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Learn more about what Medicare covers for hospice care

Dear Toni: As a certified case manager and critical care unit registered nurse, I advise spouses and adult children who are seeking advice for end-of-life issues. Those who have serious health care issues should be offered every option for proper planning for end-of-life care, especially hospice.

Can you explain hospice and respite care to your readers? I am sure it will help those who are seeking assistance for their frail loved ones. — Susan, Spring, Texas

Dear Susan: Hospice is a subject no one wants to discuss with an elderly loved one. When someone is terminally ill, it takes an emotional toll on the caregiver, the family as well as the patient.

Many wait too long to discuss the benefits of hospice care with the patient’s doctor because they believe it is only for the last days to help a person die peacefully. They are not aware that hospice can give hope along this journey through education, medication to manage symptoms, support to the patient and family, and counseling services for the patient, family members and caregivers.

Health care professionals in the hospice system include physicians, nurses, social workers, spiritual counselors, certified nursing assistants and volunteers. A hospice provider comes to where the patient lives to provide care.

The Medicare & You handbook explains what Medicare covers for hospice under Part A. A doctor who orders hospice must certify that a patient is terminally ill and has six months or less to live. When patients agree to hospice care, they agree to comfort care (palliative care) instead of treatment to cure the illness and must sign a statement choosing hospice care instead of other Medicare-covered treatments.

Hospice can be recertified every six months, as needed, by a hospice medical director or hospice doctor. Original Medicare will be billed for the hospice care.

Hospice will cover all medical care for terminal illness, and Original Medicare or Medicare Advantage Plan will pay for unrelated health problems (co-pays will apply).

Under hospice:

— You pay nothing (Medicare pays).

— You have a co-payment of up to $5 per prescription for outpatient prescription drugs for pain and symptom management.

— You pay nothing for Medicare-approved inpatient respite care, which is a five-day stay in a Medicare-approved facility so that the caregiver can have a period of rest.

Know that hospice offers control over end-of-life care for you or a loved one. It provides comfort, dignity, love and support. Talk with a geriatric case manager or geriatric doctor if you have concerns or need advice with a terminal health care issue.

Currently, my mother is in hospice because of dementia, and I am experiencing everything that hospice offers. It is truly a blessing for those who have a terminally ill loved one.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.

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