Terminal illness is an illness that cannot be cured and usually leads to death within a short period. Palliative care is specialized medical care for people with terminal illnesses. It aims to improve the quality of life for patients and their families by providing relief from pain, symptoms, and stress. Hospice care is a type of palliative care that focuses on comfort and quality of life rather than cure. This article will discuss the hospice care needs of terminally ill American patients and what financial support they can get from the U.S. government.
Types of Hospice Care
There are two main types of hospice care: inpatient and outpatient. Inpatient hospice care is provided in a special hospice unit in a hospital, nursing home, or other facilities. Outpatient hospice care is provided in the patient’s home. Hospice care is also provided by assisted living facilities and long-term care facilities.
Inpatient hospice care is for patients who need more intensive medical care and supervision. It is usually provided for a short period, such as when a patient is experiencing a sudden deterioration in their condition or when they are close to death.
Outpatient hospice care is for patients who can be cared for at home with the help of family and friends. Home hospice care can be provided by hospice care nurses , home health aides, social workers, and volunteers.
Hospice care is paid for by Medicare, Medicaid, VA benefits, private insurance, and out-of-pocket payments.
Medicare Support for Hospice Care
Medicare supports hospice care by covering the costs for the following as long as these are included in the plan of care drawn up by the patient’s hospice team:
- Physicians’ services
- Medical and nursing services
- Medical equipment to relieve pain and manage symptoms
- Medical supplies such as catheters
- Pain management medication, although the patient has a copayment of up to $5 for each outpatient prescription
- Short-term inpatient care at a Medicare‑approved facility for pain and symptom management. This could be a hospital, hospice facility, or skilled nursing facility.
- Physical therapy
- Speech-language pathology services
- Occupational therapy
- Services of an aide and homemaker
- Medical social services
- Diet counseling
- Spiritual and grief counseling for the patient and the family
- Short-term inpatient respite care up to 5 days at a time, occasionally, at a Medicare-approved facility to allow the patient’s caregiver to rest, although the patient has to pay for 5% of the cost
- Any other services the hospice team recommends to manage pain and other symptoms related to the patient’s terminal illness
For the patient to qualify, the patient’s physician must certify that the terminally ill patient has a life expectancy of six months or less. If the patient outlives this, the physician can recertify the terminally ill condition after an in-person meeting. The patient must sign a statement indicating the choice of palliative hospice care rather than other treatments that aim to cure the condition.
Veterans Administration Support for Hospice Care
The Veterans Administration (VA) supports hospice care for all enrolled veterans who are terminally ill and have a life expectancy of fewer than six months. The patient must no longer be undergoing curative treatment.
The patient can choose to have hospice care at home, in an inpatient facility, or as an outpatient. No copayments are required. A hospice care team will draw up a plan of care with the patient and the family.
Medicaid Policy on Hospice Care
Medicaid has national hospice reimbursement rates for four levels of hospice care, but these rates change every year. Changes can be checked at the Medicaid Hospice Payments site. The reimbursements do not require terminally ill patients to stop any curative treatments they may be undergoing.
The levels of hospice care provided include Routine Home Care (RHC). It also covers Continuous Home Care (CHC). That is nursing care that is given during a crisis period. To give the patient’s caregiver a break, there is also short-term Inpatient Respite Care (IRC). Finally, short-term acute or chronic pain or symptom management is provided through General Inpatient Care (GIC).
Additional services provided include:
- Physicians’ services
- Nursing services
- Medical appliances
- Medical supplies
- Physical therapy
- Speech-language pathology services
- Occupational therapy
- Services of an aide and homemaker
- Medical social services
- Counseling for the patient and the family
A physician must certify that the patient is terminally ill and needs hospice services and palliative care to manage pain and other conditions related to the terminal illness. The patient must choose a specific hospice, and the hospice must draw up a plan of care for the individual.
Ensure Hospice Care Comfort for the Terminally Ill
The U.S. government provides financial support for those with terminal illnesses through Medicare, the Veterans Administration, and Medicaid. Hospice care teams work with the patient and their family to develop a plan of care that includes managing pain and other symptoms related to the terminal illness. With proper hospice care, the terminally ill can remain comfortable during their final months.
