Most of our patients are eligible for Medicare—and almost all of them are surprised to discover this simple fact:
Medicare will pay for all expenses incurred in hospice care related to the patient’s terminal diagnosis.
If you are surprised to learn this, you’re not alone: A recent survey found that less than 10 percent of Americans over the age of 45 are aware of this remarkable, all-inclusive benefit. Though it has been in effect since 1983, this lack of awareness keeps many families from ever considering hospice care.
This amazing benefit is part of Medicare Part A, or hospital insurance. It covers all expenses involved in hospice care, including the use of durable medical equipment.
Tell me more about the Medicare Hospice Benefit.
Most private insurance or prepaid health plans also provide coverage for hospice care. Hospice care is a fraction of the cost of hospital and nursing care. You should call your insurance company to learn more about your hospice coverage.
Thanks to generous contributions we receive from the community, we provide services to people who need hospice care and qualify for financial assistance. No one who needs our services is turned away because they have no insurance or cannot afford to pay for their care.
Medicare beneficiaries must meet the following criteria to qualify:
Please note: This change only affects services related to your life-limiting illness: Coverage for services unrelated to that illness remains unchanged.
The Medicare Hospice Benefit pays for services, medications, and treatments required to manage your life-limiting illness. However, to be covered, those services, medications, and treatments must be approved by Capital Hospice as part of your individual Plan of Care.
If I sign up for hospice care, I will lose my Medicare coverage.
Not true. Under the Medicare Hospice Benefit, Medicare will not pay for any curative services directed at your life-limiting illness. But coverage for services unrelated to your life-limiting illness remains unchanged—there is no loss of coverage.
I have to change doctors to receive hospice care.
Not true. The Capital Hospice team works with your physician to provide hospice care.
Once I sign up, I’m locked in.
Not true. Whenever you choose, for example if your condition improves, you can simply cancel hospice care and return to regular Medicare coverage without penalty—there is no loss of coverage or service days. You simply sign a form and go back to receiving all benefits.
You can re-elect the Medicare Hospice Benefit again, provided you meet the eligibility criteria.
A Medicare hospice certification is a death sentence.
Not true. No doctor can unfailingly predict the course of a life-limiting illness. In fact, receiving expert palliative care—relieving pain, managing symptoms, and reducing stress—can make a huge difference that sometimes produces the side benefit that a patient lives longer.
There is no limit on the number of days a patient can receive hospice care. After six months, you can continue to receive Capital Hospice care as long as the physician re-certifies you for hospice care based on the eligibility criteria.
As long as they relate to your life-limiting diagnosis, the following services are generally included in the Hospice Plan of Care—and thus are covered by the Medicare Hospice Benefit.
Shouldn’t I wait until the last possible minute to elect hospice care?
No. Why postpone access to such a comprehensive list of services available at no charge? The earlier you enter our program, the greater benefit you will receive from the medical and psychosocial services we offer.
Remember, you are never “locked in.” You can always opt out of hospice care without penalty. We would much prefer that you sign up and change your mind than wait until the very last minute and miss out on the benefits from the many services we provide.
What if I become ill and need to be moved to a different setting for care?
The Medicare Hospice Benefit pays for inpatient hospice care in a hospice, hospital, or skilled nursing facility. The Capital Hospice team will work with you and your family to determine the best setting for you to receive inpatient care.
What if I am in a nursing home or an assisted living facility?
The Capital Hospice team and the nursing facility collaborate on your care. You will have the benefit of experts in long-term care working with experts in pain and symptom management as well as counseling. It adds up to the highest level of quality care for you and your family.
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