End-of-life care decisions are some of the most personal and important when it comes to medical comfort and support. Hospice is often the choice for individuals who are suffering from a terminal illness and the determination has been made that further treatment efforts can yield no greater result. Essentially, hospice and palliative medicine are all about improving quality of life and reducing pain and discomfort when all treatment methods have been exhausted. Choosing to enter into hospice care is usually a final decision that is ultimately made by the patient, but it is also a determination that is reached by working with one’s physician, family members and any other treatment professionals within a medical team environment.
Does Medicare Cover Hospice Care?
Individuals who receive Medicare benefits can usually receive hospice services as part of Medicare Part A coverage. This is the section of Medicare that offers benefits for inpatient hospital care and short-term care in skilled nursing facilities. In order to receive hospice care benefits under Medicare Part A, the patient will need to also meet additional requirements, including having been determined by a qualified medical provider to have six months or less to live. The patient must also choose to accept hospice care in place of further Medicare-covered treatment options, and hospice care must be administered by a Medicare-approved service provider.
Do Medicare Advantage Plans Cover Hospice Services?
Because Original Medicare benefits already provide hospice care as part of the program’s traditional menu of services, having a Medicare Advantage plan should not affect the ability to receive hospice services; however, a Medicare Advantage plan may offer additional benefits to the patient that are not included in Original Medicare. Because Medicare Advantage plans usually offer additional insurance benefits on top of Part A and Part B coverage, the specific nature of added benefits will be on a per-plan and provider basis.
In some situations, a Medicare Advantage plan may offer additional financial resources to the patient, family members and caregivers. Certain methods of care may also be available to be received outside of approved provider networks. In addition, certain medications or medical devices may be available for use in comfort and support under a Medicare Advantage plan that are not included in Original Medicare insurance. Once again, this will be determined by the plan and insurance provider, so it would be a good idea to discuss any concerns or questions you have with your plan for clarification.
Is Hospice Care Available at Home?
In most cases, hospice care services are available to be rendered in a patient’s home or within a hospital setting. Care rendered outside of the home must be done so in order to provide for pain relief, not for treatment of a terminal illness or to cure a terminal illness.
It’s also worth noting that, although hospice care through Medicare is offered for six months, there is no way to predict the exact date of passage. As a result, patients will need to re-certify for hospice care if the initial 180-day period passes and the patient is still in need of care. This will require an in-person evaluation by a Medicare-approved medical provider. Hospice can, in theory, continue to be provided indefinitely as long as the patient is continuously deemed to be terminally ill and not expected to live beyond the next six months after re-certification and at 60-day intervals after the third benefit period.