Scarlett Posted January 17, 2012 Share Posted January 17, 2012 I have a friend who has been diagnosed with lung and brain cancer. She is 62 and was between insurance at diagnosis. She has now applied for SS/Disability and Medicaid and the agencies are saying looks like she will be approved shortly (within 60 days maybe). The family is being told she will not be able to get Hospice care because Medicaid will not pay for it until all treatments have stopped. Does anyone have experience with this? Quote Link to comment Share on other sites More sharing options...
sunriseiz Posted January 17, 2012 Share Posted January 17, 2012 I have a friend who has been diagnosed with lung and brain cancer. She is 62 and was between insurance at diagnosis. She has now applied for SS/Disability and Medicaid and the agencies are saying looks like she will be approved shortly (within 60 days maybe). The family is being told she will not be able to get Hospice care because Medicaid will not pay for it until all treatments have stopped. Does anyone have experience with this? I'm so sorry about your friend. I think that sounds right about hospice. IIRC, Medicare will only pay for it if there is no ongoing treatment and the patient is expected to have less than 6 months to live. :grouphug: to you and her both. Quote Link to comment Share on other sites More sharing options...
Scarymelon Posted January 18, 2012 Share Posted January 18, 2012 She should be able to get some treatment, if it is palliative; meant to reduce symptoms. If they are actively treating her to cure the disease, then she would not be eligible for hospice. Quote Link to comment Share on other sites More sharing options...
KAM Posted January 18, 2012 Share Posted January 18, 2012 Yes, I'm afraid that's right. My mom was on hospice just before she passed (lung cancer also) and she couldn't start hospice until she had stopped active treatments. She was still on various things to help with symptoms though. I'm sorry to hear about your friend. Quote Link to comment Share on other sites More sharing options...
chicagoshannon Posted January 18, 2012 Share Posted January 18, 2012 Right you can. It be treated with the goal of curing if you're on hospice. Sometimes some treatments like radiation may be approved if its used just to manage pain. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted January 18, 2012 Author Share Posted January 18, 2012 You have to sign an agreement that you are no longer looking at curative treatment, but only palliative treatment, in order to enter hospice. That's what the rule is in our state. I think it is a Medicaid rule--of what they will pay for. Hospice is a program that can be paid for....so if someone had the money they could pay for it while continuing to receive curative treatment. I think. As with all things, ends up being about money. Ugh. She is so sick. She can barely get from her bed to the wheel chair. I had to help her dress and undress today--like one would a toddler. We have a rotating schedule in our congregation of women spending one day a week with her. Her dh is trying to keep working....personally I think they are both so deep in denial and that he needs to stop working long enough to be with her until she dies. :( Oh and their dd is pregnant and can't be around her (my sick friend) for 4-5 days post chemo treatment. That was a new one for me. Anyone ever hear of that? Quote Link to comment Share on other sites More sharing options...
PrincessMommy Posted January 18, 2012 Share Posted January 18, 2012 I have a friend who has been diagnosed with lung and brain cancer. She is 62 and was between insurance at diagnosis. She has now applied for SS/Disability and Medicaid and the agencies are saying looks like she will be approved shortly (within 60 days maybe). The family is being told she will not be able to get Hospice care because Medicaid will not pay for it until all treatments have stopped. Does anyone have experience with this? I volunteer for hospice and that sounds fairly normal for entering hospice care. Hospice is palliative care which means they provide medical and emotional help for those in the later stages of dying who are no longer in active treatment. Quote Link to comment Share on other sites More sharing options...
PiCO Posted January 18, 2012 Share Posted January 18, 2012 I think it is a Medicaid rule--of what they will pay for. Hospice is a program that can be paid for....so if someone had the money they could pay for it while continuing to receive curative treatment. I think. As with all things, ends up being about money. Ugh. No, it's not about the money. Hospice is the care you get when you stop treatments like chemo, that are designed to stop the cancer. When you enter Hospice, that means you have stopped trying to recover from the cancer. All you get is pain medication and emotional care. Don't get me wrong, Hospice is wonderful... but it's end of life care. She is so sick. She can barely get from her bed to the wheel chair. I had to help her dress and undress today--like one would a toddler. We have a rotating schedule in our congregation of women spending one day a week with her. Her dh is trying to keep working....personally I think they are both so deep in denial and that he needs to stop working long enough to be with her until she dies. :( You are wonderful people to care for her like that. What is her prognosis? Is she suffering from the chemo, or is she near the end? That's what you need to know before signing her up for Hospice. Oh and their dd is pregnant and can't be around her (my sick friend) for 4-5 days post chemo treatment. That was a new one for me. Anyone ever hear of that? Yes, I have. Many types of chemo are extremely toxic. Her dd could lose her baby by being around someone undergoing certain types of chemo. Chemo kills cancer cells, but it kill a lot of other cells as well, thus all the horrible side effects. (And I'm not talking about your hair falling out. There are truly horrid side effects to many chemos.) Quote Link to comment Share on other sites More sharing options...
CLBMom Posted January 18, 2012 Share Posted January 18, 2012 I am/was (I'm on disability) a hospice nurse. I really enjoyed it and truly miss it. The previous posters are correct. Hospice care starts when you stop trying to cure the terminal disease. You get symptom management, emotional support and help with the physical care of the patient. It can really be a wonderful thing. Before a patient can become hospice they not only need a terminal diagnosis but they need to be emotionally ready for it. It's not sayings "I give up" it's saying "I'm ready to let God/nature take it's course" When cancer reaches a certain point the treatment can sometimes make what time you have left even more difficult and possibility shorter due to side effects. I would recommended you research hospice agencies before choosing one. The way medicaid/medicare works is they pay a flat rate to the agency per 90 days. The agency has to provide certain things with that $ but some provide more then others. Particularly personal care. How many hours of nurse aide care you get a week. You may not need alot now but there wil be a point where the caregivers need a break. If the caregivers dont take care of themselves they can't take care of the patient. I hope all works out even if out isn't the ending everyone wanted. Saying prayers for your friend and their family. Quote Link to comment Share on other sites More sharing options...
Scarlett Posted January 18, 2012 Author Share Posted January 18, 2012 Thanks everyone. It is hard to watch. They are a lovely couple who clearly adore each other. I think they are both just living in the clouds...not 'there' emotionally to face the facts. Quote Link to comment Share on other sites More sharing options...
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