A Guide To Medicare Health Insurance & Hospice Benefits For Seniors
Learn The Benefits Of Having a Medicare Plan With Hospice Care Coverage
Coping with a terminal illness and the end of life is a challenging experience, and only made more difficult when a family is concerned about pain management, assistance with caregiving, and the costs of care, equipment, and medication. Surprisingly, many seniors with Medicare coverage are unaware of the hospice benefits they are eligible to receive, which can significantly ease the financial strain and decisions that need to be made in their final weeks and months of life.
Your Mesa Medicare insurance agent can help you or your family understand the hospice benefits that are available for your situation. Hospice care coverage is one of Medicare’s most comprehensive and beneficial benefits, not only helping to ease the course of terminal illness, but relieving financial pressure as well. Unfortunately, hospice benefits are often misunderstood and underutilized. Learning in advance what Medicare can offer families for end of life care can ease the difficult decision to utilize hospice care, when the time comes.
Hospice Benefits For Palliative Care
The focus of hospice is palliative care, which means helping to maintain comfort and quality of life for people who are terminally ill. This includes addressing physical, intellectual, emotional, social, and spiritual needs, while simultaneously supporting a terminally ill person’s independence, access to information about their options, and their ability to make decisions about their own healthcare.
Qualifying For Medicare Hospice Benefits
Talk with your Chandler Medicare insurance broker to help determine if you are eligible for Medicare hospice benefits. A beneficiary must be entitled to coverage under Medicare Part A – anyone over age 65, or people under age 65 with end stage renal failure or disabilities is eligible. A doctor must certify that the person has a life expectancy of less than six months due to their health condition(s). If the patient lives for longer than six months, he or she will not lose their hospice benefits; the doctor can indefinitely continue to certify the patient’s eligibility for hospice care as long as the doctor believes the patient’s life expectancy is anticipated to be less than six months.
Finally, the beneficiary must sign a statement accepting the hospice benefit and agreeing to receive only palliative care. This means the patient will no longer receive treatment that attempts to cure his or her health conditions. Instead, he or she will only receive palliative, or comfort care. Of course, this is a significant step for seniors and their families, and the decision must be made by the beneficiary if he or she has the capacity to do so.
Seniors are often relieved to learn from their Gilbert Medicare insurance agent that they can revoke their decision to utilize palliative care without losing their ability to choose hospice care again in the future. And contrary to popular belief, patients using Medicare’s hospice benefits are not required to sign “do not resuscitate” orders or complete advance directives. Seniors who opt into Medicare’s hospice benefits are also able to maintain care with their current physician. This can put patients and family members at ease, knowing that an unbiased and familiar medical professional continues to oversee their care through hospice.
What Is Covered Through Medicare’s Hospice Benefits?
Once a patient has elected to transfer to hospice, Medicare will provide coverage for any care that is considered reasonable and necessary for easing a terminal illness. Patients in hospice have 24-7 on call support available from doctors and nurses, so there is care and support available anytime it is needed. Usually, these services are provided in-home for the patient’s comfort and convenience. Your Medicare insurance broker can help you learn about these benefits, which include:
- Physician or nurse practitioner services
- Nursing care in the patient’s home
- Any medical appliances and supplies that may be needed
- Prescription medications for comfort and pain relief
- Short-term inpatient and respite care, if needed
- Homemaker and home health aide services
- Counseling, social work, and bereavement services
- Spiritual care, if desired
These services are considered appropriate and covered by Medicare if their goal is to improve the life of the beneficiary or to make him/her more comfortable.
Since the election of hospice and palliative care means comfort care and not treatment, there are some services that are not covered by Medicare hospice benefits:
- Treatment or medications that attempt to cure the patient’s medical conditions.
- Prescriptions drugs other than for pain relief or symptom control.
- Care from a provider outside the hospice network, other than the patient’s primary doctor continuing to be their attending medical professional, if desired.
- Room and board. Patients on hospice are typically in their own home or a family member’s home. Hospice benefits will not pay for nursing home care unless their hospice team determines a need for short-term inpatient care or respite services.
- Care from a hospital, whether inpatient or outpatient, or ambulance transportation, unless arranged by their hospice care providers. However, regular Medicare coverage can be used to pay for treatment not related to the patient’s terminal illness.
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