Need clarification on hospice payment.

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Need clarification on hospice payment.

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I've just been told by an advance person for a hospice company desirous of getting our business that Medicare does NOT pay for hospice, in facility, but only for the treating care staff. Apparently the daily rate in our area is about $300 daily. I had thought from reading the posts here that Medicare paid for in-facility hospice care. Apparently I'm mistaken? Has this been the situation for those who've used hospice, that any in-facility placement is out of pocket, even though the staff, meds, etc. are covered by Medicare? I'm going to call Medicare to verify as well, but would appreciate input from others. Thanks much.

Hospice Paying for Care

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That's my experience, GA. Mom was in Hospice in the NH; we had to pay the facility cost, Medicare paid for the Hospice services.

I don't know if there is any difference among various free standing hospice facilities. It might pay to call several.

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No, Medicare does not pay for the facility. Medicare pays for the nurses and aides they provide. I think for meds, but not sure. They do pay for diapers and equipment from their providers. But not the room. There is homecare but someone has to be there 24/7 because Hospice isn't. They provide an aide but only for an he or two. The family is still responsible for cleanups. Not sure about private insurance if they would pay for the room. Sorry, there does tend to be some misinformation sometimes. But it would hurt to call Medicare to confirm.

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My mother was on hospice for 3 months while she was in a nursing home. Her NH fees did not change. They continued to be covered as they were before. The hospice costs were for services above and beyond what the NH provided, and those costs were entirely covered by Medicare.

If your loved one went to a hospice home, the basic room-and-board costs would not be paid by Medicare. All of the care itself would be paid. (Some hospice facilities have funds to help cover this.)

GA, I think it would be helpful if you sat down with the NH billing person and learn exactly how having hospice will impact the monthly bills. They deal with this again and again and should be able to be very specific with you.

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Medicare DOES pay for hospice in a facility or in home. But does not pay for the cost of nursing care room, board and services. What ever fees/rent families are paying for basic care does not change.

Hospice is an added layer of care. RN visits, bath aid, social worker, volunteers, respite care etc. Most organizations use a case management system. Families can usually keep their primary doc or go with the hospice doc. If done at home hospice/Medicare can supply hospital bed, oxy supplies and lots of other needs.

If Medicare did not cover hospice few could afford it.

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It covered meds for Dad.

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GardenArtist, my parents still had to pay for the facilities where they were living, be it self-pay or Medicaid paid.

Medicare did pay Hospice for the rental of a hospital bed, oxygen supply machine, special air mattress, and of course, the Hospice Staff and any meds they needed to use.

I realize when we have to do things quickly for our love ones, it can become overwhelming.

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Windyridge you are right about the cost of hospice care. My mom was under hospice for one week in her apartment until she passed. She got two baths from an aid, had maybe three visits from the nurse, oxygen (she didn't need or want), two boxes of supplies she didn't use (and they didn't take back), and a nebulizer she never used. I got the bill later for that week and it was $1,800, which Medicare paid. Yikes.

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Thanks for your answers. I called Medicare and learned that there are only 2 situations in which Medicare pays for the room and board: (a) for pain symptoms (pretty vague) and (b) on determination of hospice staff that room and board are necessary (even more vague).

I decided for a monthly cost of $9K, I can alternately spend the money on fixing up the house. $9K buys a lot of trades' work and supplies.

I couldn't get any specifics on dysphagia complications, and fortunately or unfortunately, in my experience the pain is limited to the choking. So I don't think he's qualify for room and board coverage on the basis of pain.

I'll answer your responses later; I really appreciate them and the quickness of your advice.

I've just now been told Dad probably will be discharged tomorrow. Unbelievable! A few days ago he was dying, now he's miraculously recovering - oxygen liter flow has been brought down by 6 liters!

He sounded great this morning, but still... I had hoped he'd be there a few more days. But these days the philosophy seems to be quick in, quick out.

Gotta start getting my car loaded with clothes and stuff, including my music - wish me luck in getting my arthritic fingers nimble so I can play the magnificent baby grands at the rehab facility.

Thanks SO MUCH to all....back later.

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Need clarification on hospice payment.

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