Medicare coverage of Hospice

2010-09-16T18:51:00.000-04:00

Medicare beneficiaries are eligible for hospice coverage if they are:

Eligible for Medicare Part A (Hospital Insurance)
Doctor and Hospice Medical Director certify that the patient is terminally ill and has less than six months to live
Care must be provided by a Medicare-approved hospice program
Beneficiary signs a statement opting for hospice benefits instead of routine Medicare benefits (standard Medicare benefits will still be in place for other conditions the beneficiary may have, hospice benefits only apply to the terminal condition).

Services covered by hospice include:

Doctor Visits (provided in-home to patients of Twelve Oaks Hospice)
Nursing Care
Medical Equipment and Supplies
Prescriptions for pain relief and symptom control
Short term care in hospital, including respite care
Home health aides and homemaker services
Physical, Speech and Occupational Therapy
Dietitians
Social Workers

To read more about the Medicare Hospice Benefit, click here to go to the Medicare Brochure on Hospice.

Frequently Asked Questions

2010-09-14T09:03:00.002-04:00

Frequently asked questions about hospice

1. When should a decision about entering a hospice program be made and who should make it?

At any time during a life-limiting illness, it’s appropriate to discuss all of a patient’s care options, including hospice. By law the decision belongs to the patient. Most hospices accept patients who have a life-expectancy of six months or less and who are referred by their personal physician.

2. Should I wait for our physician to raise the possibility of hospice, or should I raise it first?

The patient and family should feel free to discuss hospice care at any time with their physician, other health care professionals, clergy or friends.

3. Is all hospice care the same?

No. While there are many choices within the community, we believe that at Twelve Oaks Hospice, we are passionate in providing exceptional care for our patients. Our staff is dedicated to providing the best hospice experience in the area. We approach the experience as if it were our own family member.

4. Can a hospice patient who shows signs of recovery be returned to regular medical treatment?

Certainly. If the patient’s condition improves and the disease seems to be in remission, patients can be discharged from hospice and return to aggressive therapy or go on about their daily life. If the discharged patient should later need to return to hospice care, Medicare and most private insurance will allow additional coverage for this purpose.

5. What does the hospice admission process involve?

One of the first things the hospice program will do is contact the patient’s physician to make sure he or she agrees that hospice care is appropriate for this patient at this time. (Twelve Oaks Hospice has medical staff available to help patients who have no physician.) The patient will be asked to sign consent and insurance forms. These are similar to the forms patients sign when they enter a hospital. The form Medicare patients sign also tells how electing the Medicare hospice benefit affects other Medicare coverage.

6. Is there any special equipment or changes I have to make in my home before hospice care begins?

Twelve Oaks Hospice will assess your needs, recommend any equipment, and help make arrangements to obtain any necessary equipment. Often the need for equipment is minimal at first and increases as the disease progresses. In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.

7. How many family members or friends does it take to care for a patient at home?

There’s no set number. Some patients have no family or friends available or willing to help, some have an unlimited amount. One of the first things our team will do is to prepare an individualized care plan that will, among other things, address the amount of caregiving needed by the patient. Our staff visit regularly and are always accessible to answer medical questions.

8. Must someone be with the patient at all times?

In the early weeks of care, it’s usually not necessary for someone to be with the patient all the time. Later, however, since one of the most common fears of patients is the fear of dying alone, we generally recommend someone be there continuously. While family and friends do deliver most of the care, Twelve Oaks Hospice has volunteers to assist with errands and to provide a break and time away for primary caregivers.

9. What specific assistance does hospice provide home-based patients?

Hospice patients are cared for by a team consisting of a physician, a nurse, social workers, counselors, home health aides, clergy, therapists, and volunteers. Each one provides assistance based on his or her own area of expertise. In addition, hospices provide medications, supplies, equipment, and other services related to the terminal illness.

10. Does hospice provide care 24 hours a day, 7 days a week?

Hospice staff is on call for emergencies 24 hours a day. Hospice care does not include a nurse in the home 24/7. If there are times when you require more care than can be provided in the home, we will work with you on temporary hospital admission and continue to provide care and follow you during your stay. Most communities have nursing homes, inpatient residential centers and hospitals with hospice care options.

11. Does hospice do anything to make death come sooner?

Hospice neither hastens nor postpones dying. Just as doctors and midwives lend support and expertise during the time of child birth, hospice provides its presence and specialized knowledge during the dying process.

12. Is caring for the patient at home the only place hospice care can be delivered?

No. Hospice patients receive care in their personal residences, nursing homes, hospital hospice units and inpatient hospice centers.

13. How does hospice “manage pain”?

Hospice believes that emotional and spiritual pain are just as real and in need of attention as physical pain, so it can address each. Hospice nurses and doctors are up to date on the latest medications and devices for pain and symptom relief. In addition, physical and occupational therapists can assist patients to be as mobile and self sufficient as they wish, and they are sometimes joined by specialists schooled in music therapy, art therapy, massage and diet counseling. Finally, various counselors, including clergy, are available to assist family members as well as patients.

14. What is hospice’s success rate in battling pain?

Very high. Using some combination of medications, counseling and therapies, most patients can attain a level of comfort they consider acceptable.

15. Will medications prevent the patient from being able to talk or know what’s happening?

Usually not. It is the goal of hospice to have the patient as pain free and alert as possible. By constantly consulting with the patient, hospices have been very successful in reaching this goal.

16. Is hospice affiliated with any religious organization?

No. While some churches and religious groups have started hospices (sometimes in connection with their hospitals), these hospices serve a broad community and do not require patients to adhere to any particular set of beliefs. At Twelve Oaks Hospice, we will work with your church or religious organization in partnering them with your care and your spiritual needs.

17. Is hospice care covered by insurance?

Hospice coverage is widely available. It is provided by Medicare nationwide, by Medicaid in 47 states, and by most private insurance providers. To be sure of coverage, families should, of course, check with their employer or health insurance provider.

18. If the patient is eligible for Medicare, will there be any additional expense to be paid?

The Medicare Hospice Benefit covers the full scope of medical and support services for a life-limiting illness. Hospice care also supports the family and loved ones of the person through a variety of services. This benefit covers almost all aspects of hospice care with little expense to the patient or family.

19. If the patient is not covered by Medicare or any other health insurance, will hospice still provide care?

The first thing hospice will do is assist families in finding out whether the patient is eligible for any coverage they may not be aware of. Barring this, some hospices will provide for anyone who cannot pay using money raised from the community or from memorial or foundation gifts.

20. Does hospice provide any help to the family after the patient dies?

Twelve Oaks Hospice provides continuing contact and support for caregivers for at least a year following the death of a loved one.

What is Hospice?

2010-09-10T18:03:00.000-04:00

Hospice is a type of care and a philosophy of care which focuses on the palliation of patient's symptoms. In layman's terms, hospice is focused on easing pain and providing comfort, rather than curing the disease. With all of the taboo's surrounding death and dying, hospice originated as a volunteer-driven movement. In recent years, the medical community as a whole has come to embrace hospice as a welcome solution for the terminally ill. Hospice is the only Medicare benefit that includes pharmaceuticals, medical equipment, twenty-four hour access to care, as well as support for loved ones following a death. In addition to these benefits, Twelve Oaks Hospice patients also receive physician visits at home, respite care, cleaning services, errands, clergy visits (if requested) as well as frequent patient-care visits from our caring nursing staff.

Hospice focuses on the quality of life for those diagnosed with a terminal illness or disease. We are committed to allowing our patients to stay in their homes, assisted living facilities or nursing homes, surrounded by caring professionals and loving family. In addition to serving our patients medical needs, we provide emotional, spiritual and social support to the family as well.

Hospice is covered by Medicare, Medicaid, and most insurance companies. Patients are admitted to hospice based on medical eligibility and the determination to receive hospice care.

Volunteers Needed!

2010-09-01T07:02:00.007-04:00

Caring Hearts Needed!

Twelve Oaks Hospice needs special people like you to be volunteers

Just a few volunteer opportunities:

Reading to patients
Running errands for patients and their families
Doing crafts or other activities with patients
Letter writing
Helping with landscaping
Working in our office
Special Event Planning
Community Education

Please complete our volunteer information request form here and we will be in touch with you about making a difference in the lives of our patients.

Volunteers must be at least 14 years of age and submit to a TB test and background check. Volunteers are accepted regardless of age, race, color, religion, national origin, sex or disability.

Common Diagnoses for Hospice Care

2010-08-16T10:27:00.001-04:00

Twelve Oaks Hospice has expertise in caring for patients with all end-stage incurable illnesses and conditions. Some of the most common diagnoses include:

A.I.D.S.
Alzheimer's Disease
A.L.S. (Lou Gehrig's Disease)
Cancer
Cardiomyopathy
Congestive Heart Failure
Chronic Obstructive Pulmonary Disease
Coma
Dementia
Emphysema
Heart Disease
Liver Disease
Multiple Sclerosis
Renal Disease
Stroke