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The cost of medical care has been an ongoing concern for many. With the economy in upheaval and unemployment rising, many people are putting off healthcare because of anticipated co-pays, even dropping health insurance because of the cost of premiums. This should not be a concern for those who are very ill and those with life-limiting illness. They should pursue hospice care if they need it. Hospice is covered by Medicare MediCal and insurance, in almost all cases, at no charge to the patient.

 “Through Medicare, hospice is a covered benefit and there is no co-pay or deductible, said Pam O’Leary, MSW.  “People should be using the service now when their ability to pay for other types of service is hampered.”

Covered by Medicare is a vague phrase, but there is nothing vague about the coverage. For those who qualify for Medicare and hospice, all health care related to the patient’s terminal illness is directed by an individualized plan of care and covered once they choose the hospice benefit – including their medications.

The benefit directs your hospitalization benefit to the hospice of your choice. It is similar to when you pick an HMO or PPO to manage your Medicare coverage. The HMO/PPO becomes responsible for your care. When you switch to the hospice benefit, the hospice of your choice covers all healthcare related costs in your hospice plan of care.  Costs related to medical equipment like hospital beds for your home, supplies such as gauze bandages, medications and after hours access to nursing support are available as are other provided services. As need is determined those services are allocated including hospice aide visits, spiritual counselors, social workers and other therapists.

Hospice care also supports the family and loved ones of the patient through a variety of services such as training to care for you, the patient, counseling and 13-months of bereavement support.

The benefit is very flexible. For example, if you should need eye care unrelated to your terminal diagnosis, Medicare and your health benefit will activate to cover that situation. Your treatment for the new condition will be paid for at the rate it would have prior to electing hospice care. Choosing hospice sometimes seems like a last choice. It is not. You can opt out of hospice any time you want and come back in again.

“You don’t have to wait for an enrollment period,” said Doug Jena, Yolo Hospice Executive Director. “You can begin hospice now and then opt out at any time. Your traditional healthcare benefits will resume. But, you should know that, everything else being equal, patients on hospice have a longer life expectancy than those who are not.”

MediCal coverage of hospice follows the Medicare Benefit so you’ll get the same coverage. HMOs also cover hospice. The State of California passed a bill requiring HMOs to cover hospice care in 1999. They must cover everything Medicare does, but coverage can differ in lifetime limits and other areas. PPOs may cover hospice, but will have their own policies regarding hospice.

“All people have to do is call us,” said O’Leary. “That’s our job. We’ll call their healthcare carrier and figure out what’s covered and what’s not.”

Uncovering what your insurance pays, even dealing with your insurance, is an added burden. Yolo Hospice will take that burden off your shoulders and report back to you. In fact, if you are in need of hospice service and do not have insurance and are otherwise unable to pay, Yolo Hospice will still provide you with hospice care.

“Your life savings, your home aren’t at risk with hospice care,” said Jena. “As a not-for-profit, we are going to do our best to see that everyone who wants and needs hospice care gets it regardless of their coverage and ability to pay.”

If you or your family member needs hospice care, don’t wait to get more information. Yolo Hospice is able to answer your questions and available as a resource to you. Please call (530) 758-5566 to talk about services today.

 

 

 

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Quotes

Ted Skiera
"I've worked for 20+ years in cardiovascular and oncology nursing, most recently working as a nurse coordinator in cardiovascular research. My work with Yolo Hospice has enabled me to focus all of my acute clinical experiences into caring for patients, and their loved ones, during a most challenging period of their lives."
~Ted Skiera, RN