Understanding Your Medicare Hospice Benefit

Article submitted by Lorree A. Ratto, PH.D., CT, Counselor, Sojourn Care.
For more information, she can be reached at 480-315-1525.

Hospice services assist patients when science cannot offer them a cure. The Medicare Hospice Benefit, part of Medicare Part A, provides medical and supportive care to help patients manage a life limiting illness. For Medicare beneficiaries there are no out of pocket costs. The hospice plan of care may include home visits by physicians and nurses, medical equipment and supplies, drugs for symptom management and pain relief, short term inpatient and respite stays, homemaker and home health aide services, counseling, social work, chaplains, volunteer helpers and bereavement services.

The symptoms that make someone eligible for hospice may include the following:

• How well the patient is breathing when resting and after walking a short distance;
• What level of oxygen content there is in the arterial blood;
• How strongly and regularly the heart is beating;
• The patient's "ejection fraction," a measurement of how much blood is pumped out of the heart's ventricles;
• Unexplained weight loss;
• The inability to control bowel and bladder;
• The inability to do daily activities without assistance;
• Wounds that do not heal;
• Increasing weakness and frequent falls;
• The inability to talk, smile or respond appropriately.

Not every hospice is the same. All Medicare certified hospices are governed by the same state and federal regulations, but each hospice operates under its own philosophy of care. A physician may recommend a certain hospice but the patient must choose which hospice program he or she will elect. Though hospices may look similar, some may not allow patients to make the most of the Medicare Hospice Benefit. Before you or your loved one begins hospice care, call several hospices and ask what makes them different from the rest?

Some questions to consider are:

• Can I remain in my home, alone, without a caregiver?
• What happens if I choose not to have a living will?
• What medications will you pay for?
• Can I continue receiving chemotherapy?
• Can I continue radiation?
• Can I have physical therapy?
• How fast can you start services?
• Can I remain on a transplant list?
• What happens if I have to go to the hospital?

An informed, educated consumer has many different healthcare options and choosing a hospice is no different. Make sure your Medicare benefit is working for you. Get the most out of your benefit and accept nothing less.