In America today, only half of people eligible for hospice care actually receive it. While the percentage of eligible individuals who receive care continues to climb, many myths persist in the common understanding of hospice and its benefit structure. Empowering ourselves and those around us with facts about hospice helps ensure all Americans can make informed decisions about the care they wish to receive.
Myths about hospice cost
Myth: Hospice is expensive.
Truth: Hospice is 100% covered by Medicare, Medicaid, and most private insurers if you are eligible to receive it. (Medicare Benefit Policy Manual, Chapter 10 – “Requirements: General.”)
Myths about choosing hospice
Myth: Choosing hospice means being ready to die.
Truth: You and your family do not have to welcome death or resign hope; you must simply be ready to receive palliative rather than curative care. (Condition of participation 418.52 (a)(2); Medicare Benefit Policy Manual 40.2.2)
Myth: Once I choose hospice, I cannot change my mind.
Truth: You can revoke your election of the hospice benefit at any time and return to your previous care arrangement and Medicare, Medicaid, or private insurance coverage. (Medicare Benefit Policy Manual, Chapter 9 – “Coverage of Hospice Services Under Hospital Insurance; 20.2.2-Hospice Revocation.”)
Myths about where hospice takes place
Myth: Hospice is a place I must go to.
Truth: Hospice care is provided wherever you call home—a private residence, retirement home, assisted living facility, or nursing home.
Myths about caregivers and hospice
Myth: To receive hospice, I need a full-time caregiver.
Truth: Hospice care does not require you to have a full-time caregiver. Most hospices will work with you to coordinate local, state, and federal resources that will help support your care.
Myths about hospice eligibility
Myth: My physician has to refer me to hospice.
Truth: Anyone can call a hospice to initiate care conversations. The hospice will assess your eligibility through a visit from your choice of an attending physician and the hospice’s physician.
Myth: I need to sign a DNR before electing hospice care.
Truth: The law prevents hospices from denying you care based on your advance directives. (Condition of participation 418.52 (a)(2))
Myths about physicians and treatments during hospice
Myth: If I start hospice, I have to stop seeing my current physicians, like my primary care provider.
Truth: When you choose hospice, you get to decide which physician you would like to attend to your care. (Medicare Benefit Policy Manual, Chapter 9 – “Coverage of Hospice Services Under Hospital Insurance; 40.1.3.1- Attending Physician Services.”)
Myth: When I choose hospice care, I must stop all other treatments.
Truth: Hospice care does not require you to stop your current, comforting treatment. Hospice care simply requires that your treatments be palliative in nature.
Myth: I can’t receive hospital care once I start hospice.
Truth: You can still choose if and when you want to go to the hospital while receiving hospice care. (Medicare Benefit Policy Manual, Chapter 9 – “Coverage of Hospice Services Under Hospital Insurance; 40.1.5-Short Term Inpatient Care.”)
Individuals and their loved ones living with serious illness already face many physical, emotional, and logistical challenges. Learning the facts about hospice care should be simple and empowering. For more information on hospice care, visit CaringInfo’s overview page.
