QUESTION: I am looking for information about hospice. What is it, does Medicare cover it and how does a person qualify for coverage?
ANSWER: Hospice is a unique way of caring for a person with an advanced illness. It focuses on palliative care instead of curative care. It includes pain management and other services to help manage the symptoms of an illness. It includes practical, emotional and spiritual support to those who are ill and their families.
Medicare will pay for hospice care if you meet certain conditions. First you must be enrolled in Medicare Part A as this is the part of Medicare coverage that covers this type of illness.
To qualify for hospice care your doctor and the hospice medical director must certify that based on your medical condition you likely have six months or less to live.
The patient must sign a statement choosing hospice care instead of a treatment to cure their advanced illness. Then your doctor and the hospice medical director need to draw up and regularly review the plan of care. That care will then be provided by a Medicare certified hospice program and paid for by Medicare.
When you qualify for hospice, Medicare will pay for a variety of services, some depending on where you reside. These services may include nursing care and doctor’s services, therapy, medical social services, home health aide and homemaker services, medical supplies, durable medical equipment, pain medication and short-term in-patient care.
Most hospice care provided by Medicare is provided at home. However if your condition is severe enough Medicare may pay for short-term in-patient hospital care.
If you choose hospice for your advanced illness, Medicare will still be your coverage for any medical needs unrelated to your terminal illness.
If you select hospice care and then change your mind you can change back to Medicare and at a later date if you want to return to hospice and meet the eligibility requirements you can return to hospice coverage for the care of your terminal illness.
If you are enrolled in a Medicare HMO or Private Fee-for-Service-Plan (PFFS) you can choose any hospice agency in your area and you do not need your plan’s approval to obtain the Medicare hospice benefit. You will continue to see your regular doctors for services outside of the hospice care.
You can have hospice care even if you are in an assisted living facility or skilled nursing facility as long as other insurance is paying for your room and board while Medicare pays for your hospice care.
THURSDAY/FRIDAY – June 20 & 21 – 12 noon to 4:00 pm – Class – AARP Driver Safety Class – at Moorpark Active Adult Center, 799 Moorpark Road in Moorpark – 2 day class. For information or to make a reservation call (805) 517-6261.
SATURDAY – June 22 – 1:00 to 4:00 pm – Workshop – “Physically Fit & Happier at Home” – at Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks. Cost is $23 and reservations are available at Goebel’s front desk.
TUESDAY –June 25- 4:00 to 5:30 – Seminar – “Navigating Placement Choices” – at Senior Concerns Day Care Center, 401 Hodencamp Road in Thousand Oaks. For reservations call (805) 497-0189.
WEDNESDAY – June 26 – 11:00 am – Event – “Salute Our Veterans” – at Cypress Place Senior Living, 1200 Cypress Point Lane in Ventura. For reservations call (805) 650-8000.
THURSDAY –June 27 – 1:30 to 3:00 pm – Seminar – “Will You Pass Your Next Driving Test?” – Simi Valley Senior Center, 3900 Avenida Simi in Simi Valley. For reservations call (805) 583-6363.
THURSDAY – June 27 – 1:00 PM – Presentation – “Burn Prevention for Seniors” – at Goebel Adult Community Center, 1385 E. Janss Road in Thousand Oaks. For reservations call (805) 381-2744.
Betty Berry is a senior advocate for Senior Concerns. The advocates are located at the Goebel Active Adult Center, 1385 E. Janss Road, Thousand Oaks CA 91362 or call (805) 495-6250 or e-mail firstname.lastname@example.org (please include your telephone number. You are invited to submit questions on senior issues.