Hospice care and home health care are both provided to patients where they live. But these services are not the same.
A Medicare beneficiary who is terminally ill with a prognosis of 6 months or less “if the disease follows a normal course” is eligible to receive hospice services. Once enrolled, the beneficiary will receive a comprehensive plan of care providing all services needed to manage the terminal diagnosis and related symptoms. An interdisciplinary team including nurses, social workers, chaplains and, in most cases, hospice aides will visit the patient according to the hospice plan of care. The patient may remain in hospice services as long as he or she is identifiably terminally ill. In most cases, patients remain in the hospice program until they pass away.
Hospice vs Home Care
A Medicare beneficiary who cannot leave home without considerable and taxing difficulty and also requires “skilled” care on an intermittent basis is eligible for the home health benefit. Visits will be made to the patient according to patient need. The patient who stabilizes or improves may be discharged from home health care. Other patients may receive home health services for an extended period of time.
Sometimes physicians will offer patients a choice: Hospice? Or home health care? Here are the significant differences:
- Hospice care is available to patients wherever they live. Even patients who reside in long term care facilities may receive hospice services.
- Home health services are generally only available when patients live in a private home or an assisted living facility.
- Hospice pays for medication related to the terminal illness.
- Home health pays for no medication.
- Hospice pays 100% of the cost of necessary medical equipment.
- Home health pays for no equipment directly. If the patient passes certain qualification tests, Medicare will pay 80% of the cost of needed equipment.
- Hospice pays for necessary medical supplies such as dressings, diapers, wipes and “blue pads.”
- Home health pays for limited supplies, but only when the patient passes “qualification” tests and only as related to their home health diagnosis.
- When patients need oxygen, hospice provides O2 at no cost to patient.
- When home health patients require oxygen, and pass qualification tests, O2 is provided but co-pays and deductibles will apply.
- All hospice patients receive visits from nurses, social workers, chaplains and, in most cases, hospice aides.
- Home health patients receive nursing visits but visits from social workers and aides are provided only when patients pass qualification tests. Home health provides no chaplains.
- Hospice offers respite care and volunteers as a means of providing relief for weary caregivers.
- Home health offers no respite care and no volunteers.
Grief Support for Family
- Hospice teams offer grief and bereavement support for family members for up to 1 year following the death of the patient.
- Home health agencies offer no bereavement services.
Making an Informed Choice
Patients and their family members should take care to select the service that will provide them with the support and care they most need and value.
Helpful information is available from:
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