements For Medicare Hospice Coverage:
- Medicare Part A coverage is required for the senior (hospital insurance).
- A hospice medical director or the senior’s regular doctor must certify that they are terminally ill with a six-month or shorter life expectancy.
- The elderly or their legal guardian must choose palliative care above Medicare-covered benefits designed to treat their terminal illness and other associated illnesses and sign a declaration confirming their decision.
- A Medicare-approved hospice provider must offer care.
Caring for a terminally-ill loved one is a physically and emotionally taxing commitment. Thankfully, Medicare-approved hospice gives the family and caregiver additional support. When the family needs a break to maintain their self-care, inpatient respite can last up to five days, and a small co-payment may be required for lodging and meals. Patients and their families may request respite several times, but it is only accessible as required.
Here is a guide to what Medicare hospice services inclusion and non-inclusion:
Hospice services are extensive, benefiting both the patient and family members. It’s critical to note that the following services may be included in a patient’s treatment plan and are, at least in part, funded by Medicare:
- Medical and related services: doctors, nurses, nutritionists, therapists, social workers, housekeeping, and aide
- Medical durables and supplies
- Prescribed medication for symptom management or pain alleviation
- Short-term inpatient treatment for pain and symptom management and inpatient respite care
- Counselling for bereavement and loss for both the patient and their family
- Any other Medicare-covered therapies that the hospice staff recommends
The following items and services are not reimbursed if a Medicare beneficiary selects hospice care:
- Emergency Treatment: Transportation by ambulance, emergency department treatment, and hospital inpatient care unless coordinated by the hospice medical team handling the patient.
- Medications and Treatments for Terminal Illnesses: Hospice care is no longer reimbursed if a senior chooses curative therapy. Nevertheless, patients can withdraw from hospice care at any time. They can also resume therapy at any time if they meet the criteria. Medicare hospice solely covers drugs for pain and symptom control.
- Unarranged Hospice Care by the Hospice Medical Team: The patient’s hospice medical team must coordinate all treatment. A Medicare-approved hospice provider cannot administer the same sort of hospice treatment to an older person. A patient may continue to see their regular doctor or nurse practitioner if they are overseeing their hospice care.
- Board and Lodging: Medicare does not cover room and board for hospice patients who live at home, assisted living facilities, in nursing homes, or in inpatient hospice residences. Room and board are only provided during short-term inpatient, or respite care stays.
For most Medicare members, hospice care is free. However, prescription co-pays and hospice care services beyond six months may need modest out-of-pocket co-pays.
Some medications and services also have co-pays. Be sure to go over all questions and concerns with the hospice team to ensure that out-of-pocket costs are at a minimum or if there are exemptions that can be explored. Hospice care will always converse with you prior to ordering anything that is not covered under the hospice benefit, so that there are no surprise charges.
Your Expert Hospice Team in Atlanta
Suppose you or someone you know is terminally ill with a six-month or less life expectancy. A hospice doctor and primary care physician will confirm this and refer to a hospice service agency. Hospice treatment can continue for an additional six months if the hospice medical director or doctor can recertify you for another benefit period confirming that you are still terminally ill. Hospice care is usually delivered in the patient’s home or at a hospice inpatient facility. At Golden Rule Hospice, we provide the best hospice care in Atlanta, covered by Medicare. We live by the Golden Rule—to treat others the way you would like to be treated. Our goal is to meet what our patients and their families need, from physical, emotional, and even spiritual. We provide these services with compassion, comfort, dignity, and high-quality palliative care and support. Refer your loved one or schedule a consultation with us today at (470) 395-6567.