Hello Toni:

As a certified case manager and critical care unit RN, I see adult children seeking advice for their parents who are closing in on end of life issues.  Those that have serious health care issues should be offered every option for proper planning of end of life care…most appropriately hospice!!

Can you explain hospice for your readers as I am sure this will help those who are seeking answers for their frail loved ones and give the caregiver some well needed rest.

Thanks in Advance…a concerned case manager/RN from the Houston area

Dear Concerned Case Manager:

When I receive comments from healthcare professionals….I stop and listen because every day you are seeing the absolute confusion on Medicare issues that the average American has to face.  This Medicare column’s main purpose is to help those that are overwhelmed by a complicated system. There is a place in heaven for healthcare professionals because without you we would truly be lost.

HOSPICE…is a subject no one wants to talk about, but can help a family when their loved one is terminally ill. And is one of Medicare’s best kept secrets.

Most believe hospice is for the last days, but many doctors and individuals wait too long to receive hospice and what hospice can offer the patient.  Hospice can give you hope along this journey with education, medication to manage symptoms, support to the patient and family, and counseling services.  Health care professionals in the hospice system consists of physicians, nurses, social workers, spiritual counselors, certified nursing assistants and volunteers and they can all come to where the patient lives to provide the care.

On page 29 of the 2013 Medicare & You handbook, it explains what hospice is in Medicare terms and what Medicare covers for hospice under Part A of Medicare.  A doctor that orders hospice must certify that you are terminally ill and have 6 (six) monthly or less to live.  (This does not mean you have to die in 6 months which is one reason too many wait to receive care from hospice.)  Hospice can be recertified every 6 months from a hospice medical director or hospice doctor, if you are still terminally ill.  Medicare will cover inpatient respite care in a Medicare-approved facility, so that the caregiver can rest.  One can stay up to 5 days each time for respite care. Hospice will cover all medical care for the terminal illness.  Medicare will pay for health problems that are not related to your terminal illness.

Those who are enrolled in a Medicare Advantage plan, when you are receiving hospice, the hospice benefit will be paid for by Original Medicare, not your plan. You will pay your co pay for any medical care that is not associated with the terminal illness.

Costs for hospice with Original Medicare or Medicare Advantage plans:

  • You pay nothing for hospice care
  • You pay a copayment of up to $5 per prescription for outpatient prescription drugs for pain and symptom management
  • You pay 5% of the Medicare-approved amount for inpatient respite care.

Hospice is never an easy choice…, but it gives the individual and caregiver control over the terminal illness.  You can choose to walk through this journey helpless or have control over your plan of care at the end of life.  Know that hospice provides comfort, dignity, protection of your loved ones wishes, love and support.

Talk with a geriatric case manager or geriatric doctor if you have some concerns or need some advice with your loved one. We may not be able to control when…But we can control how… with hospice.

Join Toni at her “Confused about Medicare” workshop on Wednesday, June 19th  

 6:30 PM at The Abbey at Westminster Plaza, 2865 Westminster Plaza Dr., Houston, TX 77082. The workshop is free and the public is invited.

Toni King, Medicare advocate, consultant and author of Medicare Survival Guide that is available only at www.tonisays.com and not sold in bookstores.  Email questions to toni@tonisays.com or call 832/519-TONI (8664).  Sign up for the new Medicare Survival newsletter available at www.tonisays.com.

 

 

 

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