How Hospice Patients Can Access Emergency Care Without Losing Their Benefits
Published on October 7, 2024
Updated on October 6, 2024
Published on October 7, 2024
Updated on October 6, 2024
Table of Contents
If you or your loved one has a terminal illness, you may have chosen hospice care to receive comfort and support in the final stages of life. Hospice care is a special kind that focuses on improving the quality of life for patients and their families rather than curing the disease. Depending on the patient’s needs and preferences, hospice care can be provided at home, in a hospice facility, or a nursing home.
Hospice care is not only about medical care but also about emotional, spiritual, and practical support. Hospice care teams include doctors, nurses, social workers, chaplains, counselors, and volunteers who work together to provide personalized care and guidance for the patient and the family. Hospice care also offers bereavement services for the family after the patient’s death.
Many people misunderstand that hospice patients cannot go to the hospital or receive urgent care if they have an emergency. They may think that hospice care means giving up on all other treatments and accepting death. This is not true. Hospice patients can access emergency care without losing their hospice benefits if they follow certain guidelines and procedures.
This article aims to help you understand how hospice patients can access emergency care without revoking their hospice services. We will explain when emergency care is covered by hospice, how hospice care continues during and after hospitalization, and what you can do to prepare for and cope with emergencies. We hope this information will help you make informed decisions and reduce stress and anxiety.
Hospice patients may experience some discomfort or pain related to their terminal illness, such as nausea, fatigue, or shortness of breath. These symptoms are usually managed by the hospice care team, who can adjust the medications, treatments, or equipment to provide relief and comfort. However, sometimes hospice patients may face a real emergency that requires hospitalization, such as a heart attack, a stroke, a seizure, or a severe infection. Terminal illness does not cause these emergencies; it is caused by other factors that may affect the patient’s health and well-being.
Some examples of valid reasons for visiting the hospital or receiving urgent care are:
If you or your loved one has an emergency, contacting the hospice care team before going to the hospital or calling an ambulance is crucial. The hospice care team can help you determine if the emergency is covered by hospice and, if so, how to proceed. The hospice care team can also arrange for hospitalization or transportation if necessary and authorized. You can avoid unnecessary delays, confusion, or complications by contacting the hospice care team first.
However, not all emergency care is covered by hospice. If the emergency is related to the terminal illness, or if the patient chooses to receive treatments that are not consistent with the hospice philosophy, the patient may have to pay for the emergency care out of pocket. For example, suppose the patient has cancer and decides to undergo chemotherapy or radiation. In that case, the patient may lose the hospice benefits and must pay for the treatments and the hospital stay. Therefore, it is important to discuss the goals and plans of care with the hospice care team and the hospital staff and understand the possible consequences of choosing or refusing certain treatments.
Going to the hospital does not mean that you or your loved one has to stop receiving hospice care. Hospice care is still available and provides support and coordination for you and your family. Hospice care can help you navigate the hospital system and ensure your wishes and preferences are respected.
When you or your loved one is admitted to the hospital, the hospice care team will communicate with the hospital staff and share information about your medical history, medications, allergies, and advance directives. The hospice care team will also monitor your condition and visit you regularly to provide comfort and care. The hospice care team will work with the hospital staff to manage your symptoms and pain and to avoid any unnecessary tests or treatments that may cause more harm than good.
The hospice care team will also help you and your family make decisions about the goals and plans of care. They will explain the benefits and risks of different options and respect your choices and values. They will also help you understand the implications of revoking hospice services if you decide to do so.
Revoking hospice services means that you or your loved one no longer wants to receive hospice care and wants to return to regular Medicare or insurance coverage. Revocation may be necessary if you or your loved one wants to receive treatments that are not compatible with the hospice philosophy, such as surgery, chemotherapy, or dialysis. Revocation may also be required if you or your loved one is admitted to the hospital for more than 24 hours and the hospice care team does not authorize the hospital stay. This is to avoid Medicare Part A billing issues, which may result in you or your loved one being responsible for the hospital charges.
However, revocation is not required if you or your loved one is not admitted to the hospital but only briefly visits the emergency department or urgent care. You or your loved one can still receive hospice care after the visit if the hospice care team approves the visit and the care is consistent with the hospice philosophy.
After the hospitalization, there are different scenarios, depending on your or your loved one’s condition and preferences. You or your loved one may return home and resume hospice care at home. You or your loved one may transfer to another facility, such as a nursing home or a hospice inpatient unit, where hospice care can continue. You or your loved one may stay in the hospital for symptom management if the symptoms are too severe or complex to be managed at home or in another facility. In any case, the hospice care team will help you and your family with the transition and the arrangements and will continue to provide support and care.
One of the benefits of hospice care is that it can reduce the need for emergency department visits and hospitalizations. By enrolling in hospice care early, you or your loved one can receive more comprehensive and coordinated care at home and avoid the stress and discomfort of going to the hospital. Hospice care can also help you and your family prepare for and cope with end-of-life issues and provide you with peace and dignity.
In this article, we have explained how hospice patients can access emergency care without losing their benefits. We have clarified the difference between discomfort related to a terminal illness and a real emergency that requires hospitalization. We have provided some examples of valid reasons for visiting the hospital, such as accidents, injuries, or new conditions that are unrelated to the terminal illness. We have emphasized the importance of contacting the hospice care team before going to the hospital or calling an ambulance. We have explained how the hospice care team can arrange for hospitalization or transportation if necessary and authorized. We have mentioned the possible out-of-pocket expenses for emergency care that are not covered by hospice. We have explained how hospice care continues during and after hospitalization and how the hospice care team works with the hospital staff to ensure the patient’s comfort and care. We have explained how the hospice care team helps the patient and the family make decisions about the goals and plans of care. We have mentioned the possible scenarios after hospitalization, such as returning home, transferring to another facility, or staying in the hospital for symptom management. We have included when revocation must take place, such as hospital admission, to avoid Medicare Part A billing issues. We have included that revocation is not required if the patient is not admitted to a hospital. We have emphasized the benefits of early hospice enrollment and continuous home care to reduce the need for emergency department visits.
This article aims to help you understand how hospice patients can access emergency care without revoking their hospice services. We hope this information will help you make informed decisions and reduce stress and anxiety.
We know that coping with emergencies and end-of-life issues can be incredibly challenging and overwhelming for hospice patients and their families. Here are some tips and resources that may help you:
We thank you for choosing hospice care and trusting us with your care. We are honored to be part of your life and your story. We wish you and your family peace and comfort.
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