Medicare beneficiaries may now discuss options for end-of-life care with their health care providers.

 

Medicare beneficiaries, of course, were already free to talk about advance care planning with their doctors or other qualified health professionals, but the practitioners could be reimbursed for such discussions only during a patient’s "Welcome to Medicare" visit, a time when the topic may not be relevant to the patient. As of January 1, 2016, Medicare will pay healthcare providers for speaking with Medicare beneficiaries and their families, at any time, about different options for end-of-life care and treatment.

 

These purely voluntary conversations will help enable patients to end their lives on their own terms. Patients are often unable to express themselves when a crisis is at hand and when a decision needs to be made about how much or how little care they want when facing a terminal illness. According to the Kaiser Family Foundation, one-quarter of Medicare’s budget is spent on patients in their last year of life. For many patients, life-prolonging medical procedures are unwanted and unwelcome. A 2011 study found that when medical personnel are informed about what type of care a patient wants at the end of life, Medicare can be spared significant sums and the patient is more likely to die at home rather than in a hospital in some areas.

 

Now that discussions about advance care planning are a regular Medicare benefit, seniors and other Medicare beneficiaries will have the opportunity to learn about the healthcare options that are available for end-of-life care, such as advance directives, palliative care and hospice care. They can then determine which types of care they would like to have and share their wishes with their doctors and their family. After sufficient conversations with their doctors and other health professionals, the beneficiaries may be ready to execute legal documents, such as advance directives or "POLST" forms, and name a healthcare proxy to ensure that their wishes will be carried out. Studies have found that 40 percent of people over age 65 have not written down their wishes for end-of-life treatment.

 

Under new regulations, the advance care planning discussions can take place during the annual wellness visit or at a separate appointment. They are a reimbursable benefit under Medicare Part B and there will be a copayment if the conversation is not part of the annual wellness visit.

 

Talk to your elder law attorney about drawing up the legal documents that can help ensure that you receive the end-of-life medical treatment that you want -- no more and no less.