How Long Does Medicare Pay for Hospice Care?

Medicare can be confusing, and with changing regulations, it can be challenging to determine how long Medicare pays for hospice care. 

Many of our clients ask us about this topic, and that’s why we want to take an in-depth look at the role Medicare plays in covering hospice services, focusing on some of your most frequently asked questions. 

Lower Cape Fear LifeCare is a nonprofit hospice. That means you’ll never be turned down based on your ability to pay. We see this as a sacred trust, as we believe the members of our community should all have access to these vital services that provide such comfort care at the end of life’s journey.  Want to know more about Lower Cape Fear LifeCare? Contact us.

First, we want you to be aware that the regulations for Medicare are always changing, and details vary significantly based on the patient’s specific Medicare plan. We always recommend that you stay on top of the latest developments by visiting the official Medicare website to evaluate the greater details of what will and will not be covered.

Does Medicare Cover Hospice Costs?

Yes, Medicare covers hospice, but you must meet the following criteria:

• Your physicians must determine and certify that you have a serious illness with a life expectancy of six months or less
• You have decided NOT to receive treatment to cure your illness
• You accept comfort-related care instead of curative care
• You sign a statement that indicates you’re choosing hospice care instead of other Medicare-covered treatments for your illness

What Health Services Are Covered by the Medicare Hospice Benefit?

The following items are covered:

• All items and services needed for pain and symptom management
• Medical, nursing and social services
• Medications needed in relation to your hospice diagnosis
• Durable medical equipment (DME) for pain relief and symptom management (i.e. bed, bedside commode, oxygen, wheelchair, etc.)
• Aide services
• Other covered services you need to manage pain and symptoms, as well as spiritual and grief counseling for you and your family

How Long Will Medicare Pay for Hospice Care?

Hospice care is for patients who have a life expectancy of six months or less, given the current progression of their illness. Typically, Medicare’s initial hospice benefit is broken down into two 90-day benefit periods. If hospice care is still needed after six months, patients can be re-certified for an unlimited number of 60-day benefits.

If you are unsatisfied with the care you are receiving, you can change your hospice provider once during each benefit period.

We can also help you understand what is covered by Medicare and any costs that may be involved for specific services.

Does Medicare Pay for Hospice Care in a Skilled Nursing Facility?

Yes, it will. However, it’s important to remember that Medicare does not cover room and board associated with living full-time in a skilled nursing facility or nursing home.

Medicare may offer some benefits if your health care team determines you need a short-term inpatient stay to manage pain and symptoms. 

Lower Cape Fear LifeCare has three hospice care centers designed to specifically meet patients’ and families’ needs. These home-like care centers are available exclusively for our patients, and LCFL is the only area hospice provider to operate these types of facilities.

Medicare’s Hospice Benefit also provides for respite care to give caregivers a much-needed break. Medicare covers most of the cost of respite care. It is available on an occasional basis for a period lasting no more than five days in a row. Lower Cape Fear LifeCare provides respite care for our families at our hospice care centers.

Review your Medicare plan to find out more information about what copays are involved or talk with us.

How Can I Maximize My Medicare Benefits?

There are several things you must know to help you maximize your Medicare benefits. These include: 

Understanding key differences between the different types of Medicare plans

There are a lot of details that you should not overlook when evaluating your Medicare plans. Again, we refer you to the official Medicare government website for the most recent information.

Free counseling and personalized help with navigating the complexities of Medicare is also available through your State Health Insurance Assistance Program (SHIP). You can find a SHIP counseling location using their online locator.

Reviewing the scope of services that are covered

We encourage you to evaluate your plan to be sure you are taking advantage of all the benefits for which you qualify.

Discovering if the doctor or provider accepts the Medicare-approved amount as full payment

You can find useful information about finding providers through the search tool at the Medicare website.

Reviewing Medicare statements

We know it can be overwhelming to receive so many Medicare documents, but it’s vital to review them carefully to be sure you’re getting the benefits for which you qualify.

Lower Cape Fear LifeCare Never Refuses Care Based on Ability to Pay

As a non-profit hospice, we understand the difference that proper care can make in the lives of our patients and their families. That’s why Lower Cape Fear LifeCare never refuses anyone care, regardless of their ability to pay. Why? Because we believe that everyone in our community deserves comprehensive, high-quality hospice care that offers people dignity and respect.

Each year, thousands of families across Southeastern North Carolina and Northeastern South Carolina trust us to provide their hospice care. According to a national caregiver survey, 93% of family caregivers say they would be willing to recommend Lower Cape Fear LifeCare.

Making a referral is easy. You can refer friends, family members, or even yourself.

Need more information? Contact us.

Is Hospice Financially Accessible?

We’ve mentioned earlier how Medicare covers hospice services. Medicaid and most private insurance companies cover hospice care as well. 

When you or someone you love enters hospice care, we understand you have extensive questions. For many of our patients, these questions center around will insurance pay for hospice?

Will Insurance Pay for Hospice and What Services Are Covered?

The truth about hospice is that it is covered under Medicare Part A. This care includes:

• A physician
• A social worker
• A chaplain
• Medications
• Durable medical equipment
• Supplies
• Grief counseling and care for 13 months

All these services are covered under the Medicare hospice benefit. There is no cost to the patient. Medicaid and most private insurances also cover hospice.

Lower Cape Fear LifeCare Has Specialists to Help You

We have a highly qualified group of insurance specialists that work diligently in collaboration with all insurance payers to ensure that our patients receive the best care. Our veterans who have the VA benefits through the Veterans Administration also may have a Medicare hospice benefit and the veteran can decide which benefit they would prefer to use to cover hospice care.

Lower Cape Fear LifeCare Is Ready to Guide You Through the Insurance Process

Will insurance pay for hospice?

You shouldn’t let your uncertainty guide your decision. The bottom line is insurance, Medicare and VA programs all include some type of hospice benefit.

The Patient Financial Services Department is available Monday through Friday, 8 a.m. to 5 p.m., and we ask that you please reach out to us with any questions and concerns you have related to your bills.

Lower Cape Fear LifeCare: Serving the Community Since 1980

We’re the longest-operating, nonprofit hospice in the area, serving more than 6,000 families annually.

Lower Cape Fear Life Care is a non-profit organization, and we never turn a patient away due to their ability to pay. As a non-profit, Lower Cape Fear LifeCare provides a million dollars in charity care and supportive programs for individuals in our local communities and surrounding counties. Our team is here to help. Please reach out to Lower Cape Fear LifeCare.

We’ve reviewed several different ways you can pay for hospice care, but you may have certain questions about what’s involved with hospice care you receive at your home. What can you expect?

In this next section, we’ll review some answers to the frequently asked questions we receive so you can make informed decisions about your care.

Hospice Care at Home – What You Should Expect

  More than 90 percent of hospice patients are served where they live and are most comfortable – at home, making hospice care at home very popular. However, some people and families may be hesitant to welcome strangers in to care for their loved one, let alone a whole team of them. 

Families may see this as an invasion of their privacy or feel that they have been doing a pretty good job on their own up to this point.

Hospice is Your Care, Your Way

While you are assigned a care team, visits are scheduled at a time you have agreed upon. Members of this team include:

• Physician
• Nurse aide
• Social worker
• Chaplain
• Volunteer 

Most often, your hospice care at home team members will visit one at a time. They are there not only to provide care for the patient, but to provide family members with education, resources, and support. 

The team looks to you for information and guidance to help them better meet your needs. They will be respectful and understanding with the patient. As you get to know them, you will find yourself looking forward to their visits.

What is Included in Hospice Care at Home?

Once the admission process is completed, the hospice team will communicate with the patient’s physician and the hospice physician to discuss the patient’s medical history, current symptoms, and life expectancy.

The following are some details concerning the roles of hospice team members and what you can expect with hospice care at home:

• • The team’s social worker provides emotional and psychosocial assessments for the plan of care.
  • Hospice Chaplains will contact the patient and/or family to discuss spiritual care needs so that care can be provided in a manner respectful of the patient’s and family’s spiritual/religious beliefs.
  • Volunteers are available by request. They can provide companionship for the patient and support for the family by way of respite, running errands, and other tasks.
  • Regular visits by individual members of the team are scheduled, so you will know when to expect them.
  • Any necessary medical equipment will be delivered to you, including but not limited to:
    • Oxygen
    • Hospital Bed
    • Bedside Toilet
  • Necessary medications will also be delivered.
  • Family caregivers receive information and education to help them manage your loved one’s pain and symptoms, even as they change.

• Patients and families have access to help and support seven days a week, 24 hours a day, including weekends and holidays.

• If pain and symptoms cannot be managed at home, patients and families have exclusive access to our home-like, inpatient hospice care centers.
• Our inpatient hospice care centers also offer respite care for families as provided for by the Medicare Hospice Benefit.

Your Hospice Care at Home Team Develops an Individualized Plan of Care

Your team considers all perspectives, including input from the patient and family, physicians, and team members to develop your own personalized plan of care. Team members meet weekly to review and revise the plan based on the patient’s condition.

Best of all, hospice care is your care, your way. The patient and family are the experts on what they want and need from care. Your team takes their cues from you, so they know how to provide the best care and support for you and your loved one.

Did you know that you can refer anyone to hospice? You can even refer yourself! All you have to do is complete our referral form. Discover the quality, compassionate care of Lower Cape Fear LifeCare.

Can You Receive Hospice Care in a Nursing Home?

While many people think that hospice is a place, hospice care is actually a specialized type of care for those with a terminal or life-limiting illness that patients receive wherever they call home – including assisted living facilities and nursing homes.

How Does Hospice Care Help Nursing Home Residents?

While nursing home staff are experts in custodial care, hospice care team members are experts in end-of-life care for nursing home residents with life-limiting or terminal illnesses with a life expectancy of six months or less.

Hospice Care Offers Residents:

• Regular visits by a registered nurse
• Consultations by a hospice physician as needed
• A care team focused on pain and symptom management
• Reduction of hospitalizations and emergency room visits
• Extra spiritual and emotional care and support
• Any additional medications or medical supplies needed related to diagnosis
• Coordination of care between all the patient’s doctors, nursing home staff and hospice care team members
• Education for nursing home staff, the patient and their family members about the patient’s condition, symptoms, medications, and how to best care medically for the patient at this time of their life
• Grief counseling for 13 months for family members after the death of their loved one

Do Nursing Homes Provide Hospice Care?

While some nursing homes may have small hospice units with specialized staff, most choose to partner with hospice providers because of their expertise in this type of care. The care provided is complementary to that being provided by the nursing home, thereby ensuring the best possible end-of-life care for residents.

How is Hospice Care Paid for in a Nursing Home Setting?

The Medicare Hospice Benefit covers the cost of hospice care for those residents who qualify:

• A doctor and medical director certify that the resident has a life-limiting or terminal illness with a life expectancy of six months or less.
• The resident signs a statement electing hospice care and stops receiving treatment for their terminal illness. This does not stop them from receiving care for other medical conditions.
• The resident can decline hospice care and restart receiving treatment for their illness at any time.
• The nursing home has a contract with a Medicare approved hospice provider. Lower Cape Fear LifeCare is a Medicare-approved provider with a history of being recognized for exceptional care.

Keep in mind that the hospice benefit does not generally pay for housing costs associated with nursing home care.

What are the Nursing Home’s Responsibilities?

In addition to the routine daily care and regular medical care and medications provided by the nursing home, the nursing home staff will:

• Communicate and coordinate with the hospice provider for the patient’s care
• Monitor the patient’s condition and notify the hospice care team of any changes

How Do I Find Out About Getting Hospice for Myself or a Loved One in a Nursing Home?

Lower Cape Fear Hospice partners with more than 40 nursing homes and assisted living facilities throughout its service area. Of course, who provides a patient’s hospice care is always their choice. If you or a loved one need hospice care in a nursing home, ask to speak to a representative from Lower Cape Fear LifeCare to find out more about our services and team. You can also contact us directly to get more information at 800-733-1476.

Hospice Is More Than a Place: Our Hospice Philosophy

More than 90 percent of hospice patients receive care where they live. 

Our hospice philosophy is that hospice is a place of compassionate service, not a mere building or facility. 

While there are some inpatient hospice care centers, hospice is much, much more than a location. 

Hospice is not a place. It’s a philosophy. It is a way to take care of a person in the most meaningful way, in the comfort of their own home, or wherever they happen to be. They can be in the hospice care center, they can be in the hospital, they can be in a nursing home.

We’ll take a closer look at hospice care, the philosophy behind hospice, and why our service is so vital for those who need comfort during their end-of-life journey. 

The Story Behind Our Hospice Philosophy 

Wherever your loved one receives hospice services, we want to give them the best care we can. You can have hospice care almost anywhere. Most people receive hospice care in their home where they’re most comfortable, and where their family is accessible to them. Most of our patients, about 95 percent, are served at home.

Our Hospice Care Centers Provide Compassionate Services

The hospice care center is a very special place, and it really embodies a lot of what we try to do everywhere, all condensed in one location. At hospice care centers, we manage pain and symptoms that cannot be managed at home. 

Our goal is to get pain and symptoms under control so that patients can return home if possible. When that’s not possible, our serene, homelike inpatient care centers offer large rooms with doors that open to an outdoor patio and provide plenty of room for visiting family members. 

Patients also come to our hospice care centers for respite care. The Medicare Hospice Benefit provides for five days of respite care at one of our care centers with no out-of-pocket expense for patients or families. 

Respite care gives caregivers a much-needed break to tend to their own health issues, attend a family event/celebration, take a short vacation, or simply have time to recharge their batteries.

Lower Cape Fear LifeCare is the only regional hospice provider that offers the continuation of care that inpatient care centers offer. However, whether in a residential setting or at one of our hospice care centers, the care provided is based on the same philosophy.

Hospice Involves the Entire Family in the Decision-Making Process

Is it time for your loved one to go to a hospice care center? There’s no one single answer that’s appropriate for everyone, so we decide on a case-by-case basis. 

But this decision is not made lightly, and it’s not made alone. 

It’s a choice that the family’s going to make, the patient’s going to make and the care team that works with them is going to make.

Our hospice philosophy means we only consider transitioning someone into a hospice care center when we can’t provide the same level of care in their current setting. 

The Patient Is at The Center of Our Hospice Philosophy

Hospice is so much more than a mere address. The hospice philosophy is centered on taking care of the person globally. 

That means caring for the whole patient. Not just easing their pain or alleviating symptoms but providing emotional and spiritual support and assistance from a team of healthcare professionals. We want our patients to achieve any goals they may have during the end of their life. 

We also support the patient’s family throughout the entire transitional process and offer  months of grief care.

Dedicated to Serving The Ones You Love 

We understand that our patients have needs throughout the day and night, which is why we have people on call 24 hours a day to answer your questions or, if needed, make a visit to address the situation. You won’t be alone. 

That’s the best thing about hospice. You’re not alone.

Not Sure What Kind of Care Is Right for You or Your Loved One? Contact Us Today

See why Lower Cape Fear Life Care is ranked as the best hospice in the area, with stellar rankings from the National Caregivers Survey.

Anyone can make a referral to hospice: family members, friends, doctors, neighbors, pastors, and even the patient themselves!

For more information, give us a call at 800.733.1476. We would consider it a privilege to serve you.