 | Tom Welk
DMin is Director of Pastoral Care & Professional Education at Harry Hynes Memorial Hospice. He also teaches at the University of Kansas School of Medicine-Wichita. He has certification with the American Association of Pastoral Counselors in Clinical Pastoral Education. His memberships include Park Ridge Center for Study of Health, Faith, and Ethics, and St. Louis University Center for Health Care Ethics, Charter Board Member Kansas Health Ethics, Inc., and Ethics Committee Member for National Hospice Organization. He has received the President's Award of Excellence for Public and Community Awareness, for the "Dying Well" project from The National Hospice Organization. Tom's group presentations include: Association of Kansas Hospices, Midwest Congress on Aging, and Kansas Health Ethics Conference. Tom Welk can be contacted by fax at (316) 265-6066, by e-mail at: twelk@hynesmemorial.org, or at his office at (316)219-1791. |
Hospice
2004-04-01 08:49:00
Do you buy insurance for hospice?
: Does one need to buy insurance for hospice, or is it a part of most long term care policies anyway?
ANSWER: Sorting out all of the different types of medical insurance coverages available can be a formidable task. The consumer has an almost endless array of options available. I will cover a few that are relevant to hospice.First, long term care coverage. This type of insurance covers the costs involved in a nursing home. How much of those costs are covered obviously will depend on the type of insurance that is purchased. As is true of all insurance coverage, the more costs that are covered, the higher the cost of the premium.Does Medicare pay for long term care? Not generally. Medicare, however, will pay for skilled care in the nursing home. To qualify for this, the individual must have some kind of medical need that goes beyond the demands of ordinary, daily care. This coverage will only be for a limited basis.Does Medicaid pay for long term care? Yes. In these cases, financial need must be shown. Individuals seeking Medicaid coverage are required to undergo a financial assessment to prove this financial need.Second, what about insurance coverage for hospice? Whether or not insurance covers hospice services depends on the type of insurance purchased. Practically all major employers now offer an insurance plan to their employees that includes coverage for hospice services.Both Medicare and Medicaid offer a Hospice Benefit. This Benefit is based on a prospective payment system. This means that the hospice program providing care to Medicare or Medicaid eligible recipients will receive a set payment each day (amount depends on whether the patient is in an urban or rural setting). In turn, the hospice program is responsible for covering all the costs of care (medications and supplies related to the terminal illness; medical equipment; nursing, social work and pastoral care services).In order to be able to elect this Hospice Benefit, two physicians must certify that the patient has a terminal illness, meaning that the patient is likely to die within six months or less.In order to answer the last part of the reader's question "…is [hospice] part of most long term care policies anyway?" one would have to examine each individual insurance policy to determine if this is the case.The easier way for me to answer the question is to direct the reader to examine the type of insurance coverage already being provided at one's place of employment. If hospice services are not part of that plan, the employee may want to discuss this issue with the company/employer. The company's benefits coordinator will know the answer to that question.For those who are Medicare/Medicaid eligible, there already is coverage provided through the Hospice Benefit.Some non profit agencies provide care regardless of insurance coverage or the ability to pay. Readers are advised to ask what policies hospice providers may have regarding this issue.
