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What Is the Connection between Medicare and Hospice?

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  • Written By: Marlene de Wilde
  • Edited By: O. Wallace
  • Last Modified Date: 20 November 2016
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The connection between Medicare and hospice care is that hospice is available as a benefit for those eligible under the Medicare scheme. Medicare is a government social insurance program in the US that provides medical and health-related care and services for the elderly. Hospice care is the care of the terminally ill whose treatment no longer includes a cure but necessitates medical and supportive care.

In order to be eligible for hospice care under Medicare, a physician must certify that the patient is terminally ill with a life expectancy of half a year or less. This must then be confirmed by the hospice medical director. Patients must be 65 years old or over or under 65 and disabled. The support may include inpatient or home care and the goal of palliative care is to help the person remain as comfortable and pain-free as possible.

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The services included in hospice care are physical care, counseling, equipment, supplies and drugs. The drugs included under the Medicare and hospice program are not designed to cure the condition but only to relieve pain. Where possible, the care is provided in the person's home by a specially trained team of professionals including doctors, nurses, social workers, physical and occupational therapists. The team works together to set up a care plan to cover not only physical needs but also emotional, social and spiritual ones. The support system also covers family caregivers who can face a great deal of stress in these circumstances.

In order to be eligible for Medicare and hospice benefits, patients need to be entitled to part A of Medicare which involves hospital insurance. Along with the physician's confirmation of a terminal illness, the person concerned must sign a statement to the effect that he is choosing hospice care over other Medicare benefits. Finally, the hospice chosen must be one that is approved by Medicare.

Once in the care system, a hospice doctor and nurse are available on-call for 24 hours a day and seven days a week. Priority is given to home care within a family environment when at all possible but should it be necessary, there are inpatient facilities. For those eligible for Medicare and hospice benefits, the treatment is comprehensive and involves not only medical care and equipment, but also drugs for symptom control or pain relief, physical and occupational therapy, dietary counseling, social worker services and grief and loss counseling. Should the caregiver, usually a family member, need a break, then Medicare also covers short-term respite care in an inpatient facility.

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