WHO PAYS FOR HOSPICE CARE?
Essentially you did…Hospice is a Medicare Benefit that YOU are entitled to, literally made by your very own contributions to Social Security. It is also paid by most private insurance plans.
Beneficiaries who elect the Medicare Hospice Benefit due to clinical criteria being met, and agree to forego curative treatment for care & comfort of their terminal condition, are entitled to not have any out of pocket costs or deductibles for you or your family.
For conditions unrelated to their terminal diagnosis, Medicare and other payor sources continue to cover items and services outside of Hospice. An example would be a patient who has fallen and broken a bone, most definitely qualify to seek treatment by their physician and he/she would be reimbursed for your care.
MEDICARE SET THE CLINICAL CRITERIA BASED ON SPECIFIC INDICATORS FOR ALL HOSPICES TO FOLLOW
- Medical equipment and supplies.
- Respite care, which allows the patient to go to a palliative care unit or nursing home for a short period so the family caregiver can take a break.
Medicare pays hospices a daily flat rate for each day a beneficiary is served. The payment rates are set for four categories: routine home care, continuous home care, inpatient respite care and general inpatient care. About 95 percent of days of hospice care provided are at the routine home care level, according to Medicare.
WHEN TO CONSIDER HOSPICE CARE?
It is time to consider hospice care when a patient exhibits one or more of the following:
- Patient/family chooses comfort care, as curative treatment is no longer an option
- Loss of function/physical decline
- Increase in hospitalizations
- Dependence in most activities of daily living
- Multiple co-morbidities
- Increase in ER visits
- Weight loss
- End stage, specific diseases with specific indicators such as: Cancer, Heart disease, Congestive heart failure, Liver disease, Kidney disease, Alzheimer’s & Dementia, Pulmonary disease, etc.
Call Valiant Hospice & Palliative Care with all or any of your questions or at 602-274-1952