What Is Hospice Care?

Hospice care is for terminally ill persons. Unlike regular medical or home care, hospice care has a team of caregivers who focus on the total needs of the individual and family or patient's caregivers. In this manner, hospice care provides several aspects of care, including medical, physical, emotional, and spiritual care. Hospice care focuses on providing comfort for terminally ill persons, which includes medication, assistance with life needs (bathing, for example), and counseling. Hospice care generally occurs in the terminally ill person's home, but there are also hospice care facilities. The comfort of being at home, rather than at a facility, during hospice care is important to many terminally ill persons. The hospice care facilities are designed to care for the comfort of the whole person and their family.

How to Choose the Right Hospice Care Provider

Remember that the terminally ill patient has a right to choose the course of his/her care. This means that if the terminally ill person or the family is unhappy with the hospice team or hospice facility, they have a right to request different care providers.

To choose hospice care, the terminally ill person and family or caregivers should discuss the following:

• Is the patient more comfortable with home hospice care or facility hospice care?
• Is the facility and hospice team licensed, bonded, and certified?
• What is the response time of the hospice team?
• What is the patient-to-caregiver ratio?
• How often will the hospice team arrive at the home?

To find a hospice care team and facility:

• Ask the hospital, doctor, and nurses
• Contact Senior Services, social workers, and counselors
• Ask family and friends
• Look in the Yellow Pages. Many small, comfortable hospice providers will be listed in the Yellow Pages but not online, depending on their size.

Who Is Eligible for Hospice Care through Medicare?

Hospice care is provided under Part A of Medicare. Medicare Part A will provide hospice benefits when all of the following conditions are met:

1. The terminally ill person is eligible for Medicare Part A, which is Hospital Insurance.
2. The person seeking hospice care has less than six months to live due to the terminal illness, as determined by the patient's physician and the hospice medical director. The doctor will be able to give you information on contacting the hospice medical director in the hospital or area. Please be aware that if the terminally ill patient has chosen a nurse practitioner or physician's assistant for their main course of treatment, the patient must contact a medical doctor to determine the course of the terminal illness. Medicare Part A does not cover hospice care when a nurse practitioner or physician's assistant makes this determination.
3. The terminally ill person must also sign a statement that hospice care has been chosen over other Medicare-covered benefits, like assisted living or hospital care. The person entering hospice care will still receive eligible Medicare coverage for medical needs that are not related to the terminal illness. It is important to know that care directly related to the terminal illness must be given and approved through the hospice team to be covered under Medicare Part A. However, medical care that is not related to the terminal illness may still be received, and covered by Medicare, without the hospice team.

What Hospice Services are Provided Through Hospice Care?

According to the Centers for Medicare & Medicaid publication on Hospice Care, Medicare Part A includes the following services in Hospice Care:

• Doctor, nursing, and assistive care
• Medical supplies and equipment
• Medication for pain and symptom control
• Physical, occupational, and speech therapy
• Dietary, social, and grief counseling
• Short-term inpatient and respite care

What Hospice Services are NOT Covered Through Medicare?

Hospice care does not cover different medications and medical teams that provide treatment for curing the terminal illness. This means that the person in hospice care must stop hospice care to receive treatments that are centered on curing the terminal illness. Please remember that the patient can cancel the hospice care at any time.
Any care of the terminal illness that is not part of the hospice care and is not set up or provided by the hospice team is not covered. However, any care that is separate from the terminal illness would be covered, such as a fall or another illness.
The terminally ill person may be responsible for paying no more than $5 for each prescription drug for pain relief and symptom control.
Room and board at the hospice care client's home is not covered. This includes rent, mortgage, electricity, food, and so forth. Facility stays, such as at hospice and hospitals, are covered under Medicare Part A, but must be approved by the hospice team if this stay is related to the terminal illness.