Why does medicare not cover hospice

suze0450

My dad is not eating or drinking and only tiny amounts. I was told medicare will not cover hospice. This is nuts .. Maybe someone can explain this to me.

loveskitties

I am not sure who gave you this information, but Medicare does cover Hospice.

If you have an advantage plan, then that is up to the plan provider.

Quilting brings calm

Medicare Advantage does  not cover hospice …. But that doesn’t matter.  If you have an advantage plan, this is the one situation where you actually go get the original  Medicare  card and use it.

zauberflote

Both my mom and MIL had original Medicare, and different supplements. For each of them, Medicare covered meds and supplies and hospice provider fees I guess, for, and only for, the condition they were on hospice for. MIL was COPD, Mom was dementia. They each had hospitalizations which caused us to remove them from hospice so that Medicare would cover the reasons for hospitalization. They both were accepted right back into hospice on their respective arrivals home. In MIL's case we had to do our own wound care after a bout with cellulitis, but in Mom's case our nurse decided that checking Mom's healing incision from hip replacement was comfort care, so she checked it a couple of times for us, very kindly. For that same hip, we were able to find a mobile, self-pay physical therapist, as Medicare would certainly not have covered that.

Jo C.

Hello Suze, it will be good to know that Medicare DOES cover Hospice.  When a person is in an Advantage Program, they STILL get Hospice - that is the law governing such entities.   In an Advantage Program, Hospice can be ordered and it is paid for by Medicare, out of the Advantage Program medical group but your Loved One (LO) would still be in the Advantage Progam - Advantage Plans are simply another form of medical insurance through a Medicare contract.

No matter if a person is Medicare, or Medicare Advantage or Medicaid, Hospice is covered.

One of the issues will be that a person must fit Hospice criteria for a diagnosis to be able to fit into Hospice. While Hospice law states a patient must have six months or less to live, that is in reality adjusted for many.   One still however must have certain criteria that are met.

Sometimes, the diagnosis of dementia being SO hard to fit criteria for Hospice admission, that the Hospice will take the patient into service using a different  diagnosis from a secondary condition the person may have.

Hospices are also different.  The larger ones, rather than the smaller Mom and Pop ones are usually more generous.  If one Hospice does not accept the patient onto service, if the LO is really ill, then it is  good idea to call a different Hospice.  Some Hospices are more beneficent than others.

You can look up Hospice entities that serve your area.   I usually would contact the Hospices I was looking into. When the nice person answers the phone, I ask to speak to the Nursing Supervisor; when asked what the call is about, I simply say it is "personal," and that is usually honored. I then ask the RN about their services and describe my LO; after speaking to two or three Hospices I have a good feeling about which would be the best fit.

Hospice will send out a licensed nurse to the home to do an intake which is very lengthy as required by Medicare.  If the LO is accepted onto service, then a doctor's order is needed to start - the Hospice RN will get the order for you; they do this all the time.

If your LO is not accepted, you can then call the next Hospice to come out and assess; you will have to have the intake assessment done all over again.

If your LO does not quite fit Hospice, you can call again later; Hospice can guide you about this. If your LO is accepted, any necessary equipment such as a Hospital bed, Guerney Chair, Lift, etc. will be placed in the house within a day at no cost to you.  Your RN and bath aide will be assigned along with a Social Worker and Chaplain if you wish one.

So hoping all goes well with this; let us know how it goes, we will be thinking of you.

J.

JJ401

Whoever gave you your information was wrong.  Medicare pays for Hospice care.

This link is a pretty clear explanation of how it works if you have an Advantage plan. https://www.compassus.com/for-caregivers/hospice-and-medicare-advantage-plans

You actually don’t have to worry about how this works. The Hospice takes care of the billing. They know what to bill to Medicare, your supplement if you have one, and your Advantage plan if that is what you have.

If your LO is ready for Hospice, apply to the Hospice in your area, and once your LO is admitted they will take care of the billing.