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"How to get Medi-Cal coverage for your nursing home care... without selling your home or leaving your family without a dime... Surprising ways to pay for your assisted living and long term care costs."

Elder Law Today Newsletter | Vol. 16 | February, 2007


Hospice Care: Benefit for Those With Life Limiting Illnesses

Hospice care is a team-oriented approach to medical care, designed to enhance the quality of life as it nears its end. It is designed to aid in pain management and to offer emotional and spiritual support through palliative therapy, education and counseling. It is tailored to meet the needs and wishes of the patient as well as the patient’s family and friends. Hospice care focuses on caring for the patient as opposed to curing the illness.

Generally, hospice care is available to people of all ages with all types of illnesses who have been advised by their physician that their illness is terminal and that their life expectancy is six months or less. Obviously, the prognosis is often uncertain and may change. However, the benefit is not limited in terms of time. In the case of Medicare covered hospice services, for example, when a physician initially certifies a patient for hospice services, a patient receives coverage for two initial 90-day “election periods.” The election periods can then be extended by an unlimited number of 60-day election periods so long as a physician certifies the need for coverage.

A family member usually serves as the primary caregiver when a patient begins receiving hospice benefits and that family member helps the patient make decisions. Hospice staff (physicians, nurses, home health aides, social workers, physical therapists, chaplains and other members of the hospice team) are on-call 24 hours a day, 7 days a week and make regular visits to assess the patient as well as to provide additional care/services.

Hospice care is provided in a variety of settings – the patient’s home, hospitals, nursing homes (for those patients receiving hospice care in a nursing home, hospice does not pay for the nursing home bill itself unless it is considered necessary respite care) and other long-term care facilities and free-standing hospice centers. Services are covered by Medicare, private insurance plans and HMOs. Each policy is different however, so you should contact your insurance company or employer to find out what hospice benefits are covered by your plan.

During the time the decision is being made regarding Hospice, it is important to review the patient’s health care durable power of attorney which will allow someone to make decisions for you when you can’t, regarding doctors, hospitals, etc. The financial durable power of attorney should be updated to be effective immediately, and to provide that additional planning can take place in the event the patient loses mental capacity. The wills and trust should be reviewed and possibly revised. For instance, it may no longer be appropriate for assets to pass to the ill spouse if the well spouse dies first, etc.

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