The Cost of Hospice

Originally published in the Lincoln Tribune, June 3, 2007

Q: My granddad has lung cancer, and he just decided to end his treatments. Mom and I think he is more than Grandma can handle right now. No one will ask them about hospice, though, because they say it will cost too much. How much does hospice really cost?

A: Very little, as compared with his radiation treatments or a hospital stay. As a senior citizen who is not continuing curative treatment, your grandfather qualifies for the Hospice Medicare Benefit (HMB). The HMB covers nearly all the costs associated with his illness.

It is a myth that hospice is expensive. Most hospice patients qualify for one or more benefits that lighten their financial burdens. The Medicare benefit is open to all Americans in their time of need, regardless of their financial standings. We are fortunate in North Carolina to also have the option of a Medicaid Hospice Benefit; some states do not. Most private health plans also include provisions for hospice. Whether your grandfather is eligible for these benefits or not, however, hospices provide their services based on need, not the ability to pay.

You may wonder what "costs associated with his illness" means. Put simply, hospice would pay for medications related to his illness, medical equipment and supplies. As a lung cancer patient, he might need prescriptions like Albuterol, a special bed, or an oxygen concentrator; all would be covered by hospice. However, the HMB does not pay for prescriptions or equipment unrelated to his lung cancer. If he needs Nexium for his acid reflux, for example, he would still be responsible for that bill. (Other Medicare benefits may apply that would cover the unrelated medications or equipment; ask a social worker for more details.)

If you need more information on benefits and payment options, I suggest using the online Hospice Locator from the Carolinas Center for Hospice and End of Life Care: http://www.carolinasendoflifecare.org. An admissions or billing specialist will be able to help with your financial questions.

If this column made you think of someone in your family, please email me at asklinda@pchcv.org. I would love to be able to help. See you next week!