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The Hospice Benefit and What it Covers

November is Hospice & Palliative Care Month, when we celebrate hospice care and engage in outreach and education to help people in our community, including our local physician and community partners, to understand what a gift hospice can be for patients-and families of patients-nearing the end of life.

When we meet with patients and their families to discuss hospice, we often get asked ‘How much will hospice cost me and my family?’ and ‘What services are provided if I enroll in hospice care?’

We recognize that deciding to enroll in hospice care requires careful consideration and consultation with trusted medical professionals as well as family, extended family, and friends. Here is a summary of the services typically provided by the hospice benefit.

What is hospice care? Hospice is a program of care for people who are terminally ill and nearing the end of life.

Hospice is not a place. Care is provided wherever a person resides, including nursing homes, assisted living facilities, and community care homes. All Vermonters have access to the McClure-Miller Respite House, which is owned and operated by the University of Vermont Home Health & Hospice, in Colchester.

Hospice provides expert medical care, pain and symptom management, emotional, and psychosocial support to people and their families. Hospice care at CVHHH is provided by a trained team of clinical and medical professionals, including registered nurses, rehab therapists, licensed nurse’s assistants, personal care attendants, social workers, a bereavement coordinator, and a non-denominational chaplain.

What services does the hospice benefit cover? The hospice benefit typically covers everything you need related to your terminal illness as long as the care is provided by a Medicare-approved hospice provider like CVHHH. Care will be provided according to a care plan, which is created by your hospice care team.

  • Nursing care
  • Medical equipment (e.g. wheelchairs or walkers)
  • Medical supplies (e.g. bandages and catheters)
  • Prescription drugs
  • Hospice aide and homemaker services
  • Physical, Occupational, and Speech-Language Pathology services
  • Social work services
  • Grief and loss counseling
  • Short-term inpatient car (for pain and symptom management)
  • Short-term respite care
  • Support from volunteers
  • Non-denominational spiritual support provided by a CVHHH chaplain. Meet CVHHH’s chaplain Leslie Ruster here.
  • Any other Medicare-covered services needed to manage your terminal illness and related conditions as recommended by your hospice team

What services are not covered by the hospice benefit? Enrolling in hospice care signals that you will no longer receive curative treatment. As such, the hospice benefit will not cover the following services.

  • Treatment intended to cure your terminal illness and/or related conditions. You always have the right to stop hospice care at any time. Similarly, you can decide to re-enroll in hospice. The choice is yours.
  • Prescription drugs that are not for your terminal illness or related conditions.
  • Care from a provider not set up by your hospice medical team
  • Room and board – Hospice does not cover room and board. This means that if you or your family member lives in a nursing home or other facility, the room and board portion of the total cost is not covered by the hospice benefit. If your hospice team determines that you need short-term inpatient or respite care, Medicare will cover your stay in the facility. You may have to pay a small copayment for respite stay.
  • Care you get as a hospital outpatient visitor (in an emergency room), or care you get as a hospital inpatient visitor, or ambulance transport unless your hospice team arranges it or the care is unrelated to your terminal illness and related conditions.
  • Please contact your hospice team before you get any of the above services.

What will I pay for hospice care? Once your hospice benefit starts, everything you need related to your terminal illness is covered.

Medicare pays the hospice provider for your hospice care. There is no deductible. You will pay your monthly Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) premiums as you did before enrolling in hospice care. You may also pay a small copayment of up to $5 per prescription drugs for pain and symptom management.

How long can I get hospice care? Hospice is for people with a life expectancy of six months or less if the illness runs its normal course. This does not mean that every individual enrolled in hospice care will die within six months. If you live longer than six months, which many people enrolled in hospice do, you can continue to receive hospice care as long as the hospice medical director recertifies your condition.

You have the right to stop hospice care at any time, at which point you may resume curative treatments.

CVHHH’s Hospice & Palliative Care Manager, Jim Budis, is always available to answer your questions about hospice. Please feel free to reach out to Jim by filling out the contact form below.

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