Hospice and Medicare Advantage Plans

[ctg]

We recently moved my wife's aunt into an assisted living community to be closer to her oncologist for treatment of her lung cancer. Her condition has deteriorated and she has elected hospice care. She has never had a med supp and enrolled in a MAPD plan effective January 1st.

Would it be prudent to keep her on the MAPD? She has lived a frugal life and has some savings, so the premium isn't an issue. My feeling is that keeping the MAPD won't be detrimental but may or may not be beneficial.

Am I on the right track?

 

[insuranceconceptscindy]

Hospice is covered by original medicare, regardless of MAPD. It is at no cost, other than prescriptions.

 

[midwestbroker]

I would keep the MAPD for her.

If your aunt needs to go to the hospital, most hospice companies will actually dis-enroll her from hospice while she is an inpatient, and then will place her back under hospice care when she is discharged. This is due to the double billing that would occur with Medicare and the billing nightmare that would ensue.

Hospice also only pays for treatment for her primary diagnosis which placed her under hospice care. Any other treatments would be billed normal through her insurance (Medicare and/or her MAPD).

I have always recommended that patients under hospice care carry on their insurance as to make sure they are covered for any other treatments that may occur while under hospice care which hospice will not pay for.

 

[ctg]

I would keep the MAPD for her.

If your aunt needs to go to the hospital, most hospice companies will actually dis-enroll her from hospice while she is an inpatient, and then will place her back under hospice care when she is discharged. This is due to the double billing that would occur with Medicare and the billing nightmare that would ensue.

Hospice also only pays for treatment for her primary diagnosis which placed her under hospice care. Any other treatments would be billed normal through her insurance (Medicare and/or her MAPD).

I have always recommended that patients under hospice care carry on their insurance as to make sure they are covered for any other treatments that may occur while under hospice care which hospice will not pay for.

That's what I'm thinking. Hospice pays for the comfort in end of life things, but I wasn't certain about instances such as if she falls and breaks a hip.

I just wanted to make sure that keeping it wouldn't hurt in any way.

Thanks!

 

[MedicareAgent]

I was just informed by a higher up at Aetna that if someone has an mapd and hospice is involved they will automatically be disenrolled, put on a drug card and a&b will cover the hospice amounts.

 

[TwoCents]

I was just informed by a higher up at Aetna that if someone has an mapd and hospice is involved they will automatically be disenrolled, put on a drug card and a&b will cover the hospice amounts.

Say what? Disenrolled from the MAPD due to hospice? I don't buy it. Show me the CMS guidance for that.

 

[senior-advisor-indiana]

Say what? Disenrolled from the MAPD due to hospice? I don't buy it. Show me the CMS guidance for that.

You would be beter off to put him/her on your ignore list...

 

[ctg]

For my own peace of mind, I verified with Humana that she can stay with her MAPD so we'll keep it for anything that may come up not related to her terminal illness. Hospice pays for nearly everything to make her end of life more comfortable. Pain management meds, daily activity aides, even spiritual guidance counselors. Pretty much anything that won't prolong her life due to her cancer. A hospital bed and a wheelchair were delivered today at no cost to her. She seems happy with her care until the time comes.

Thanks for the input everyone.

 

[openmindedone]

I was just informed by a higher up at Aetna that if someone has an mapd and hospice is involved they will automatically be disenrolled, put on a drug card and a&b will cover the hospice amounts.

You need to keep going a little higher up for some good info.

 

[WCMason]

I was just informed by a higher up at Aetna that if someone has an mapd and hospice is involved they will automatically be disenrolled, put on a drug card and a&b will cover the hospice amounts.

Not disenrolled, but Original Medicare does take over on the hospice care.