When medical science can no longer add more days to life, hospice adds more life to every day.
Hospice Care
& The Military Family
A Guide to the TRICARE Hospice Benefit
Military families have special needs, particularly at those times when life-threatening illness strikes. Generally far from home, frequently on the move, military families often find that communication can be difficult, compassion and caring or even grief almost impossible to express in an immediate or personal way. Religious or spiritual support or guidance may not be easily available. Family and closest friends may be distant. That is when hospice is most important, when it can be of vital help wherever you and your family are living.
What is Hospice?
Hospice is a special kind of care for patients with a very serious illness. Patients usually have six months or less to live and are not looking for treatments to cure them. Hospice services are provided to the patient and family by a team of highly skilled professionals and trained volunteers. Hospice care focuses on taking care of symptoms and controlling pain. The hospice team works together to help patients live each day as fully and comfortably as possible.
The hospice team generally cares for the patient in his or her own home. The team is available to help and support the patient and family 24-hours-a-day, seven-days-a-week. The patient's doctor and the hospice doctor direct the patient's care and talk to the patient and family. Patients might go to the hospital when symptoms cannot be taken care of at home. This is called general inpatient care. When the family needs a rest from caring for the patient at home, the hospice can have the patient go to a hospital or nursing home for up to five days at a time. This is called respite care.
Hospice Can Help
Hospice offers comfort rather than curative treatment. Under the direction of a doctor, hospice uses expert methods of pain and symptom control to help the patient to live as fully and comfortably as possible.
Hospice treats the person, not the disease. The hospice team deals with the medical, emotional, and spiritual needs of patients and their loved ones. The hospice team also helps to find valuable community resources.
Hospice emphasizes quality of life. Hospice believes in the dignity and worth of each individual.
Hospice considers the entire family the "unit of care." Patients and their families are included when decisions have to be made. Special counseling and other services are given to family members after the death of the loved one. This is to help with their feelings of sadness and grief.
Hospice Care Includes . . .
The hospice benefit is based on a patient and family centered model. The ideas of the patient and family or friends are very important in making decisions about the best care. The services listed here are available and can be a part of the patient's plan of care:
- Nursing services
- Physician services
- Medical social services
- Home health aide and homemaker services
- Spiritual, dietary, and other counseling
- Physical, occupational, and speech-language therapy
- Trained volunteers
- Medicine for controlling pain and other symptoms
- Medical supplies and appliances
- Continuous care at home during periods of crisis
- Special services for grief counseling
- Short-term inpatient care
Who can have TRICARE Hospice services?
Each TRICARE member can have hospice care. The TRICARE hospice plan is the same as the Medicare hospice benefit. TRICARE members who want hospice care must follow these rules:
- The member must choose TRICARE hospice care in place of regular benefits.
- The member must use a Medicare-certified hospice program that accepts TRICARE.
- Hospice cares for people who have six months or less to live, if the disease runs its normal course. The member's main doctor and the hospice doctor must agree that the member fits this standard.
- Hospice patients can have hospice care as long as they meet hospice rules to qualify. Their care must be reviewed at set times by the hospice doctor and the hospice team.
Do you have more questions?
You can check with one of these people to learn more.
- Your TRICARE Health Benefit Advisor
- Your Primary Care Manager
Who pays for Hospice care?
TRICARE pays the hospice directly for all authorized hospice services. There may be a five percent copayment for drugs and inpatient respite care. Services and care not related to the terminal illness are not cove red by the hospice benefit.
Instead, they are covered as they normally would be under the patient's regular TRICARE benefits.
Only Medicare-certified hospices can provide and bill for the TRICARE hospice benefit. Therefore, it is important for the patient and family to check with their Health Benefit Advisor (HBA) or Health Care Finder (HCF) to help them locate a qualified hospice agency. The Medicare-certified hospice files all hospice benefit claims in addition to providing services related to the TRICARE hospice benefit.
TRICARE Terms
TRICARE is the health care program for active duty and retired military personnel, their families and their survivors. It replaces the CHAMPUS Program. TRICARE includes three health care plans:
- TRICARE Prime is a managed care program like health maintenance organizations. Members are required to go through a primary care manager (PCM) to enroll in a hospice program.
- TRICARE Extra is similar to preferred provider organzations. Members do not have a PCM and can locate a qualified hospice in the TRICARE network through their Health Care Finder.
- TRICARE Standard (the old CHAMPUS program) is a fee-for-service, cost-sharing plan. Members do not have a PCM and can locate a qualified hospice through their HCF.
Health Benefit Advisor (HBA) is the member's main point of contact and is located at MTFs.
Military Treatment Facilities (MTF) are military hospitals and clinics.
Nurse Advisors are available by phone in most regions 24-hours-a-day, seven-days-a-week to answer medical questions and offer advice.
Primary Care Manager (PCM). This is a physician or a group of practitioners who provide routine care and refer patients to a specialist when necessary.
TRICARE Service Centers (TSC) are located in each region and are staffed by :
- Health Care Finders (HCF), who research, find the right specialist, and make appointments for members. They are available 24 hours a day, seven days a week.
- Beneficiary Service Representatives, who will help explain the different programs, enroll members, assist with the selection of a Primary Care Manager, and help resolve billing problems.
FOR MORE INFORMATION
Each Medical Treatment Facility has a Health Benefits Advisor or TRICARE Service Center. Members and providers can get additional information by calling the telephone numbers listed below. The TRICARE website is located at http://www.tricare.osd.mil/.
Region |
Geographic Area |
Telephone |
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CT, DE, DC, IL, IN, KY, ME, MD, MA, MI, NH, NJ, NY, NC, OH, PA, RI, VT, VA, WV, and WI (and some zip code areas in IA, MO, and TN) |
1-877-TRICARE (1-877-874-2273) |
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AL, AR, FL, GA, LA, MI, OK, SC, and TN (excluding 35 TN zip codes in the Fort Campbell, KY area), and TX (excluding, only, the extreme southwestern El Paso-area) |
1-800-444-5445 |
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AK, AZ, CA, CO, HI, ID, IA (except 82 IA zip codes that are in the Rock Island [Illinois] area), KS, MN, MO (except the St. Louis area), MT, NE, NV, NM, ND, OR, SD, TX (the southwestern corner, including El Paso, only) UT, WA, and WY |
1-888-TRIWEST (1-888-874-9378) |
The Hospice Foundation of America (HFA) created this brochure because we care about you and your family. This brochure has information about hospice and bereavement care. HFA is a participant in the Combined Federal Campaign as a member organization of Health and Medical Research Charities of America.
Hospice Foundation of America
1621 Connecticut Ave., NW
Suite 300
Washington, DC 20009.
(800) 854-3402
www.hospicefoundation.org
