Understanding the Medicare hospice benefit

Former Medical Director Dr. Ken Barnes, Mission Hospice & Home Care

The first modern hospice was founded in London in 1967 by physician Dame Cicely Saunders, and the movement spread to the U.S. in the 1970s. Hospice gained significant momentum in this country with the 1982 creation of the Medicare Hospice benefit.

Along with more than 50 million other Americans, most of our patients are covered by Medicare. Understanding this benefit can help them take advantage of a wide range of services to support them – and their families – through the last months of life.

A patient can enter hospice care once a physician determines that the patient has six months or less to live and the patient chooses hospice over aggressive treatment.  Medicare covers a broad range of services to manage pain and other symptoms, as recommended by the hospice team. The benefit covers care from hospice nurses and physicians, home health aides, social workers, chaplains, physical and occupational therapists, volunteers, dietary counselors, and other counselors, including those specifically trained in bereavement.

The Medicare hospice benefit also covers the rental of medical equipment such as wheelchairs or walkers, medical supplies, and prescriptions related to the hospice diagnosis. Medicare will pay for hospice care whether the patient is in her own home or in a facility such as a nursing home or board and care home. It will not, however, cover room and board, or the cost of private caregivers.

While most of our hospice patients are in treatment for less than thirty days, they can stay in hospice care as long as their six-month terminal prognosis remains certified by a physician. As patients’ needs or wishes change, hospice care may no longer be appropriate.

Here at Mission Hospice, our Transitions and Palliative Care programs helps ensure a continuum of care for patients who are not ready for hospice, whose health improves during hospice care, or who choose to seek additional treatments not covered by the hospice benefit. Our goal across our three programs is to provide pain relief, comfort, and emotional and spiritual support throughout the last months of life.

Many of our patients are covered by Medicare, but donations from the community help us serve people regardless of whether they are insured or can afford care. We are grateful for the support of our donors, who share our belief that everyone has the right to die pain-free and with dignity.

– from our February 2014 newsletter