Hospice care at home offers a comprehensive range of supportive services to incurably ill individuals and their families. Given the level of help provided, many people in Chicago think it’s beyond their budget. But for the majority, there are little to no out-of-pocket costs.
How is this possible? The costs of hospice care are covered by Medicare, the Illinois Medicaid program, and most commercial insurance plans. And when a patient isn’t insured, other approaches can be taken – and hospice professionals are always ready to assist in finding a solution. For more on who pays for hospice care at home in Chicago, keep reading.
The Medicare Hospice Benefit
Most Chicago hospice patients are older and have health insurance through traditional Medicare. For these individuals, choosing a Medicare-certified hospice agency is enough to ensure that nearly all of the costs of hospice care are covered. Under the Medicare benefit, there are no out-of-pocket expenses for the following:
- Physician and skilled nursing services
- Medication to relieve pain and distressing symptoms
- Durable medical equipment and medical supplies
- Physical, occupational, and speech therapy
- Nutritional support and dietary counseling
- Special services, like pet therapy and massage
- Assistance from social workers and home health aides
- Bereavement care, grief counseling, and emotional support
The Medicare benefit covers all four levels of hospice care. In most cases, routine home care – the official term for hospice care at home – is the best option. When medically necessary, continuous home care, with around-the-clock nursing support, is covered. In the event symptoms cannot be managed in the home setting, in-patient care at a Chicago hospital or hospice facility can be arranged at no cost. Respite care, which offers a much-needed break to family caregivers, is also available.
For services to be covered under the Medicare benefit, a patient must have a terminal diagnosis and an expected prognosis of six months or less, as certified by a physician. But, that doesn’t mean Medicare only covers 180 days of hospice services – the benefit allows for two 90-day periods, followed by an unlimited number of subsequent 60-day periods. As long as an individual’s diagnosis and prognosis remain unchanged, all necessary care continues to be covered.
While the Medicare benefit provides comprehensive coverage, it must be noted that Medicare doesn’t pay for curative treatments or medications unrelated to the terminal diagnosis. Also, services that aren’t provided or arranged by the hospice team, including ambulance transportation and emergency room visits, aren’t covered. Neither is room and board at a local hospital or hospice facility, unless in-patient care is deemed medically necessary.
Other Ways to Pay for Hospice Care
Not all hospice patients in Chicago are eligible for Medicare. However, the federal program isn’t the only way to handle the costs of hospice care. For anyone who isn’t eligible for Medicare, coverage may be available through one of the following:
Medicaid
The Illinois Medicaid program offers services that are quite similar to those covered by Medicare. Medicaid can also be used in conjunction with Medicare coverage. Generally speaking, this type of assistance is for disabled individuals, but anyone can contact the Illinois Department of Healthcare and Family Services to ask about the requirements for Medicaid hospice coverage.
Private Insurance
Private insurance plans provided by employers and those purchased by individuals and families vary in coverage, but most pay for at least some of the costs of hospice care – and some offer coverage that is comparable to the Medicare benefit. Conversely, some place limits on hospice expenses. To find out what is and isn’t covered, patients need to contact their insurance providers.
Military Benefits
For veterans who need hospice services, the Veterans Administration provides full coverage. The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) covers hospice costs for eligible relatives of those who served in the armed forces. As for active duty military service members and their dependents, Tricare through the Department of Defense pays for hospice care.
What if none of the above apply? Some older adults use personal savings to cover the costs, and Chicago homeowners sometimes take out reverse mortgages, essentially withdrawing a portion of their home equity and using that to pay for hospice care. For other alternatives and information on payment assistance programs, patients and families can always reach out to a local hospice agency.
Contact Suncrest Hospice of Chicago Today
If a loved one has received a terminal diagnosis, looking into hospice care is a good way to look after their interests. Hopefully, the information above has helped you understand how the person you hold dear will pay for hospice – but the professional team at Suncrest of Chicago would be happy to answer any questions you might have.
At Suncrest, we realize that many people worry about the costs of hospice care. And, we have specialists on staff who are ready to help patients find the financial means to pay for end-of-life care. Turn to us, and we’ll do whatever we can to pinpoint an affordable solution. For more on hospice care at home in Chicago, Illinois, contact us today.
