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Polk County Enterprise - Local News
Stories Added - March 2010
Copyright 2010 - Polk County Publishing Company


Medicare’s Hospice benefit comforts patients, families

Polk County Enterprise

By Bob Moos

Hospice care isn’t about giving up. It’s about making every moment matter. Medicare beneficiaries who choose hospice receive palliative care and support for their terminal illness. They are no longer seeking a cure, but they do want to live out their last months as comfortably as possible and with dignity. Medicare’s hospice benefit began in 1983 and has helped millions of Americans and their families. To qualify, patients must be eligible for Medicare’s Part A hospital insurance, and they must be certified by their physician and hospice medical director that they have a prognosis of six months or less to live, if their illness runs its normal course. They also must sign a statement electing the Medicare hospice benefit and another statement that they understand they are forgoing curative treatment for their terminal condition. When considering and selecting a hospice program, ask these questions: Is it certified and licensed? What kind of training does the hospice provide its caregivers? How does the hospice staff respond to after-hour emergencies? What measures are in place to ensure quality care? How does the hospice involve the family in planning the care? Hospice programs follow a team approach. The doctor and the hospice medical staff work with the beneficiaries and their families to plan the care. Most patients remain at home and receive regular visits from the hospice’s nurses, social workers and counselors. If someone needs hospital care, though, the hospice makes the arrangements. The primary goal is to relieve the pain and manage the symptoms. As long as the care comes from a Medicare-approved hospice program, Medicare covers such costs as the physician services, nursing care, drugs, medical equipment and supplies, and physical and occupational therapy. Though the hospice benefit is part of original Medicare, it’s also available to anyone with a Medicare Advantage plan. Both original Medicare and Medicare Advantage will continue paying for the treatment of other conditions unrelated to someone’s terminal illness. Medicare understands that family members need a rest from caregiving. So, beneficiaries can request to stay up to five days at a time at a Medicare-approved hospice inpatient facility, hospital or nursing home. For that, they pay 5 percent of the Medicare-approved amount for respite care. Overall, Medicare beneficiaries pay almost nothing for their hospice care. Their only expense may be copayments of $5 or less for drugs prescribed to manage their symptoms or relieve pain. Patients can receive hospice care as long as they are recertified. After 90 days of care, beneficiaries are re-evaluated by the hospice’s medical director or other hospice doctor to determine if the care is still appropriate. Another re-evaluation is done after another 90 days and then every 60 days. Patients whose health improves or whose illnesses go into remission may not need to remain in a hospice program. In those cases, they return to their previous Medicare coverage. If someday their condition worsens and they again require hospice care, they can get recertified and re-elect the benefit. Beneficiaries wanting to learn more about hospice programs in their area should talk to their doctor or call their state’s hospice organization or state health department. Their physician will also help determine whether a particular hospice program has been approved by Medicare. Even if a patient is enrolled in a Medicare Advantage HMO plan, that person can still choose hospice care from any available Medicare-approved hospice. For more about Medicare’s hospice benefit, visit the Medicare Web site at medicare.gov or call Medicare’s 24-7 customer service line at 1-800-633-4227. A Medicare publication, titled “Medicare Hospice Benefits,” can also be downloaded from the Web site or requested by phone. Do you have a question about Medicare benefits you’d like answered in a future column? E-mail it to bob.moos@cms.hhs.gov.

 

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