Is Accepting Hospice Under Medicare "Choosing to Die"?

A fellow caregiver asked...

Is accepting hospice under Medicare "choosing to die"?

Expert Answer

Hospice is a type of care that focuses on relieving pain and other suffering for patients nearing the end of life. To qualify forĀ Medicare-covered hospice care, a patient's treating physician must certify that the patient's illness is likely to be terminal within six months. Once hospice care is begun, there's no more medical treatment for the terminal illness itself.

Given this requirement of a prognosis of only six months to live, and the ending of treatment for the terminal disease, many people resist hospice because it seems like "choosing to die." Many people also fear hospice because they believe that all medical care will end. For several reasons, though, neither one of these fears should stop someone from choosing hospice care.

In the first place, the decision to choose hospice isn't final. If a patient's condition stabilizes or improves, he or she can give up hospice and return to regular Medicare coverage. All it takes is to have a change of mind about giving up treatment, or a doctor's advice to try a new treatment. Or for some reason the patient might not like hospice care and prefer to return to regular Medicare coverage. Patients don't have to give Medicare or the hospice provider a reason -- they can end hospice and return to regular Medicare coverage at any time.

Choosing hospice does not mean giving up treatment -- and Medicare coverage -- for all illnesses or conditions that a patient might have. If he or she has any medical problem other than the terminal illness itself, he or she can receive normal treatment for it and have it covered by Medicare Part B.

Also, hospice provides patients with specialized medical treatment for any symptom of the terminal disease. This care includes any drug needed to stay as comfortable as possible, provided directly by hospice, without having to go to the pharmacy, get a doctor's prescription, or use other insurance coverage. The same is true for medical equipment such as a hospital bed, wheelchair, walker, or the like.