When you think about Medicare, you probably think about senior citizens with health insurance coverage getting many services for free, or for a reasonable premium, and paying 20% of the cost of many medical services. You probably view it as health coverage that helps aging Americans stay healthy, and live as long as they can.
That's fair. There's an aspect of Medicare that many don't know about, though, and it can make a real difference in the life and death of you and your loved ones -- even financially. I'm referring to hospice.
Hospice in a nutshell
Hospice is a big deal, having served an estimated 1.6 million to 1.7 million people in 2014. Despite that, there are lots of misconceptions about hospice.
For starters, don't think of it as a place dying people go to. Think of it more as a kind of care -- which can be delivered in places such as healthcare facilities, nursing homes, and a patient's own home. (In 2014, about 36% of patients receiving hospice care received it in their own homes.)
The goal of hospice is to help those with a "life-limiting illness" live as comfortably, and as well as possible, for as long as they can. And indeed, studies have shown that those in hospice care often live longer than those in similar conditions who do not opt for hospice services.
Hospice care is available to people of all ages with a wide range of life-ending conditions who are not expected to live longer than six months. Here's how Medicare describes it:
- The focus is on comfort, not on curing an illness.
- A specially trained team of professionals and caregivers provide care for the "whole person," including physical, emotional, social, and spiritual needs.
- Services typically include physical care, counseling, drugs, equipment, and supplies for the terminal illness and related conditions.
- Care is generally provided in the home.
- Family caregivers can get support.
The case for hospice
If you're thinking that hospice sounds pretty good, you're not alone. So why would people with little life likely left not choose it?
Well, several reasons. If they're still trying various treatments in the hope of curing their diseases, or extending their lives significantly, it's not the right time for hospice. That's a good reason not to enter hospice care.
On the other hand, many people don't choose hospice because they assume it will cost them money, and money is tight. That's not a good reason to ignore hospice -- because hospice is often free. It's covered by Medicare and Medicaid and most insurance plans, in part because it makes financial sense.
The cost of caring for someone in hospice is generally lower than caring for someone with costly treatments. If someone somehow does not qualify for free hospice care via their insurance, many hospice providers will offer their services for free.
This is how hospice typically works: Imagine that you (or someone you love) has a terminal illness and are not expected to live for more than six months. If you choose to enter hospice care, your doctor will need to certify that you're eligible, and you'll need to sign a document saying that you no longer want curative treatments and are now interested in the palliative care offered by hospice. Then you, your doctor, the hospice team, and perhaps your family, as well, will come up with a suitable care plan for you.
Once hospice care begins, what does it look like? You'll see physicians, as needed, and will receive home visits by registered nurses and licensed practical nurses. Home-health aides will arrive to help with daily living activities, such as bathing and getting dressed.
Medical equipment and supplies will be provided, as needed. These include hospital beds, wound dressings, catheters, wheelchairs, walkers, oxygen, and so on. Your pain will be managed via drugs or other means.
Services such as nutrition counseling, physical therapy, and more will be available, as needed, and volunteers will support family members, especially those who are serving as caregivers. Attention will be paid to making sure that you live as long as possible comfortably, with as little pain as possible, and with dignity.
Best of all, just about all of this will be free. Whereas before entering hospice, someone was likely receiving bills for medications, treatments, tests, doctor visits, nursing care, home health visits, and perhaps hospital stays, as well, all healthcare costs will now be taken care of through hospice. If you need 24-hour nursing care, you'll receive it -- again at no cost. You'll no longer have to worry about high deductibles, or expensive tests and treatments.
Dying can be expensive, so hospice is a welcome treatment for one's wallet, as well as one's body and state of mind. It's not for everyone, but if you've pretty much run out of options, as many older people have, it can make a lot of sense.
Here's a final thought: Even if you don't envision hospice care in the near future for yourself or loved ones, consider learning more about it, and perhaps even making a charitable donation to a local hospice service. Even though Medicare and other entities pay hospice services to care for the dying, having additional funds means that services can do an even better job. Some, for example, are able to offer music therapy or pet therapy.