Hospice Care Defined

What is hospice care? Hospice care is generally provided for terminally ill patients, and does not contemplate care for patients who are likely to recover from illnesses, regardless of severity. Hospice care generally involves the process of managing an illness and not curing an illness. The rules covering hospice care are detailed and also vary from state to state. Medicare does provide certain coverage for services known as "hospice" care. If you have any questions about your particular state’s laws about hospice care, please contact member services and be connected with an attorney that best suits your needs.

Generally, the following requirements must be met for coverage by Medicare to exist:

  • There must be a certification from a physician that the patient is expected to die in 6 months.
  • The patient must receive normal hospice services and not other kinds of services not normally supplied by a hospice.
  • The hospice facility must be certified and approved by Medicare.

Some examples of actual covered hospice services include:

  • Pain relief
  • Nursing care
  • Social services
  • Medication
  • Physical, speech or vocational therapy
  • Medical equipment
  • Counseling
  • Physician's services related to the patient's terminal condition

While it is contemplated that the patient has a terminal illness, there can be limits on the hospice care coverage provided by Medicare. The limits include coverage for two periods of 90 days, one period of 30 days and one additional unlimited period. There is a definite treatment and care schedule contemplated by the Code and the regulations, which will vary depending on your specific situation.

Prior approval for your hospice care is recommended and consultations with Medicare regarding the limits should take place to avoid any surprises. Usually, this is a difficult time for families and there are many issues other than legal battles which are much more important.

There are a number of steps that may be completed early to assist people considering hospice care for themselves or their family. Drafting Wills, Trusts, Guardianships and Conservatorships, Durable Powers of Attorney for Healthcare and a number of other legal steps can prevent a huge number of legal obstacles, delays and expenses later. To better prepare yourself or a family member in the event of terminal illness, please contact member services to be paired with an attorney that will best fit your needs for advanced planning and advice.

Posted in: Elder Care