Comfort Care Options for VNS Health Medicare Members
As your health changes over time, so does the type of health care you need.
When you’re sick, you want curative care — the kind that cures what ails you. But when your health takes a turn for the worse, you might just want medicine that makes you feel okay. The kind of care that treats pain, nausea, and other kinds of discomfort — the kind that makes you feel better — is called palliative care.
When no amount of care can cure your condition, you and your family may want another kind of care. You may want help feeling better in body, mind, and spirit, and have as good a quality of life as you can, while you and your family get ready for what’s coming. This kind of care is called hospice care.
Hospice and palliative care are available to you as a VNS Health Medicare member. They focus on improving quality of life for people with serious and terminal illnesses and are provided by health professionals who are expert in these types of care.
Contact your Care Team for more information about this benefit.
Palliative Care Frequently Asked Questions
You may be worrying about your illness and how to manage it. You’re not feeling well and there are so many things to remember. Palliative care gives you extra support.
Palliative care focuses on treating symptoms of serious illness that make you feel unwell so that you don’t feel so unwell.
No, you don’t. You can continue getting curative care. Palliative care is just an extra layer of support to help you feel better.
No, you do not need a terminal diagnosis to receive palliative care.
Your doctors and Care Team will be able to help you decide if palliative care is a good choice for you. Some questions they will consider include:
- How serious is your condition? Do you have more than one condition harming your health?
- Do you have symptoms like pain, nausea, or other discomforts that can be treated to make you feel better?
- How many times have you been in the Emergency Room or hospital this year?
- Is your condition causing you and your family emotional or spiritual distress?
- Have you thought about Advance Care Planning (including Advance Directives) and do you and your family have a clear understanding of your health care goals?
- Are you eligible for hospice care but don’t feel ready to take that step?
Yes, you will still be able to see the doctors you have been seeing. Your palliative care is provided by a specially trained team, led by a nurse practitioner. Members can include doctors, nurses, and other health care professionals. They will work together with your regular doctors to provide an extra layer of support, at no additional cost.
- A diverse team of health care professionals (nurse practitioner, registered nurse, social worker, spiritual counselor, health and wellness coaches, and transitional care associates) providing support in your home
- Management and relief of symptoms, pain, and stress
- Emotional and spiritual support
- Access to your regular doctors
- Connection to community-based organizations/resources
- Curative treatment for illnesses
If you have any questions about services available to you under the palliative care benefit, please speak with your Care Team.
Hospice Care Frequently Asked Questions
Your doctors have given you difficult news. Hospice care can help you and your family find much-needed comfort.
Hospice care focuses on providing you and your family with emotional, spiritual, and physical comfort during one of the most challenging stages of life. It isn’t just for the final days or weeks of life. The sooner you enroll, once you are eligible, the sooner you can begin receiving the benefits of hospice care that can improve your quality of life.
Yes, you do. In order to be eligible, two of your doctors must conclude that you have six months or less to live.
Not at first. If you are in an in-network hospice program, you may continue to get transitional curative care for 30 days from the beginning of your enrollment.
The hospice care team is a group of specially trained health care professionals that includes a physician, nurse, hospice aide, social worker, volunteer, chaplain, and bereavement counselor. This team works together to ensure that your needs are met. Among its major responsibilities, the interdisciplinary hospice team:
- Manages your pain and symptoms through palliative care
- Provides you with physical, emotional, and spiritual support
- Provides medications, medical supplies, and equipment
- Provides coaching to your caregivers on how to care for you
- Delivers special services like physical therapy when needed
- Makes short-term inpatient care available for you if your caregivers need a break
- Provides bereavement support for you and your family
- Doctor services
- Nursing care
- Medical equipment (such as hospital bed or wheelchair)
- Medical supplies (such as bandages and catheters)
- Drugs to control pain and other symptoms
- Home health aide and homemaker services
- Physical and occupational therapy
- Speech therapy (to help with problems such as swallowing)
- Social worker services
- Dietary counseling
- Emotional and spiritual counseling
- Respite care designed to give your family members a short break from caring for you at home
- Thirty days of transitional concurrent care if you are enrolled in an in-network hospice program
If you have any questions about services available to you under the hospice benefit, please speak with your Care Team.
You may enroll in an out-of-network hospice program, but be aware that you would not be eligible for 30 days of transitional curative care or the Hospice Benefit Allowance of $500 per calendar year for certain items and services in addition to those already covered by the benefit.
Currently three hospice providers are in-network:
VNS Health Medicare Hospice Supplemental Allowance
If you are a VNS Health Medicare plan member enrolled in an in-network hospice program, you may receive an allowance of up to $500 for the 2023 calendar year (January 1 – December 31) for approved items or services that improve your quality of life while you’re in hospice.
Here are answers to some common questions you may have about this allowance. If you have other questions, please call your Care Team.
The allowance can be used to pay for certain goods or services that improve your quality of life and provide more comfort to you during your time in in-network hospice care.
Eligible goods and services can include:
- Home and bathroom safety devices and installation
- Housekeeping services*
- Meal preparation and home delivery
- Transportation not related to health care
- Private duty nursing*
- Pest control*
- Indoor air quality improvement devices and services, such as air purifiers or humidifiers
- Legal services
- Support animal services
Other needs will be reviewed upon request.
*Please note that for VNS Health Total members, some services may be covered under Medicaid (MLTC) benefits.
Talk with your family and your doctors about what you might need to make you more comfortable or to make your life easier. You (or an authorized representative) should then contact your Care Team at 1-866-783-1444, weekdays, 8 am-8 pm, to begin the process. We will determine if your request fits the requirements of the allowance. If it does, we will coordinate paying for it and help you get the goods or services you requested.
This benefit is good for the calendar year. We will track how much you have available for the year up to $500, whether you elect hospice once or more than once throughout the year.
Your health plan benefits come first. The allowance is for items that are not already paid for through your plan or other insurance.