Hospice care has become an increasingly popular choice among those dealing with terminal illnesses in this country. Since 1974, hospice care in the United States has developed into a well-established and respected philosophy in the healthcare spectrum.

Essentially, hospice care is switching from aggressive curative treatment to palliative treatment. Palliative treatment is the focus on pain and symptom management, in order to increase quality of life of patients with life-limiting diseases.

Hospice is a team-based approach to healthcare that is focused on the whole person, rather than just the disease. Services also include comprehensive support for the family and caregivers. The hospice team usually consists of a physician, nurse, medical social worker, hospice aide, chaplain, volunteers, and bereavement staff.

Hospice services are generally provided in-home, whether it is a private residence, nursing home, or assisted living facility. Eligibility requirements for hospice care are set by Medicare at a federal level and do not differ among providers. To receive hospice services, a patient’s predicted life expectancy must be six months or less and must be certified by a physician. A patient must also not be seeking curative treatment for his/her illness, instead opting for comprehensive symptom management and support services as the disease progresses. Emphasis is placed on quality of life and helping the patient and family make the most of their remaining time together.

Medicare, Medicaid, and some private insurance companies provide coverage for hospice care. Specific private insurance plans may vary, but Medicare reimburses hospices on a per diem (per day) basis and the hospice pays for the following services, when related to a terminal diagnosis: physicians’ services, nursing care, medical equipment in the home (beds, oxygen, etc.), medication for symptom management and pain relief, short term acute inpatient care, hospice aide services, social services, physical therapy and/or occupational therapy when necessary, and dietary and spiritual counseling. Nonprofit hospices generally do not require out-of-pocket payments for these services, but privately-owned “for-profit” groups may. Charges may include co-payments on medication and equipment or for costlier services not fully covered by the Medicare reimbursement. To avoid unanticipated expenses, it agreements with a provider before choosing services.

Hospice services are available in Medicare-defined benefit periods. A beneficiary may elect hospice care for two 90-periods, followed by unlimited 60-day periods. Benefit periods may be used consecutively or at intervals. A patient may choose to change hospice programs once during each benefit period, if necessary. He/she may also choose to cancel hospice services at any time and return to standard Medicare coverage, then later reelect the hospice benefit during the next benefit period. (Any days for hospice coverage left in the benefit period at the time of cancellation are forfeited.)

Hospice care is a comprehensive program, but is often underutilized due to lack of understanding about services available and how they are covered by insurance. For more information regarding Medicare coverage, visit http://www.medicare. gov/publications/Pubs/pdf/02154. pdf. There are also many resources available online regarding services and differences among the many providers in each community. Please visit www.hospicefamilycare.org to find out more about nonprofit hospice care in Madison County