Understanding Medicare’s hospice

Providing support and resources to those with terminal illnesses
Sep 6, 2018 ·
Elderly woman receiving care from a medicare hospice care worker

A terminal illness is a difficult situation for a sick loved one’s family, friends, and caregivers. 

But it’s nothing compared to the fear and distress experienced by the patient who may feel a loss of control over what will happen to them in the days and weeks ahead.

One option is hospice care, which provides compassionate medical care, emotional support, and spiritual resources to those with terminal illnesses, which could include those suffering from cancer, heart failure, or a similar life-limiting condition. 

Hospice also helps family members and caregivers to manage their loved one’s illness and care for them through emotional support and other services. Often occurring in the home, a hospice bed in the hospital, or a nursing home, hospice care is centered around keeping the patient comfortable while treatment to keep them living is stopped.

If I’m on Medicare, can I receive hospice?

Medicare is a health insurance program for those age 65 and up, though people under 65 who have disabilities also qualify. Those with long-term, chronic kidney failure on dialysis are covered as well. 

People or their spouses who paid Medicare taxes while employed are eligible for Part A benefits, which cover the following:

  • Hospital stays
  • Nursing home care
  • Care at a skilled nursing facility
  • Hospice 
  • Home health services

What else determines eligibility?

Life-limiting illnesses are covered. These might include heart disease or heart failure, dementia, renal disease, chronic liver disease, neurodegenerative disease, or COPD. In addition:

  • A doctor and the hospice medical director must certify that a patient seeking hospice is expected to live less than one year
  • A patient must sign a document stating that they choose hospice care over other Medicare-covered benefits to treat their illness
  • The hospice must be approved by Medicare

What services are included in hospice care?

For Patients
Those enrolled in hospice receive basic medical care that provides pain and symptom control. Needed medical supplies and equipment such as a hospital bed, wheelchair, or incontinence pads are also covered. Hospice staffers are available 24/7 on an as-needed basis. Patients also have access to counseling and social support for psychological, emotional, and spiritual issues.

For Caregivers
Hospice also helps family members and caregivers emotionally handle their loved one’s illness and care for them. Since caregivers can experience their own feelings of sadness and fatigue, hospice provides them with respite care workers to pitch in with meal prep or running errands. They also stand in for caregivers when they need a break. A caregiver can also receive counseling and support after a patient’s death.

What will a patient receive in hospice care?

Hospice programs receive a daily rate from Medicare to cover services needed to care for a patient in the end stages of a life-limiting illness. They include:
  • In-home nursing care. While live-in nursing is not covered, occasional visits by a nurse are; they are available 24/7 as symptoms arise or help is needed. Occasional homemaker and home health aide visits are also covered as are visits from a counselor or social worker.
  • Medication. Medicare doesn’t charge more than $5 a prescription for medication or products that ease pain and control symptoms. Dietary counseling is also provided.
  • Doctor visits. Those that help manage a life-limiting illness are covered.
  • Temporary hospitalization. Sometimes symptoms can’t be managed at home. When this happens, hospital visits are covered.
While deciding on end-of-life care is a difficult process, understanding what’s involved in hospice can help you and your family decide if it’s the right option for you.