GOOD TO KNOW: Medicare hospice benefits

The Medicare hospice benefit is available under Medicare Part A to a beneficiary with limited life expectancy of six months or less. A Medicare beneficiary who chooses hospice care receives non-curative medical and support services for his or her terminal illness, including some home care services, inpatient services as required under a plan of care.

Medicare hospice coverage is available to a Medicare beneficiary who is in Medicare Part A, is certified by a physician as terminally ill, makes a hospice election, and receives care from a Medicare-approved hospice program.

Hospice services must be reasonable and necessary for the palliation or management of a terminal illness as well as related conditions. The election of hospice care must be established prior to the establishment of hospice services.

Covered hospice services include nursing care, social services, physician’s services, counseling to the beneficiary and his or her family, short-term inpatient care conforming to the hospice plan of care, respite care for caregivers on an occasional basis, drugs for pain management and symptoms control, and some home services.

When a beneficiary elects hospice care, he or she is only electing palliative care for his or her terminal illness. Medicare remains in place for all other, non-terminal illness related health conditions. A beneficiary may also forgo the Medicare hospice benefit and return to traditional Medicare for treatment at any time.

Additional information on Medicare’s hospice benefit can be found at Medicare.gov or by calling 1-800- Medicare and requesting additional information.

If you have additional questions, you may call Pat Hafermann, elderly benefits specialist with the Aging and Disability Resource Center, at (920) 459-4389.

Resource: “The Specialist” October 2009