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“You matter because you are you. You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but to live until you die.”
-Dame Cicely Mary Saunders
Founder of the modern day hospice movement.

Hospice Medicare Benefits and Services



Policy:
It is the policy of Family Hospice Care to provide patient care and services according to the Medicare Hospice Benefit. This information will be made available to all prospective patients in written as well as verbal form prior to the signing of the Election form.

Information:

What is the Hospice Medicare Benefit?
It is a Medicare program designed specifically to allow terminally ill patients to die at home. It is a home-care program that allows patients as much control over their life/choices as possible while at the same time working to alleviate pain through symptom control regimes.
Hospice Medicare Benefit is designed to be the single source of all health care related to your terminal illness. Hospice is a source of service not available through your traditional Medicare.


Who is Eligible for Coverage Under the Benefit?
Any person who is eligible for Part A Medicare either by age or by having a Social Security disability status who meets the following criteria:
Has a diagnosis of a terminal illness with a six-month or less prognosis, which is certified by the patient’s primary care physician, based on medical evaluation, diagnostic tests or X-rays.
The participant and significant others have decided they want no further curative treatment and palliative measures are only used for symptom management.


How Many Days of Care Are Covered Under the Hospice Medicare Benefit?

There are two ninety (90) day and subsequent 60-day benefit periods of an unlimited number. These benefit periods do not need to be consecutive. After the first 90-day period, if the terminal condition is not progressing, the patient may go off the benefit until their medical condition warrants resumption of coverage and the patient is certified by the Hospice Physician. The patient may revoke the election of the hospice benefit at any time, however they then forfeit any days remaining in that benefit period.


What does the Hospice Medicare Benefit Cover?

  • Physician Services
  • Skilled Nursing Visits
  • Hospice Aide
  • Drugs, equipment and medical supplies related to the terminal disease.
  • Social worker
  • Spiritual counselor
  • Dietary Counseling
  • Bereavement Counseling
  • Volunteers


The Hospice Medicare Benefit will pay for drugs and some supplies i.e., catheters and catheter supplies, colostomy supplies if related to the terminal disease. Oxygen is covered only if use relates to the terminal diagnosis. The benefit does not cover personal items. These items are the responsibility of the family.

The hospice aide provides personal care under the supervision of the RN when the primary care person is not physically or emotionally able to provide total care. The hospice aide visits will be scheduled as needed, as determined by the case manager.

Inpatient respite care is available under the Hospice Medicare Benefit as needed by the primary care giver and determined by the Interdisciplinary Team.


What Levels of Care Does Medicare Provide?

There are four levels of care provided under the benefit. The appropriate level is determined after a thorough assessment of patient needs by the nurse and interdisciplinary team.

  • Routine home care
  • Inpatient respite care
  • Continuous care at home
  • Inpatient (acute setting) short term in the event of a medical emergency that cannot be managed at home



Additional Professional Services:

Social Services

A professional social worker is available to assess patient and family’s special needs and to assist them through the terminal phase. The social worker can provide information regarding community resources, financial and legal issues, as well as assist in making final arrangements. Hospice services include bereavement counseling services for one year following a death.



Spiritual Care Services

Spiritual care may be provided to patient and/or significant others who desire spiritual or emotional support. These services are on a non-denominational basis.



Volunteer Services

Community volunteers who are specially trained and available to provide a helping hand and a caring heart to patients and/or their family members.