Medicare Hospice Benefit Explained (DRops of Wisdom)
Today we continue “DRops of Wisdom,” our physician blog, with Dr. Andrea Miller, the medical director for Good Shepherd Hospice. She describes the Medicare hospice benefit.
What is the Medicare Hospice Benefit?
Second only to being asked tips on how to talk about hospice, I am often asked, “What is covered under the Medicare hospice benefit?” In the Unites States, Medicare covers 100 percent of hospice services, with no out-of-pocket expenses to the patient or family. Additionally, most private insurance companies and Medicaid cover hospice services.
At all affiliates of Chapters Health — Good Shepherd Hospice, HPH Hospice and LifePath Hospice — each hospice patient has a unique plan of care that addresses their specific end-of-life needs. This plan also takes into account the needs of the caregivers.
The Medicare hospice benefit for patients and families includes the following:
- Home visits by nurses, social workers, hospice aides, chaplains, physicians, nurse practitioners and volunteers as described in the patient’s plan of care
- Medications, supplies and durable medical equipment related to the hospice diagnosis
- Assistance with advance care planning
- Support and education for caregivers
- Counseling, emotional and spiritual support
- Grief support before and after death
Who is Eligible for the Medicare Hospice Benefit?
In order for patients to access the Medicare hospice benefit, they must be eligible for Medicare Part A. They must also agree to pain/symptom management and not curative care.
Following Medicare hospice benefit regulations and rules, in order for any of the Chapters Health affiliates to provide care for patients, the community physician or hospice medical director must certify that, based on his or her clinical expertise, the patient has a prognosis of six months or less should the diagnosis runs its natural course. It is important for patients to understand and know that their physician—if chosen as the attending physician—will continue to see and care for them if that is what they desire. However, a patient’s physician can refer him or her to hospice but does not necessarily need to be the attending physician. The patient or family can also ask for a patient to be evaluated by hospice.
Under the Medicare Hospice Benefit, Are There Different Hospice Levels of Care?
Often times, patient’s symptoms can change, resulting in an adaptation of the plan of care. Under the Medicare hospice benefit, patients are able to receive four different levels of hospice care based on their situation.
Routine Care: Visits are made according to the plan of care and are provided wherever the patient calls home — private residence, assisted living community or nursing home. Day-to-day care is provided by caregivers.
Respite Care: When caregivers need a short-term relief, a hospice patient can be admitted to an inpatient facility for up to five days and still receive routine visits from the hospice team.
Inpatient Care: When a patient needs short-term, round-the-clock care due to a variety of acute medical needs, inpatient care is available in a hospice house. This level of care is strictly available for acute symptoms that cannot be managed with routine care.
Continuous Care: If a patient is experiencing acute pain and symptoms that cannot be managed with routine care, continuous care can be offered. This level of care is provided for a minimum of eight hours per day. Although not exclusively, the continuous care provided is primarily nursing care. Once reaching a state of comfort, the patient can return to routine care.
We are always available to speak with patients, families and physicians about any questions they might have about the Medicare hospice benefit and other hospice and palliative care topics.
What Would You Like to Read about in Future Posts?
In “DRops of Wisdom,” we want to feature posts with subject matter that interests you. Please leave a comment or email us with your ideas.
At Chapters Health System, every day is devoted to educating our patients and keeping them in the place they call home. We are dedicated to ensuring that patients, young and old alike, and their families are able to make educated decisions about important healthcare matters. For more information, please call our helpful Chapters Health team at 1.866.204.8611 or send an email to info@chaptershealth.org.
About Dr. Andrea Miller
Dr. Andrea Miller, Medical Director for Good Shepherd Hospice, is a local resource for area hospitals seeking to educate staff on issues surrounding chronic conditions, palliative care and hospice programs.
The New Card is in the Mail
Do you know that personal identity theft occurs every 2 seconds? This fact is staggering, and the demographic hardest hit happens to be people age 65 or older. This is the reason why the Centers for Medicare and Medicaid Services (CMS) developed an initiative to combat identity theft by issuing new Medicare cards without Social Security Numbers.
Starting next month, CMS will begin mailing new Medicare cards that include a new Medicare Number. The mailings will be staggered across the country throughout the year, with completion expected by April 2019.
The new Medicare Number is unique for each individual who has Medicare and will be a combination of 11 numeric and alphabetic characters. As soon as the new card arrives in the mail, patients should destroy their old card. Patients can start using the new card immediately. Medicare Advantage members who have plan-issuer ID cards will not be affected by this change and can continue using their plan cards.
Helping You Prepare for the Change
As part of the new Medicare initiative roll out, Florida residents are scheduled to start receiving new cards after June 1, 2018. With such a widespread undertaking, cards might arrive at different times for friends or neighbors.
In the meantime, if you have Medicare, please make sure your mailing address is up to date. If an address needs to be corrected, you can contact Social Security here or call 1‐800‐772-1213, and TTY users can call 1‐800-325‐0778. With the new Medicare numbers, your benefits will not change.