There are many myths and misconceptions about hospice care. The lack of understanding can create a barrier that prevents people who need and qualify for the benefit from actually receiving hospice care. We thought it would be helpful if we answered some of the most commonly asked questions in this week’s blog update.
Q: How do patients pay for hospice care?
A: Medicare, Medicaid and most private health insurance plans will pay for hospice services. The Hospice Benefit provides coverage for visits by the interdisciplinary hospice team members, as well as the cost of medical equipment, supplies and medications related to the hospice plan of care. Most private insurance plans provide similar coverage.
Q: What makes someone eligible for hospice?
A: Hospice care is provided for patients who have been certified by their physician as having a life expectancy of six months or less if their disease follows its normal course. There are specific criteria based on diagnosis that helps to determine where the patient might be in the disease process and if they are eligible for hospice yet.
Q: How long can a patient receive hospice care?
A: Once a Medicare recipient is determined to be eligible for hospice care, they can continue to receive services as long as the hospice physician certifies to their terminal diagnosis. Medicare hospice patients have two 90-day periods of care followed by an unlimited number of 60-day periods. As long as they continue to meet Medicare’s eligibility requirements, hospice care will continue.
Q: Will the Medicare Hospice Benefit pay for care in an assisted living community or a nursing home?
A: The Medicare Hospice Benefit will reimburse for hospice services that are provided in a residential care or long-term care setting. However, the benefit does not pay for the expenses associated with room and board. If the patient is eligible for Medicaid in their state, it will often cover room and board expenses.
Q: Does hospice provide 24/7 caregivers?
A: While hospice supports patients 24/7, a caregiver does not stay with the patient around the clock except in a time of crisis. The hospice team supplements the care and support the family caregivers provide. Hospice can be called at any time day or night if problems, questions or concerns arise.
Q: Do hospice patients have to use the hospice physician or can they continue to see their own primary care physician?
A: That depends upon the patient’s physician. Some will choose to follow their patient while others will defer to the expertise of the hospice physician and want them to take over the patient’s care plan. Rest assured that hospice will never interfere with the physician/patient relationship.