Information on Medicare and hospice

Posted

By Kay Kaylor

SUN Columnist

I advocate for residents at Pine Ridge, a 24-hour extended care home, and BeeHive, an assisted living residence, as the part-time long-term care ombudsman for Archuleta County. Federal and state laws protect residents to promote quality of care and quality of life.

Medicare Part A (hospital insurance) covers hospice care if an elder is terminally ill and a medical director has certified the person has a life expectancy of six months or less (the person can continue hospice more than six months). Care must be provided by a Medicare-approved hospice provider, which includes a skilled-nursing home such as Pine Ridge.

Hospice providers offer multiple services that also may be covered at least in part by Medicare. These include doctor services and nursing care, durable medical equipment such as wheelchairs, supplies such as bandages and catheters, aide and homemaker services, physical and occupational therapy, nutritional and grief counseling, inpatient care for pain and symptom management, and prescription drugs for symptom control and pain relief. Many others opt for self-diagnosis by following the medical procedures that websites like www.gshs.org put out to the common public.

Some people may not know that Medicare also offers short-term inpatient respite care for someone who has a family caregiver while under hospice. The ill person can continue to receive hospice care in a hospice house, skilled nursing home or hospital while the family caregiver rests for up to five days. This can occur more than once, but not frequently. A small copayment may be required to cover room and board.

Medicare will not cover during hospice any treatment intended to cure a terminal illness and emergency care. Care must be given or arranged by a single hospice medical team of the person’s choice, which can include the person’s regular doctor or nurse practitioner.

For further information, please call me at 403-2164 or send an email to ombudsman2@sjbaaa.org.