Many people are unfamiliar with hospice care and how it works, beyond a basic passing familiarity with the name. Patients often have questions about it, including how long hospice care lasts, and even if they can come off it if their condition improves. The good news is that hospice care is not that difficult to understand, and we’re going to provide you with the guidance and advice you need, including the answers to some of your most pressing questions about duration.
How Long Can I Be On Hospice?
Hospice care is offered for terminally ill patients with six months or less of life expectancy. However, that does not mean that if you live longer than six months you will lose your coverage. You’re able to continue receiving hospice care as long as the hospice doctor or the medical director certifies that you are still terminally ill.
How Does the Hospice Care Timeframe Work?
Most patients receiving hospice care are on Medicaid, so we’ll use that as the primary example. Medicaid allows you two 90-day benefit periods (six months total). After those two periods are exhausted, you are eligible for an unlimited number of 60-day benefit periods.
What’s Required to Begin the Process?
At the beginning of the first 90-day benefit period, your doctor, the hospice doctor, or the medical director must certify that you are terminally ill with six months or less remaining to live. At the beginning of every subsequent benefit period, the same certification must be made. So, it looks a little like this:
- You’re certified as terminally ill, with six months or less to live, beginning your first 90-day period.
- Your initial 90 days end, and you’re re-certified as terminally ill, beginning your second 90-day period.
- Your second 90-day period ends, and you’re recertified as terminally ill, beginning your first 60-day period.
- Your first 60-day period ends, and you’re recertified, beginning your next 60-day period.
- You’re allowed an unlimited number of 60-day periods, so long as your doctor, the hospice doctor, or the medical director will certify your condition as terminally ill.
As you can see, you can remain on hospice as long as medically necessary to receive palliative care for your terminal illness. However, understand that only your doctor or the hospice doctor (or the hospice medical director) can certify your illness and qualification for Medicaid-related hospice coverage.
Can You Change Hospice Coverage After Beginning Care?
Yes, you have the right to change your hospice care provider once you have entered care. Note that you’re only allowed to do so once during each benefit period (90-day periods or 60-day periods). Why would someone wish to change their care provider after beginning hospice? There are many reasons, including:
- The desire for access to alternative therapies not offered
- The desire for access to different treatment options
- A desire to build a more robust team of medical professionals and caregivers
- Moving to a new area not served by the original hospice care provider
Can You Stop Hospice Care Once Started?
Many patients and their family members believe that once hospice care is started, it must be finished, but that is not the case. If your terminal illness improves or you enter remission, you can stop hospice care if it is no longer required. You have the right to stop care at any point.
Note that if you do decide to stop hospice care, you will be required to sign a form acknowledging that you are stopping care and providing the effective end date for care. It’s also important to understand that you should not be required to sign such a form when entering hospice care, or for any reason other than you choosing to stop hospice care on your own.
What happens if your illness returns or you develop a new terminal illness? Qualifying patients can re-enter hospice care at any time. Doing so will require that your doctor or the hospice doctor certify that you are terminally ill, with six months or less remaining to live.
How Does Changing Hospice Care Affect Your Medicaid?
If you were originally part of the Medicare Advantage Plan coverage before entering hospice, you will maintain your coverage, but be responsible for paying the premiums. However, if you were not part of the Medicare Advantage Plan before hospice, you will lose that coverage, but maintain your original Medicare protection.
Get the Help You Need
As you can see, hospice care duration can vary a lot. In theory, you could remain on it indefinitely, so long as you are terminally ill and your doctor or the hospice doctor will certify your situation. You even have the right to leave care and then return later if you so desire. Contact us today to learn more about hospice care.