Hospice care follows specific clinical and insurance standards that define the scope of medical services, personal support, and financial coverage available during end of life care. While hospice care focuses on comfort and symptom control, it does not extend to every type of medical treatment or personal service.

APEX Health Services offers hospice care for terminally ill patients whose medical goals emphasize pain relief, symptom management, and comfort-based medical care. Hospice services support both the patient and the patient’s family through coordinated care planning, clinical oversight, and access to emotional and spiritual support.

A Simple Definition of Hospice Care

Hospice care applies when a patient has a terminal illness with limited life expectancy, and care goals shift away from curative treatments. Medical care centers on comfort-focused services designed to reduce physical distress and support emotional well-being.

Hospice and palliative care share symptom-based goals. Hospice care begins during the final stage of illness, when the focus remains on symptom control rather than disease-directed medical treatments.

Differences Between Hospice and Palliative Care

The scope of what isn’t included often depends on the type of care chosen. Palliative care may occur alongside curative treatments at any illness stage. Hospice care starts only when care goals shift fully toward comfort during the final months of life. This distinction affects service scope, medical coverage, and care coordination

Services Commonly Included in Hospice Care

Hospice care services cover medical and supportive needs directly related to the terminal illness. These services form a defined scope and don’t represent unlimited care.

Included in hospice care:

• Pain and symptom management: Specialized medical care to alleviate physical distress.
• Prescription drugs: Medications related to the primary illness and symptom control.
• Durable medical equipment: Necessary tools such as hospital beds, wheelchairs, and oxygen.
• Basic medical supplies: Items like bandages, catheters, and gloves.
• Hospice team visits: Intermittent nursing visits and consultations with the hospice provider.
• Home health aides: Support for personal hygiene and basic personal assistance.
• Emotional support: Spiritual counseling and social work services for patients and their families.
• Respite care: Temporary relief for primary caregivers through short-term inpatient care.
• Bereavement support: Grief counseling and support groups after the patient passes.

These services form a stable foundation for end-of-life care by prioritizing comfort and dignity. The hospice benefit ensures that patients receive the medical care and emotional support they need to manage a terminal illness without the burden of extra costs for standard supplies.

What Is Usually NOT Included in Hospice Care in Chicago?

The hospice benefit is extensive, but it doesn’t cover every medical expense. There are specific exclusions to prevent the use of hospice funds for curative or unrelated care.

Curative Treatments for the Primary Illness

Hospice care does not include medical treatments intended to cure, reverse, or significantly slow the progression of the terminal illness. Once a patient elects the hospice benefit, the focus shifts entirely to quality of life.

Curative treatments hospice care does not cover:

• Chemotherapy or radiation with curative intent
• Dialysis used to extend life rather than manage comfort
• Surgical procedures aimed at disease correction
• Experimental or investigational medical treatments

Medical treatments appear only when they support pain relief or symptom management, not disease modification.

Emergency Room Visits and Hospital Stays

Hospice care emphasizes symptom management outside of acute hospital settings. The hospice care team manages crises at the patient's home or a designated facility to maintain stability.

Hospice usually does not include:

• Emergency room: Visits unrelated to pain or symptom crises or those not authorized by the hospice provider ER care may occur if coordinated by the hospice provider for symptom control.
• Inpatient hospital stays: Admissions for aggressive medical treatment or surgeries.
• Unauthorized ambulance transport: Costs for transport not coordinated by the hospice plan.

The hospice care team is available 24/7 to address symptom changes and reduce the reliance on the emergency room.

Room and Board Expenses for Hospice Care

Hospice care addresses medical needs rather than residential costs. This is often a point of confusion for families in a facility transition.

Hospice does not cover:

• Rent or mortgage expenses in the patient’s home
• Room and board in an assisted living facility
• Room and board in a nursing home

Short-term inpatient hospice care includes room and board only when specific medical necessity criteria for symptom control or respite care apply. Decisions regarding inpatient hospice vs. home hospice impact the level of room and board coverage and the clinical environment for the terminally ill.

Continuous Paid Caregivers for Hospice Care

Hospice care includes limited personal assistance, but it doesn’t replace custodial care. The hospice benefit relies on primary caregivers to manage daily needs.

Usually not included in hospice care:

• Paid caregivers for 24-hour supervision
• Continuous custodial care (tasks like feeding, dressing, and constant monitoring)
• Ongoing private duty services

It’s common for families to coordinate additional care through private duty or home care services if the primary illness requires constant physical presence.

Rehabilitative Therapies with Restorative Goals

Hospice care doesn’t support restorative medical goals or recovery-based outcomes.

Rehabilitative therapies not included in hospice care:

• Physical therapy: Exercises for strength recovery or return to previous function.
• Occupational therapy: Training for skill redevelopment.
• Speech therapy: Long-term functional improvement for communication.

Therapy services appear only when they support comfort, such as techniques to improve swallowing or reduce pain.

Medical Care for Unrelated Conditions

Hospice coverage applies only to the primary illness and associated symptoms. Any health issues that are independent of the terminal diagnosis fall under other insurance plans.

Hospice usually does not include:

• Specialist visits for unrelated diagnoses (e.g., a podiatrist for an unrelated foot issue)
• Diagnostic testing unrelated to symptom management
• Medical treatments for unrelated chronic conditions

Other Medicare-covered services needed for unrelated needs continue to be available outside the hospice benefit.

Complementary and Alternative Therapies for Hospice Care

Some hospice programs allow limited complementary therapies, though coverage remains restricted under standard insurance plans when it’s tied to documented symptom relief.

Often excluded services include:

• Art therapy without documented symptom benefit
• Massage therapy unrelated to pain relief
• Acupuncture for non-hospice conditions

Private payment arrangements often apply for these specialized services.

Key Factors That Determine Hospice Coverage Limits

Coverage exclusions reflect structured hospice benefit rules and benefit periods. Families can manage expectations when they understand these factors.

Patients can revoke hospice care at any time to pursue curative treatments and later re-elect hospice if they are still eligible.