What is Palliative Care & How Does it Work?
When a person receives a diagnosis of a life-threatening illness, they have to consider palliative care. Palliative care is a type of care where doctors and nurses provide treatments which relieve the symptoms of this fatal health condition and improve the person’s quality of life so they can enjoy their final days.
Palliative care is often provided in a hospital, nursing home, palliative care clinic, and even the comfort of the patient’s own home. Some conditions that may require palliative care include AIDs, Alzheimer’s, cancer, ALS, dementia, end stage liver or renal disease, MS, and Parkinson’s.
When you’re diagnosed, your doctor will help you find a palliative care specialist who will then build a team of other specialists to make sure every aspect of your care is covered. Before your appointment with your palliative care specialist, put together a list of documents related to your illness and your medical history. They will review this information and create a personalized plan and team just for you.
Your palliative care team may include a care doctor, pharmacist, dietitian, and counselor. Working together, you’ll create a plan involving weekly therapy sessions, medication, and a personalized meal plan.
What is Included in Palliative Care?
With palliative care, you and your family can be provided with:
- Grief counseling
- Doctor and nursing care services
- Equipment that aids in helping you get around and experience comfort
- Prescriptions for pain relief
- Nutritional counseling
- Physical therapy
- Respite care
- Social work services
Differences between Palliative Care vs. Hospice Care
Hospice care is an end-of-life medical care which provides emotional and physical support to terminal patients and their families. It is specifically reserved for those with a life expectancy of 6 months or less, and focuses on relieving the symptoms of the illness as well as supporting the patient emotionally and helping with important decisions regarding the end of their life.
Palliative care focuses on improving your well-being after receiving the diagnosis of a serious illness, and offers a support system so you and your family can continue to enjoy a quality of life as similar to normalcy as possible. Those receiving palliative care can continue to undergo life-prolonging treatments and can receive the care from wherever they choose.
Which Medicare Plans Cover Palliative Care?
Both Original Medicare and Medicare Advantage cover palliative care, with or without hospice care, when deemed medically necessary. (source)
Medicare Part A covers inpatient hospital stays, short-term stays at a skilled nursing facility, limited home health care, and hospice care – therefore, it covers much of the inpatient and skilled care associated with palliative care.
Medicare Part B covers most outpatient services needed during palliative care, specifically doctor’s appointments, durable medical equipment, mental health counseling, and rehabilitation therapy.
Medicare Part C, also known as Medicare Advantage, is sold by private insurance companies and covers the same services as Medicare Part A and Part B, along with prescription drugs, special-needs plans, and long-term care.
Medicare Part D covers prescription drugs needed during palliative care, such as medications prescribed for anxiety, depression, fatigue, pain, and nausea. Medications not covered under available hospice benefits may still be covered under Medicare Part D.
What Are Additional Expenses That We Should Consider?
Medicare Part B typically covers the costs of someone receiving palliative care outside of a hospice. However, for Medicare to cover palliative care in a hospice, the patient must certify that they are unlikely to live for longer than 6 months, they must choose palliative care for comfort rather than a cure for their illness, and they must sign a form stating they chose hospice care over treatment-related care.
Medicare does not cover living expenses if a person is in their own home or in another living facility when it comes to hospice care. Some options you have in terms of coverage and care include:
- Palliative specialists. They provide extra support for those with severe illnesses and their family. Your doctor can connect you with a palliative care team made up of specialists who will organize every aspect of your care.
- Emotional support. Therapy, including grief counseling, are available through Medicare, even if they are in weekly sessions. You may also be able to find support through charities associated with your illness.
- Financial support. If you have difficulties paying out-of-pocket expenses during your palliative care, you can find additional support through Medicaid and their hospice benefit, or through healthcare programs provided by agencies such as the Veterans Administration.
Find Medicare Plans that Cover Palliative Care Today
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