Many terminally-ill patients reach a point when their care must shift from curing their illness to providing comfort as they let it take its natural course. Hospice care can be used during this time to help people enjoy the maximum quality of life possible. While having assistance from Medicare can be very beneficial the question arises, how long with Medicare pay for hospice care?
In hospice care, the approach is based on the whole person, including not only their physical state but also their social, spiritual and emotional needs. It is typically given in the patient’s home. In addition to physical care, it includes counseling, equipment, supplies and medications for their illness and its related conditions. Hospice care also provides support to family caregivers.
Although it is often associated with cancer patients, hospice can help patients who are in the final stages of all types of life-limiting illnesses, including dementia, heart disease, kidney failure and neurological disorders.
Length Of Time Medicare Will Pay For Hospice
Medicare covers hospice care for eligible patients. It comes at very little cost to terminally-ill patients and is considered one of Medicare’s most generous benefits. In most cases, it covers the initial consultation, services from doctors and nurses plus around-the-clock on-call support, medication, medical equipment and home health aides. It also covers speech or physical therapy, dietary counseling and short-term care in hospitals or other types of facilities as recommended by the hospice team.
To be eligible for hospice care, patients must have Medicare Part A and enroll in a hospice program approved by Medicare. The patient’s doctor and the hospice program’s medical director must both certify that they believe the patient will probably live for less than six months, and the patient must actively decide to receive hospice care and discontinue treatments aimed at curing their terminal illness.
In terms of caregiver support, Medicare covers coaching for family members on how to best support the patient, short-term respite care for up to five days at a time for the patient when their caregiver needs a rest, and grief and loss counseling.
Patients are not financially responsible for hospice care itself, although they may be required to pay a copayment not exceeding $5 for each prescription drug they are given for pain relief or symptom control at home. Inpatient respite care is billed at 5 percent of the Medicare-approved amount for the care.
Hospice care is intended for people who have a life expectancy of six months or less if their illness runs its normal course. However, predicting how long a person will live with certain illnesses is not an exact science, and there are sometimes cases where a patient will need hospice for a longer period. Outlined below is a look at how hospice care can be extended under certain circumstances.
How To Continue Payment Past 6 Months
Hospice care is given to patients in units of time known as benefit periods. A person can receive hospice care for two benefit periods of 90 days each, and this can be followed by an unlimited number of benefit periods lasting 60 days each as deemed necessary by the patient’s doctor.
Have A Doctor Certify The Patient’s Illness
At the beginning of each benefit period, a hospice doctor or medical director must recertify that the patient is terminally ill for hospice care to continue. However, there is no need to choose the care provider again and start from the beginning of the process; this serves as an extension of the original hospice care plan.
Nevertheless, patients who are unhappy with their care for any reason do have the right to change their hospice provider once during each benefit period.
In some cases, a doctor may not believe a patient is still eligible for hospice care because of dramatic improvements to their condition. Patients who do not agree with this decision have the right to request a review of their case. The BFCC-QIO notice explains an individual’s rights to an expedited review in these circumstances.
What Happens If My Health Improves?
Although hospice is usually associated with the final days of a person’s life, there are cases in which a patient’s illness might go into remission or their health may improve to the point where hospice services are no longer required. An individual may choose to stop hospice care at any time and for any reason.
A person who was part of a Medicare Advantage Plan, such as a PPO or HMO, before beginning hospice can remain on the plan throughout hospice care as long as they continue paying the premiums on their plan. That way, if they end hospice care, they are still eligible for Medicare coverage from their original plan. Those who were not part of an Advantage Plan can continue to receive Original Medicare when hospice care stops.
Patients whose condition worsens to the point of becoming eligible for hospice once again can return to hospice care any time they choose.
Talk With Hospice Care Professionals About How Long Will Medicare Pay For Hospice Care
If you or a loved one is facing a terminal illness, work with the compassionate hospice care professionals at Harbor Light Hospice. Their experienced team can help patients and their families alleviate suffering and enjoy the best quality of life possible.