Deciding when it's time for hospice is difficult and should be discussed with loved ones and a physician. It is generally time for hospice when:
The vast majority of hospices follow Medicare requirements to provide the following, as necessary, to manage the illness for which someone receives hospice care:
Not all services provided to patients enrolled in hospice care are covered by the Medicare Hospice Benefit. The benefit will not pay for:
To receive hospice services, a hospice physician and a second physician (often the individual’s attending physician or specialist) must certify that the patient meets specific medical eligibility criteria; generally, the patient’s life expectancy is 6 months or less if the illness, disease or condition runs its typical course. However, if the individual lives longer than six months and their condition continues to decline, they may be recertified by a physician or nurse practitioner for additional time in hospice care. Similarly, if a hospice patient's condition improves, they may be discharged from hospice care. The patient is eligible for hospice again if his or her condition begins to decline.
When determining if hospice is the right decision, these questions will guide the conversation. Do you/your loved one want:
Hospice services are provided in the setting that the patient calls home, which may be their private residence or that of a loved one, a hospital, assisted living center, or nursing home. Some hospices have their own long-term residential center where they provide hospice care.
For those who qualify; Hospice care costs are covered 100% by Medicare Part A, Medicaid (in most states), private insurance or The Veteran’s Health Administration
It is not surprising that people often associate hospice with cancer. In the mid-1970s when hospice came to the U.S., most hospice patients had cancer. Today, more than half of hospice patients have other illnesses for which they are medically eligible for hospice services, such as late-stage heart, lung or kidney disease, and advanced Alzheimer's disease or dementia.