For Cincinnati residents who are approaching the final chapter of life, hospice care offers significant benefits. Improved symptom control, emotional guidance, mental support and bereavement care are just a few of the services available – and more often than not, hospice care takes place in the home, or wherever the patient lives.
All of that certainly makes hospice worth considering if you’re caring for a loved one with an incurable condition – but is it within your means?
Actually, for many terminally ill Cincinnati patients, hospice care comes with little to no out-of-pocket costs thanks to Medicare, Medicaid or private health insurance. However, some services may not be fully covered. Read on to learn more.
The Medicare Hospice Benefit
Most Cincinnati hospice patients are seniors, with health insurance through Medicare. This is advantageous, as the Medicare Hospice Benefit is designed to provide complete coverage – virtually all of the care services needed to manage an incurable condition are provided at no cost to patients or their families.
Plans of care are personalized to meet the individual needs of each patient, but the Medicare Hospice Benefit offers coverage for:
- Physician services
- Skilled nursing care
- Prescription medication
- Medical equipment
- In-home care supplies
- Specialized therapies
- Speech-language pathology
- Nutritional counseling
- Social worker services
- Bereavement support
- Home health aide assistance
In addition, when medically necessary, Medicare covers the cost of around-the-clock nursing support, or continuous home care. If a health crisis can’t be managed in the home setting, short-term in-patient care at a Cincinnati hospital or hospice facility is covered. Respite care, or a break for family caregivers, is also available through the Medicare Hospice Benefit, as are any other services deemed necessary by the hospice care team.
What isn’t covered? First of all, Medicare only covers hospice services provided by an approved home health agency, like Suncrest. Furthermore, once a patient enters hospice, Medicare may not cover any of the following:
- Treatment intended to cure the patient’s condition
- Services not provided or arranged by the hospice team
- Room and board, unless the patient requires a facility stay
- Medications that aren’t related to the incurable condition
Also, before calling for ambulance transportation or heading to the emergency room, patients need to contact the hospice care team – otherwise, Medicare may not cover the cost.
Paying for Hospice without Medicare
Not every Cincinnati resident is eligible for Medicare. Fortunately, anyone who doesn’t have health insurance through the federal government program can consider other coverage options.
In Ohio, Medicaid offers coverage that is on par with the Medicare Hospice Benefit. The core services provided are much like those listed above, and Medicaid covers hospice care at home as long as the patient goes through a home health agency that is licensed by the Bureau of Regulatory Operations at the Ohio Department of Health.
For those who don’t have Medicare or Medicaid, payment for hospice care services may come from a managed care plan or through a private health insurance policy. Cincinnati patients who aren’t insured may find payment assistance by speaking with the staff at a local home health care agency, as hospice specialists understand the available resources and can help families find a financially viable solution.
How to Access Hospice Care Services
The vast majority of those receiving hospice services have coverage through Medicare, and for most other Cincinnati patients, the costs are covered by Medicaid or another form of health insurance.
Despite this, many people who could benefit from in-home care services end up missing out. Some are unaware or misinformed about hospice, and others don’t realize that they can initiate the process on their own if they meet the criteria for eligibility. People who qualify are those who:
- Are terminally ill and have a life expectancy of six months or less, as certified by a physician
- Agree to forgo any further curative treatment and instead receive services that bring comfort
No one needs to wait for a doctor to raise the topic of hospice care – Cincinnati patients or their family members can contact a home health care agency directly to request a consultation. However, eligibility must be confirmed, typically by the hospice physician and/or the patient’s attending physician, before services can begin.
The Suncrest Difference
Are you caring for a loved one who is terminally ill? Navigating the hospice process can be a challenge, but the compassionate professionals at Suncrest are here to provide the help you need.
We’re an approved Medicare home health care agency, and we have specialists on staff who can help you understand the coverage provided through Medicare, Medicaid or another insurance plan. Or, if your loved one is uninsured, you can count on our team for expert advice and guidance in finding a way to move forward that doesn’t cause financial stress.
At Suncrest, we recognize that everyone has unique concerns at the end of life – and we take an interdisciplinary approach, allowing terminally ill patients to receive hospice services that align with their needs and preferences. To learn more about our professional team and what sets Suncrest apart from other home health care agencies in southwestern Ohio — or to discuss hospice care at home for a loved one in the Cincinnati area — contact us today.
