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Medicare Hospice Benefits

July 2004

What is Hospice?

  1. Hospice is a way of caring for patients who are terminally ill.
    1. Hospice is covered under Medicare Part A.
    2. Focus is on care, not cure of the patient.
  2. Eligibility requirements.
    1. Patient is eligible for Medicare Part A;
    2. The physician and hospice medical director certify terminal illness with less than six-month life expectancy;
    3. Patient signs statement choosing hospice care instead of routine Medicare covered benefits for the terminal illness; and
    4. Care is provided from a Medicare-approved hospice program.
  3. Length of Medicare covered hospice.
    1. Coverage can be extended as long as physician certifies terminal illness.
    2. Coverage is for two 90-day periods of care. If terminal illness continues, coverage can be continued for an unlimited number of 60-day periods.
    3. Physician certification of terminal illness is required at the start of each period of care.
    4. Patients can terminate hospice care at any time and resume care with the patient’s regular physician or health plan.
  4. Hospice Covered Services include, but are not limited to:
    1. Physician services;
    2. Nursing care;
    3. Medical equipment and supplies;
    4. Medications for symptom control and pain relief;
    5. Short term hospitalizations or respite care;
    6. Home health aides and homemaker services;
    7. Physical, occupational and speech therapy;
    8. Social services;
    9. Dietary counseling; and
    10. Grief and loss counseling for the patient and family.
  5. Non-covered services.
    1. Treatment to cure the terminal illness.
  6. Resources
    1. The National Hospice Organization
      1901 North Moore Street, Suite 901
      Arlington, VA 22209
      (800) 658-8898
    2. The Hospice Association of America
      228 7th Street, SE
      Washington, DC 20003
      (202) 546-4759
    3. Pennsylvania Hospice Network
      (717) 230-9993
    4. Medicare
      (800) 633-4227