Medicare Your Coverage Options

Three things to consider about end-of-life care

Written by Diane Archer
If you’re caring for someone at the end of life–with a life expectancy of no longer than six months–Medicare covers either curative care or palliative end-of-life care. It’s important to understand your loved one’s preferences. Here are three things to consider about end-of-life care.
  1. Would the person you are caring for prefer care to ease pain, along with social and emotional supports over aggressive medical interventions?  If so, Medicare will cover palliative nursing and therapy care, as well as home health aides, medical social services, durable medical equipment and drugs, through a Medicare-certified hospice agency.  There is only a small copay. This care is usually provided at home, but sometimes is available through a facility. To receive this coverage, the patient must forego Medicare coverage for medical interventions to treat the terminal condition. (Medical interventions to treat conditions unrelated to the terminal condition continue to be covered.) Also, the patient can end hospice coverage at any time and receive Medicare coverage for curative care to treat his or her condition whenever the patient chooses.
  2. Is care available to the person when the hospice team is not on site? The Medicare hospice benefit covers only a few hours a day of care.  As a general rule, the hospice agency will only accept patients who have someone to care for them when they are not on site.
  3. How do you find a Medicare-certified hospice agency?  Your local hospital should have a list of agencies in your community.  Ask the patient’s doctor to reach out to the hospice on behalf of the patient. The Centers for Medicare and Medicaid Services just launched an online tool for comparing different hospice agencies, Hospice CompareKaiser Health News reports that right now it’s of no real value because it doesn’t do a good job of distinguishing among hospice agencies and suggests that nine out of ten hospices are very good. That said, Hospice Compare does let you know about hospice agencies you can contact in your community.  And, the Hospice Foundation of America offers a list of questions you should ask of hospice agencies before choosing one.

Note: The hospice benefit includes some benefits for family caregivers, including respite care and bereavement services. Respite care will allow a family caregiver to take a break from caring for a loved one who is terminally ill.  And, after a loved one passes, a hospice may cover grief and loss counseling for family caregivers, support groups and memorial services. Counseling coverage for the family member can last up to a year after a loved one’s death.

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