By Mary K. Spengler
The Medicare Health Care System is complex and complicated with its variety of programs, various types of coverage and forms that are often difficult to understand. One needs an advocate to assure that you can take advantage of the services that are available to you, to insist that you get the care you deserve and to facilitate payment for that care.
In this midst of all the Medicare gaps, co-pays and deductibles, there is one program funded by Medicare that is relatively simple to understand, covers the continuum of care from home to hospital and pays for medications and durable medical equipment. Moreover, the program is holistic in nature, caring for the physical, social, psychological and spiritual welfare of the patient. And while other services provided under Medicare are limited to care of the patient only, this service is mandated to care for the family as well. It is hospice care as funded under the Medicare Hospice Benefit.
The Medicare Hospice Benefit is available to individuals with a life-limiting illness who have decided to opt for care and comfort as a goal rather than an aggressive treatment regime. Under this benefit, patients and families receive care from a team of trained professionals and community volunteers where you live””home, assisted living facility or a nursing home. When necessary, hospice care is provided on an inpatient basis at local hospitals. Nurses, social workers, spiritual counselors, home health aides and volunteers visit the patient wherever they live and set up a plan of care to manage pain and other symptoms. The psycho-social needs of the family are also addressed as caring for a loved one can be a difficult and emotional time. The hospice staff is available on-call, seven days a week, to attend to patient and family needs.
Along with the services of the team already mentioned, the Medicare Hospice Benefit pays for medications related to the illness, durable medical equipment, oxygen and medical supplies ”” all at no cost to the patient. The hospice team works with your own physician whose services you keep under this benefit. Also, you can continue to seek care for other conditions that are not related to the hospice diagnosis. It is a rare example of the health care system at its best. A benefit that is all encompassing in its payment, that cares for the totality of the patient and family, that doesn”™t interfere with the relationship with between physician and patient and cares for you where you live.
As Medicare”™s best kept secret, hospice needs to be shared with more people. Hospice is not a place, but a comprehensive health care service offered to anyone with any life-limiting diagnosis. These services enable people to live as fully and comfortably as possible in familiar surroundings. The sooner you call, the sooner hospice can help.
Mary K. Spengler, MS, is executive director of White Plains, N.Y.-based Hospice & Palliative Care of Westchester, which provides comprehensive end-of-life care to people with any life-limiting illness.
