It is often difficult for patients to understand the difference between hospice care and palliative care. Each distinction has several levels, which can add to the confusion. Many patients and family members are perplexed by how charges are billed or paid for by private insurance and the Medicare Hospice Benefit. Palliative Care is treatment that relieves suffering and improves quality of life for people of any age and at any stage in a serious illness, whether that illness is curable, chronic, or life-threatening. Treatments are paid for in same way you would pay for regular medical service. Medicare, Medicaid, and most insurance plans cover all or part of the services provided.
Hospice care is palliative in nature, but patients no longer receive curative treatments for their underlying disease. The focus is on comfort. A doctor has to certify that the patient is expected to have a life expectancy of six months or less, under “normal conditions”. It is difficult to account for the strength of the human spirit, and the exact date of death, just like the exact date of birth, is uncertain.
There is a specific Medicare Hospice Benefit, which has a per diem rate that covers treatment, services, and equipment. The first two benefit periods last 90 days, then an unlimited amount of 60 day benefit periods follow. The hospice team reviews the patient’s medical history following set clinical guidelines. If it looks as if the patient is still near the end of life, they are approved for recertification. If they have improved, they may be discharged back into palliative care.
