Hospice Care Questions Answered
The concept of hospice care was first introduced to the U.S. in the mid-1960’s, and in the intervening years, the number of Americans receiving care has increased dramatically. In 1982, for example, hospice served only 25,000 people. Thirty years later, 1.6 million people received care. And with 10,000 Baby Boomers turning 65 every single day, we’re likely to see another dramatic increase in the coming decades. While these statistics point to a growing awareness around the benefits and availability of hospice, there’s still some confusion about how care is administered and paid for. In this post, we’ll set out to bring a bit of clarity to a few of those questions.
What is Hospice?
Simply put, hospice provides care and support for patients who are terminally ill. But there’s a lot underlining this simple statement. Hospice doesn’t seek to cure terminal illness. Instead, care focuses on relieving symptoms and improving quality-of-life. This is accomplished by a team of medical professionals working together to treat the patient’s whole body. A typical care team includes doctors, nurses, counselors, social workers, and spiritual advisors who each work within their specialty to bring comfort to patients and their families. As part of their mission to provide comfort, hospice providers typically administer care in the patient’s home. But if necessary, in-patient care is also available.
Who is Eligible for Care?
A patient becomes eligible for care after their primary care physician and a hospice doctor both certify their illness is terminal and they have a prognosis of six months or less to live. When a patient enrolls in hospice, they agree to accept palliative care for symptom relief rather than curative care for their illness.
How Long Can You Receive Care?
Hospice care is for patients who have 6 months or less to live. But patients can receive care for longer than six months if necessary. Coverage is broken out into benefit periods consisting of two 90 day segments and an unlimited number of 60 day segments. At the beginning of each benefit period, a hospice medical director must certify that a patient is still terminally ill. If a patient experiences a remission, they can leave hospice at any time and return again if necessary. A patient can also choose to leave at any time, even if they aren’t in remission.
Who Pays for Care?
President Clinton designated hospice care as a guaranteed service in 1993. As a result, most private insurers now cover care. In practice however, Medicare pays for the vast majority of end-of-life care. Benefits are generous and patients typically pay very little out-of-pocket. Medicare, for example, pays for everything associated with a patient’s terminal illness. However it will not pay for:
- Treatments intended to cure your terminal illness.
- Prescription drugs for anything other than symptom control or pain relief.
- Care from a provider not coordinated by a hospice care team.
- Room and board.
- Inpatient or outpatient care, unless ordered by a hospice provider or unrelated to the patient’s terminal illness.
It’s important to note that Medicare will only pay for care from an approved hospice provider. To find a provider, talk to your doctor or consult medicare.gov/contacts.
Hospice is designed to control symptoms and meet its patient’s final care wishes. Other institutions don’t do this well at all. As a result, patients and their families consistently report higher levels of satisfaction with in-home hospice care than with in-patient end-of-life care. Studies have also shown that longer hospice stays produce higher patient satisfaction results. So if you believe you, or someone you love needs hospice care, don’t wait to seek it out.