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What is Hospice Care?
Hospice care provides medical services, emotional support, and spiritual resources for people who
are in the last stages of a terminal illness, such as cancer or heart failure. Hospice care also helps
family members manage the practical details and emotional challenges of caring for a dying loved
one.
The goal of hospice treatment is to keep you comfortable and improve your quality of life while you
are dying. This philosophy is a shift from usual medical treatments, in which health professionals
strive to cure your disease. Hospice services are not intended to speed up or prolong the dying
process, but focus instead on relieving pain and other symptoms. Hospice caregivers are concerned
with enhancing the quality of remaining life by keeping you as alert and comfortable as possible in a
familiar environment with family and friends.
Hospice programs offer services 24 hours a day, 7 days a week, in your own home or in a hospice
center. Some hospices also offer services in nursing homes, long-term care facilities, or hospitals.
Hospice services generally include:
- Basic medical care with a focus on pain and symptom control.
- Medical supplies and equipment as needed.
- Counseling and social support to help you and your family with psychological, emotional,
and spiritual issues. - Guidance with the difficult, but normal, issues of life completion and closure.
- A break (respite care) for caregivers, family, and others who regularly care for you.
- Volunteer support such as meal preparation or errand running.
- Counseling and support for your loved ones after you die.
Most of the time, hospice care is provided in your home. A family member or loved one will
generally look after you much of the time. And someone from your hospice team will usually visit
you for an hour or so one or more times a week. Your loved ones will work with the hospice team
to give you the best care possible.
Hospice teams usually include a doctor and nurses, social workers, spiritual advisors, nursing
assistants, and trained volunteers. It may also include pharmacists, respiratory therapists,
psychologists, psychiatrists, music therapists, physical therapists, and occupational therapists. If
you have an emergency or get scared, you can call the 24-hour hospice number for advice. When
necessary, a nurse can usually come to your home at any time of the day or night.
Some people worry about losing touch with their regular, trusted doctor. But being on hospice does
not mean that you won't see your regular doctor. He or she can work with others on your team to
stay involved in your care.
Eligibility for most hospice programs is based on two criteria:
- Your condition is considered incurable. This is called a terminal illness.
- Your doctor has indicated that your life expectancy is 6 months or less if your illness runs
its normal course. Usually a form must be signed by your primary doctor as well as the
medical director or physician member of a hospice team.1
It can be hard for doctors to know how long a person will live. Some people live longer than
expected. If you live longer than 6 months, you can continue on hospice. If your illness gets better,
you can stop receiving hospice care.
Hospice care programs do not discriminate. Care is provided regardless of age, sex, religion,
diagnosis or type of health problem, ethnic or cultural background, sexual orientation, or ability to
pay.
Payment for hospice services is covered through Medicare and most Medicaid programs. Most, but
not all, private insurance programs offer a hospice benefit. It is important to research whether your
health insurance coverage offers hospice benefits and determine exactly which services are
included. Many hospice programs will research your medical coverage for you.
Medicare is a health insurance program for people 65 years of age and older, for some people
younger than 65 who have disabilities, and for people with long-term (chronic) kidney failure
treated with dialysis or a transplant. Medicare is administered by the Centers for Medicare and
Medicaid Services (CMS) of the United States government.
expected. If you live longer than 6 months, you can continue on hospice. If your illness gets better,
you can stop receiving hospice care.
Hospice care programs do not discriminate. Care is provided regardless of age, sex, religion,
diagnosis or type of health problem, ethnic or cultural background, sexual orientation, or ability to
pay.
Payment for hospice services is covered through Medicare and most Medicaid programs. Most, but
not all, private insurance programs offer a hospice benefit. It is important to research whether your
health insurance coverage offers hospice benefits and determine exactly which services are
included. Many hospice programs will research your medical coverage for you.
Medicare is a health insurance program for people 65 years of age and older, for some people
younger than 65 who have disabilities, and for people with long-term (chronic) kidney failure
treated with dialysis or a transplant. Medicare is administered by the Centers for Medicare and
Medicaid Services (CMS) of the United States government.
Medicare consists of:
- Part A, or hospital insurance. Part A benefits provide coverage for hospitals, nursing
facilities, some home health care, and hospice. People (including a spouse) who paid
Medicare taxes while they were working are eligible for Part A benefits. A monthly payment,
or premium, is not required for Part A benefits. - Part B, or medical insurance. Part B benefits pay for services not covered by part A, which
would include care for any health problems that are not related to your terminal illness. Part
B benefits are optional and are not paid from Medicare taxes: you must pay a monthly
premium as well as deductible and/or copayment fees.
The Medicare hospice benefit provides coverage for services related to a life-limiting illness. Hospice care is
covered under Medicare Part A benefits. You must meet all of the following criteria to be eligible for the
Medicare hospice benefit:
covered under Medicare Part A benefits. You must meet all of the following criteria to be eligible for the
Medicare hospice benefit:
- You must be eligible for Medicare Part A benefits.
- Your doctor and hospice medical director must certify you as having a life-limiting illness with a probable life-
expectancy (prognosis) of less than 6 months to live. - You must sign a statement that documents your intent to receive the Medicare hospice benefit. This means
that you agree to receive services to maintain your comfort and control the symptoms of your life-limiting
illness and are willing to stop treatments designed to prolong your life. However, your regular Medicare
benefits will still cover services for any health problem that is not related to your life-limiting illness. - You must receive care from a hospice approved by Medicare.
most services related to a life-limiting illness, including:
your symptoms. Nurses are also available 24 hours a day, 7 days a week to visit if you need help.
However, live-in nursing care is not covered.
If your condition changes so that hospice is no longer appropriate, you can get your previous
Medicare benefits reinstated. You can also re-apply for hospice benefits at a later time if necessary.
your symptoms. Nurses are also available 24 hours a day, 7 days a week to visit if you need help.
However, live-in nursing care is not covered.
- Medical supplies and equipment, such as a wheelchair, hospital bed, or incontinence pads.
- Medications for symptom control and pain relief. You will have to pay no more than $5 for
each prescription drug and other related products. - Visits to your doctor to help manage your life-limiting illness.
- Intermittent homemaker and home health aide services. However, the service of a live-in
homemaker or home health aide is not covered. - Physical, occupational, or speech therapy, if needed because of your life-limiting illness.
- Dietary counseling.
- Visits from a counselor or social worker.
- Spiritual care, if desired.
- Visits from trained volunteers. Volunteers are available on a short-term basis to provide
companionship, to help with your care, or to run errands. - Short-term care in a skilled facility (such as a hospital or nursing home) to give temporary
relief to your caregiver. This is called respite care: it is helpful if a family member, friend, or
hired caregiver needs a temporary break from the demands of caregiving (because of illness,
for example). The hospice program can charge up to 5% of the daily skilled facility costs for
respite care. You can stay for up to 5 days per each admission. There is no limit to the
number of times you can receive respite care. - Temporary hospitalization, if needed, to help manage symptoms that cannot be controlled at
home. - Counseling (called bereavement care) for your family, friends, and caregivers following your
death.
If your condition changes so that hospice is no longer appropriate, you can get your previous
Medicare benefits reinstated. You can also re-apply for hospice benefits at a later time if necessary.
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