Hospice

What is hospice?

Hospice is a special way of caring for people who are terminally ill.

People of all ages who are terminally ill can get hospice care during the final months of life.

Families of people who are terminally ill may also benefit from hospice care and can receive counseling services.

Hospice care for people who are terminally ill includes physical, psychological, social, and counseling services.

A public agency or private company can provide hospice services.

The goal of hospice is to provide care for people who are terminally ill to manage their pain and other symptoms, not to cure their illness.

Who can get Medicare hospice benefits?

• You can get Medicare hospice benefits when you meet all the following conditions:
• You are eligible for Medicare Part A (hospital insurance), and
• Your doctor and the hospice medical director certify that you are terminally ill and have six months or less to live if your illness runs its normal course, and
• You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness, and
• You get care from a Medicare-approved hospice program. Medicare still will pay for covered benefits for any health problems that aren’t related to your terminal illness.

How Does Hospice Work?

Your doctor and the hospice medical team will work with you and your family to set up a plan of care that meets your needs. Your plan of care includes hospice services that are covered by Medicare. For more specific information on a hospice plan of care, call your state or national hospice organization.  If you qualify for hospice care, you will have a specially trained medical team and support staff available to help you and your family cope with your illness. Hospice comfort care helps you make the most of the last months of life. Hospice comfort care includes use of drugs for symptom control and pain relief, physical care, counseling, equipment, and supplies to make you as comfortable and pain free as possible. The focus of hospice is on care, not cure.

Those involved in your care included:

• You
• Your Family
• A doctor
• A nurse
• Counselors
• A social worker
• Physical, Occupational, and Speech therapies
• Home health aides
• Volunteers

In addition, a hospice nurse and doctor are on call 24 hours a day, seven days a week to give you and your family support and care when you need it.   Although a hospice doctor is part of the medical team, your regular doctor also can be part of this team. If you choose, a nurse practitioner may serve as your attending doctor. However, only your doctor and the hospice medical director can certify that you are terminally ill and have six months or less to live.   The hospice benefit allows you and your family to stay together in the comfort for your home. If you should need care for your illness in an inpatient hospice facility, hospital, or nursing home, the hospice medical team will make the arrangements for your stay.

Who can refer to Oaklawn Hospice?

Anyone can refer to Oaklawn Hospice, including:

• Patients, family or friends
• Primary/Attending Physician

What will Medicare pay for?

The care you get for your terminal illness must be from a Medicare-approved hospice program.  Medicare pays for these hospice services for your terminal illness and related conditions.

• Doctor services
• Nursing care
• Medical equipment (such as wheelchairs or walkers)
• Medical supplies (such as bandages and catheters)
• Drugs for symptoms control or pain relief
• Home health aide and homemaker services
• Physical and occupational therapy
• Speech therapy
• Social worker services
• Dietary counseling
• Grief and loss counseling for you and your family
• Short-term inpatient care
• Short-term respite care
• Any other covered Medicare services needed to manage your pain and other symptoms, as recommended by your hospice team

Important: Medicare still will pay for covered benefits for any health problems that aren’t related to your terminal illness.

What is respite care?

Respite care is care given to a hospice patient by another care giver so that the usual care giver can rest. While in hospice care you may have one person who takes care of you every day, such as a family member. Sometimes this person needs someone to take care of you for a short time when he or she needs a break from care giving. During a period of respite care, you will be cared for in a Medicare-approved facility, such as a hospice inpatient facility, hospital, or nursing home.

What won’t Medicare pay for?

When you choose hospice care, Medicare won’t pay for any of the following:

• Treatment intended to cure your terminal illness. You should talk with your doctor if you are thinking about getting treatment to cure your illness. As a hospice patient, you always have the right to stop getting hospice care at any time and receive the Medicare coverage you had before you chose hospice care.
• Prescription drugs to cure your illness rather than for symptom control or pain relief. If you are enrolled in Medicare prescription drug coverage, however, drugs unrelated to your illness would be covered (for instance, if you needed medicine to treat an infection unrelated to your terminal illness).
• Care from any provider that wasn’t set up by the hospice medical team. You must get hospice care from the hospice provider you chose. All care that you get for your terminal illness must be given by or arranged by the hospice medical team. You can’t get the same type of hospice care from a different provider, unless you change your hospice provider.
• Room and board. Room and board are not covered by Medicare if you get hospice care in your home or if you live in a nursing home or a hospice residential facility. However, if the hospice medical team determines that you need short-term inpatient or respite services that they arrange, your stay in the facility is covered.
• Care in an emergency room, unless it’s arranged by your hospice medical team.
• Care in an inpatient facility, unless your hospice medical team arranges it.
• Ambulance transportation, unless it’s arranged by your hospice medical team.

What will I have to pay for hospice care?

Medicare pays the hospice provider for hospice care.

How long can I get hospice care?

You can get hospice care as long as your doctor and the hospice medical director or other hospice doctor certify that you are terminally ill and probably have six months or less to live if the disease runs its normal course. If you live longer than six months, you still can get hospice care, as long as the hospice doctor re-certifies that you are terminally ill.   Important: Hospice care is given in periods of care. You can get hospice care for two 90-day periods followed by an unlimited number of 60-day periods. At the start of each period of care, the hospice medical director or other hospice doctor must re-certify that you are terminally ill, so that you may continue to get hospice care. A period of care starts the day you begin to get hospice care. It ends when your 90-day or 60-day period ends.

Why would I stop getting hospice care?

If your health improves or your illness goes into remission, you no longer need hospice care. Also, you always have the right to stop getting hospice care for any reason. If you stop your hospice care, you will receive the type of Medicare coverage that you had before you chose a hospice program. If you are eligible, you can go back to hospice care any time.

Can I change the hospice provider that I get care from?

You have the right to change providers only once during each period of care.