What Is Not Covered Under Hospice Care

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Last Updated on September 10, 2021 by Frank Davis

There are so many benefits and services that hospice care provides to the patient and family that are very beneficial. You may be inundated with all the information that is provided to you, and find yourself at a loss as to what to do next. In my opinion, you are better off starting with learning what Medicare does not cover, since the list is shorter.

If you were to find out what hospice does not cover, then you would know what you will have to pay out of pocket, so that you could plan accordingly. Here in this article, I will give you an overview of three things that hospice care does not cover that you should be aware of.

1) Curative treatments and prescriptions

In order for you to qualify for Medicare, it is necessary that you are not interested in pursuing any treatment options. Since hospice care is all about comfort, aggressive treatments can have unwanted side effects and symptoms that adversely affect the quality of life of a patient during their final days. In some cases, certain treatments may be permitted if they ease certain symptoms.

If you do wish to pursue treatment, talk with your doctor. If you do change your mind you can always cancel hospice care at any time and start receiving treatment again.

2) Caregiver

For the most part, hospice care is focused on the medical side of things. This often entails physicians, nurses, therapists, counselors, medical equipment, and pharmaceuticals, among other resources. In the event you decide to receive hospice care at home, we do not provide you with a caregiver 24 hours a day. As a matter of fact, it is most of the time that family members or close friends do the caregiving, which in turn is a more affordable option. In the event a caregiver cannot be found, the patient will most likely receive care in a skilled nursing facility.

3) Room and Board

If you receive hospice care in a facility or at home, the cost of your room and board will not be covered. Usually, it is the patient who is responsible for the room and board charges. Patients typically choose home hospice services in order to avoid incurring the costs associated with inpatient care.

In case you do decide to get hospice services at a general inpatient facility, Hospice Valley can assist you with placement services. Our team takes into consideration all of your specific needs, including your care needs, long-term financial goals, and your location.

4) Hospital/Emergency Room

Medicare provides no coverage for hospital inpatient care, hospital outpatient care, or ambulance transportation. It is one of the main goals of hospice care to help reduce hospitalizations as much as possible. If a patient seems to have any difficulties, such as a urinary tract infection, a hospice physician or registered nurse should be consulted. The hospice agency can diagnose the cause of the problem, and if necessary, send you medications as soon as possible. If you have any concerns, make sure to notify your hospice agency, most likely there is something they can do to resolve the matter.

Only if it is not related to your terminal illness can you get coverage for it. For example, the patient may suffer a broken bone due to falling. In this case, the terminal illness isn’t related to this and you could go to the emergency room to be treated. In the event that you are having any problems, such as pain, or having bad symptoms, please contact your hospice agency as soon as possible. Ideally, they will be able to arrange the right medications or other services to ensure that the patient is comfortable.

Conclusion

If you are planning to go forward with hospice care, it is important to know what is and isn’t covered by it. Three things that are not covered, namely, treatments and prescriptions intended to cure the illness, a caregiver, and room and board. Knowing this may affect your plans for care and the location where you desire hospice care. Our staff at Hospice Valley will be happy to answer any additional questions you may have regarding hospice care. Please give us a call at (747) 755-5181.