As I have said, hospice is no longer a wonderful group of
people supporting those that are dying and their loved ones. Hospice is now big business and most are for
profit, not non-profit. The more money
they bring in, the better. The people
working in them may have hearts of gold but they are driven by their
corporations to bring in more clients and if it appears they might be needed
then they are helping, right? Important
to remember when speaking to hospice representatives: if they don’t fully understand their services,
the charges for those services, and how they will be paid, how will you?
The one line that angers me more than any other when talking
to a hospice representative now is, “Well, Medicare pays that amount per diem
so that’s what we charge…” It doesn’t
seem to matter if the actual services provided warrant the per diem charges.
Think about it – we hear so much about how long Medicare and
Social Security will be able to support the population. At the same time, corporations have learned
to work the system and cause a constant drain on Medicare funds for unneeded
services.
So, when considering hospice, first make sure you have
answers to these questions…
DOES YOUR LOVED ONE REALLY NEED HOSPICE?
Hospice is supposed to be called in when your loved one has
only six months or less to live. They
are supposed to help you cope with the impending loss and help keep your loved
one comfortable until the end of life.
Alzheimer’s and the other forms of dementia don’t run on
timetables so how do you know? Keep an
open conversation with your loved one’s physician. If they have been following your loved one
for a long time, they should have an idea when the end game is coming or there
is a lot of pain to be managed and hospice would be helpful.
You don’t need hospice for routine care of your loved one if
they are already living in a nursing home or assisted living facility and
receive routine care from the staff. For example, Mom takes no meds and has no
pain to be managed. She is still
somewhat ambulatory and all of her needs can, and are, provided by the staff of
the assisted living facility.
Hospice provides those services (showering/bathing, etc.)
these days and if your loved one is at home, those services may be necessary
and much appreciated.
DO YOU HAVE MEDICARE AND IF SO, DO YOU HAVE THE RIGHT
MEDICARE?
Hospice representatives assume if you are 65 or over that
you have Medicare and hospice will be covered.
There are many who do not have the Medicare coverage needed to pay for
hospice! If your loved one has never
paid into Social Security, nor had a spouse that paid in, your loved one may
not be covered.
Daddy is a good example of that situation. As a teacher, he was considered a state
employee. Neither Social Security nor
Medicare deductions were taken from his paycheck. Instead, he had a pension that would pay
instead of Social Security and he had a health plan that would stay with him
throughout his life. Mom was a homemaker
but as his spouse, she was the beneficiary of his pension and his health plan
even after his death.
Even though I worked in a health insurance company for over
20 years, I didn’t know that Mom didn’t have full Medicare. I knew she had the health plan, but she also
has a Medicare card. I now know there is
a difference between her card and others.
Her card has an “M” at the end of her social security number and states
Medical (Part B) Benefits Only. Because
she’s never been hospitalized, I didn’t realize that she only had physician
coverage until the bills for hospice started coming in.
DO NOT SIGN HOSPICE PAPERS UNLESS YOU FULLY UNDERSTAND THE
CHARGES!
When I signed the paperwork for hospice, the representative
evidently was assuming Medicare would pay and I didn’t know better. There was a page where she could list the
insurance copays, deductibles and out of pocket maximums but she marked them
with zeros. The bottom of the page had a
table of services at per diem, per hour or per visit fees but there were no
fees listed and the section had a line through it. Talk about misleading!!
Don’t let a hospice representative lead you by the nose as I
did! Make sure they fill in the actual
fees that will be charged and what the out of pocket costs will be, if
any. Know what you are getting into
before you sign. I trusted them and was
blindsided.
I don’t want to go without giving an update on Mom. She’s doing well as always and takes care of
her “baby” every day. She doesn’t always
know I belong to her but she’ll smile and loves hugs and kisses. She’s still happy to see great
grandchildren when they visit, too. :)
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