I’m going to break briefly from posting chapters from Alonzo Calkins’ “Opium And The Opium Appetite” (1870) to let my readers know about a new ebook I’ve just published entitled “Veteran’s Guide To Hospice Planning“.
I’ve been working on this book as a labor of love, and my co-author Layng Guerriero is an expert in both Veteran’s benefits and Hospice Care. Together we have put together what I believe is a really comprehensive, personalized guide for Veterans – and really for anyone – with a terminal illness who may not be fully aware of their rights to Hospice Care, or even what Hospice Care is all about.
The book is an extensive collection of personal essays on this topic, one of which I’m posting here as a sample. I hope that if you are a Veteran, or if there is a Veteran in your family or friendship network, you will take a look at this resource. And as I indicated, you don’t have to be a Veteran to find more information on Hospice here than you’re likely to find anywhere else in one place.
Can Veterans Receive Medicare Hospice Care While Living At Home?
The short answer is yes, as long as the Veteran is enrolled in Medicare along with any VA-related coverage they may have. Many Veterans choose to enroll in Medicare in order to obtain Part B benefits that cover things that neither Medicare Part A nor Veterans health care programs will pay for. You don’t have to be enrolled in anything but Medicare Part A, which is automatic at age 65, to qualify for Hospice, but there are some important parallel considerations that we’ll outline here.
Also very important, Veterans over 65 cannot enroll in TriCare-For-Life UNLESS they also have Medicare Part B, and if they do go into Hospice, while Medicare Part B coverage goes away, TriCare-For-Life does not. So while Part B can be a strain on limited finances, it can also be critically important in terms of continuing to receive treatment for non-terminal illnesses while in Hospice for a terminal condition.
Finally, veterans who have TriCare-For-Life don’t have to pay a penalty if they sign up for Medicare Part D even years after age 65 for since TFL is considered to be “prior” prescription drug coverage.
Veterans who have Medicare, even if it is only Part A, are eligible for Medicare-paid hospice care at home if and when they become terminally ill. A Veteran who is not enrolled in Medicare and uses only VA health care is limited to the use of VA out-patient and in-patient medical services, including hospice care. VA at-home hospice services may be severely limited in some places, whereas Medicare at-home hospice services are widely available, so there’s no reason for any eligible Veteran to not have at least Part A.
Some VA hospital facilities have a hospice in-patient unit integrated into their services, while those that do not refer Veterans needing in-patient hospice care to community-based hospice providers regardless of the Veteran’s Medicare status. Even if the VA facility does have an “in-house” hospice unit for in-patients, if an out-patient Veteran with Medicare who becomes terminally ill prefers a community-based hospice to care for them at home they are 100% within their rights to ask for that option from their VA doctor. If things get to the point where they can no longer be cared for at home, they still have a choice. They are not automatically required to go into the VA in-patient hospice care unit if they have Medicare and think that better care if available in a community-based in-patient hospice facility.
If a Veteran is an in-patient at a VA facility and also has Medicare, even though Medicare doesn’t “kick-in” for regular in-patient VA health care, when the time comes they have the right to choose a community-based hospice instead of going into the VA hospice unit. There are as many reasons why a Veteran who is an in-patient might choose to stay within the facility as there are reasons why an in-patient Veteran might decide that they prefer community-based hospice care.
There are many issues that can affect a Veteran’s rights to health care under different circumstances, so it is a good idea for veterans and their families to begin asking direct questions about both hospice home-care and in-patient options before such care becomes a necessity.
When I was a child I moved around the world with my military family, always traveling by ship in the days before aircraft could cross oceans. I would spend hours on deck writing messages, sealing them with candle wax in bottles I snagged from somewhere on board, and then consigning them to the sea knowing in my heart that they were on their way to someone, somewhere who would read them. Sometime replies arrived at my grandparents’ house years later, and they would forward them to me wherever I was living. From these contacts I developed pen-pals who I stayed in touch with for many years. I was fortunate to develop, very early in my life, a sense of the network that invisibly but seamlessly connects us all. Thank you for picking up this message in a bottle, dear reader. We are here together.