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Living with chronic obstructive pulmonary disorder (COPD) or a similar pulmonary disease can be a harrowing and demanding battle. As a caregiver, you’ve likely been with your loved one through a number of painful physical and emotional symptoms, from breathing difficulties to unbearable pain to fatigue and even social isolation as the weight of the disease takes its toll.

Many forms of pulmonary disease eventually turn fatal. While this is devastating, patients and their families eventually have to face it. But you don’t have to take this final journey alone. Pulmonary disease hospice can help make sure your loved one’s final months are as comfortable as possible, and that they’re treated with the compassion, dignity and respect they deserve.

Read on to learn about the hospice eligibility requirements for COPD and other forms of pulmonary disease. You’ll see the many benefits of hospice care, and how insurance coverage works to pay for it.

Pulmonary Disease and COPD Hospice Eligibility Criteria

All pulmonary disease patients are eligible for hospice care when their physician determines that they have six months of left to live if the illness takes its natural course. This is a universal guideline from the Centers for Medicare & Medicaid Services, and it applies to all states. 

Before entering hospice care, the patient must also accept that all curative treatments will be stopped upon admission. When you enter hospice, the focus of care shifts to comfort at the end of life. 

In addition to the six-month rule, hospice centers often have their own hospice criteria for COPD and other pulmonary diseases. These may include:

  • Being dependent on oxygen therapy
  • A poor response to bronchodilators (​​a type of medication that improves breathing by relaxing the muscles and dilating the airways)
  • Recurrent pulmonary infections
  • Oxygen level ≤ 88% on room air
  • Hypercapnia (a condition in which there’s too much carbon dioxide in the blood)
  • Increased pulse while resting
  • Labored breathing while at rest
  • Increased emergency room visits and/or hospitalizations
  • Weight loss of 10% in past six months

What Is Pulmonary Disease Hospice?

Pulmonary disease hospice is end-of-life care for those nearing the end of life with lung disease. The main goal of hospice care is to provide comfort and enhance quality of life in patients’ final days, weeks and months. The holistic approach focuses on physical, emotional and spiritual health. 

Types of Pulmonary Disease That May Warrant Hospice Care

There are several types of pulmonary disease that can turn fatal. For each disease below, hospice care can step in to improve your loved one’s comfort and quality of life, and to help prepare them for life’s final transition. 

When curative treatments no longer work, the chronic pulmonary diseases that may require hospice care include:

  • Chronic Obstructive Pulmonary Disorder (COPD)
  • Chronic Bronchitis
  • Emphysema
  • Pulmonary Fibrosis
  • Cystic Fibrosis
  • End-Stage Tuberculosis
  • Bronchiectasis

Benefits of Hospice Care for Late-Stage Pulmonary Disease

Making the decision to start hospice care can be extremely emotional for families. Some may want to put it off as long as possible to avoid saying goodbye. But prolonging the inevitable may result in worse health outcomes for your loved one. Enrolling in pulmonary disease hospice as soon as your loved one is eligible can elevate their quality of life, because they’ll have access to the many services that pulmonary disease hospice offers.

Maximized Comfort and Improved Quality of Life

Early hospice admission gives your hospice care team more time to support your loved one’s comfort as they prepare for the end of their life. Rather than prolonging difficult curative treatments that are no longer working, care shifts to pain relief and managing other symptoms like labored breathing, chronic cough and respiratory infections. Dietary support helps meet your loved one’s nutritional needs. All of these measures together lead to improved quality of life during your loved one’s final months.

Greater Access to Providers

Your loved one’s pulmonary disease hospice care team will consist of doctors, nurses, social workers, mental health counselors, dietitians, physical and occupational therapists, home health aids, volunteers and other healthcare experts with specialized training in end-of-life care. Enrolling in hospice care once your loved one is eligible gives them access to these specialists sooner and with more visits than if they were admitted at later stages.

Emotional and Spiritual Support

The end of life can bring up several difficult and complex emotions. Grief, anger, anxiety and despair are all common at this time for both those who are dying and their families. Many people also experience spiritual concerns — even those who weren’t previously religious. Pulmonary disease hospice offers access to both mental health counselors and faith leaders to address any emotional or spiritual worries your loved one or family may have.

Caregiver Relief

Caregiving can take a major toll on both mental and physical health. Pulmonary disease hospice provides important resources that can help relieve the burden of caregiving, including care assistance, counseling and respite services which will allow you to take breaks to focus on your own health and wellbeing.

Flexible Care Options

Earlier admission to pulmonary disease hospice allows more time to develop an individualized care plan. Facilitates can make more informed decisions about end-of-life care, including the option to receive care at home. This may not be possible with later-stage hospice admissions, as the illness may become too severe to manage outside of a healthcare setting.

Pulmonary Disease Hospice Coverage

If you’re new to hospice care, you may have questions about costs and insurance coverage.

Many hospice patients are eligible for full hospice care coverage through Medicare and Medicaid. For those who don’t qualify for government-run insurance programs, private insurance companies may also cover some hospice costs.

Medicare and Medicaid

Under the Medicare Hospice Benefit, the full cost of hospice care is covered for those who qualify for Medicare (adults in the U.S. age 65 and older). Medicaid also offers a similar benefit in many states. Check with your state Medicaid agency for more information on eligibility requirements and hospice coverage.

Private Insurance

Some private health insurers will provide coverage or reimbursement for pulmonary disease hospice costs. This coverage will vary by provider and plan. Each insurer has their own guidelines for how they reimburse for costs. Contact your insurer for more information on pulmonary disease hospice coverage.

CIGNA Hospice Coverage

Coverage for hospice care under CIGNA is subject to the terms, conditions, and limitations of each benefit plan, per the insurer’s 2023 Medical Coverage Policy. When the benefit coverage for hospice care is applicable, hospice services are considered medically necessary when all the below criteria are met:

  • The individual is terminally ill and expected to live twelve months or less.
  • Potentially curative treatment for the terminal illness may be part of the prescribed plan of care.
  • The individual or appointed designee has formally consented to hospice care (i.e., care which is directed mostly toward palliative care and symptom management).
  • The hospice services are provided by a certified/accredited hospice agency with care available 24 hours per day, seven days per week.

The list below includes some of the other top health insurance providers in the U.S., and the information they provide on hospice coverage.

Pulmonary Disease Hospice: Three Oaks Hospice Can Help

Late-stage pulmonary disease is an incredibly challenging condition for both patients and their families. When curative treatments are no longer working, Three Oaks is here to make sure your loved one is cared for with compassion, and their comfort and peace are prioritized during their final months. 

If you have any questions about eligibility for pulmonary disease hospice and how your family can take advantage of the many benefits hospice care offers, please get in touch with our staff. We’re here to provide any information and guidance you may need. Reach out to a Three Oaks Hospice location near you or contact us online today. 

References

Frequently Asked Questions

Here are some frequently asked questions about pulmonary disease hospice.

There’s no way to determine exactly how long any one person will live with COPD. Consult with your doctor if you have any questions on your life expectancy with pulmonary disease. In general, patients qualify for hospice care when their physician estimates that they have six months or less to live. Many patients live less than six months, while others go on to live beyond this period. Individuals who live longer than six months can remain in hospice care as long as their doctor recertifies that their illness is terminal.

Most long-term pulmonary diseases are terminal. COPD and lung cancer are among the most common lung conditions that are always fatal.

While every person’s experience with end-stage pulmonary disease is unique, there are some telltale signs that the end may be near. These include: worsening breathing troubles, constant wheezing, inability to catch your breath for a very long time, crackling sound when breathing, extreme fatigue and weight loss. In addition to these, signs that death is close include a rapid but weak heartbeat, a drop in body temperature, decreased blood pressure and mottled skin that’s turned blue or purple in color.

Respiratory failure is the major cause of death with COPD. This occurs when the lungs can’t get enough oxygen into the blood. Other common causes of death with COPD include heart failure, pulmonary infection, pulmonary embolism and lung cancer.

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Share this helpful resource:

Living with chronic obstructive pulmonary disorder (COPD) or a similar pulmonary disease can be a harrowing and demanding battle. As a caregiver, you’ve likely been with your loved one through a number of painful physical and emotional symptoms, from breathing difficulties to unbearable pain to fatigue and even social isolation as the weight of the disease takes its toll.

Many forms of pulmonary disease eventually turn fatal. While this is devastating, patients and their families eventually have to face it. But you don’t have to take this final journey alone. Pulmonary disease hospice can help make sure your loved one’s final months are as comfortable as possible, and that they’re treated with the compassion, dignity and respect they deserve.

Read on to learn about the hospice eligibility requirements for COPD and other forms of pulmonary disease. You’ll see the many benefits of hospice care, and how insurance coverage works to pay for it.

Pulmonary Disease and COPD Hospice Eligibility Criteria

All pulmonary disease patients are eligible for hospice care when their physician determines that they have six months of left to live if the illness takes its natural course. This is a universal guideline from the Centers for Medicare & Medicaid Services, and it applies to all states. 

Before entering hospice care, the patient must also accept that all curative treatments will be stopped upon admission. When you enter hospice, the focus of care shifts to comfort at the end of life. 

In addition to the six-month rule, hospice centers often have their own hospice criteria for COPD and other pulmonary diseases. These may include:

  • Being dependent on oxygen therapy
  • A poor response to bronchodilators (​​a type of medication that improves breathing by relaxing the muscles and dilating the airways)
  • Recurrent pulmonary infections
  • Oxygen level ≤ 88% on room air
  • Hypercapnia (a condition in which there’s too much carbon dioxide in the blood)
  • Increased pulse while resting
  • Labored breathing while at rest
  • Increased emergency room visits and/or hospitalizations
  • Weight loss of 10% in past six months

What Is Pulmonary Disease Hospice?

Pulmonary disease hospice is end-of-life care for those nearing the end of life with lung disease. The main goal of hospice care is to provide comfort and enhance quality of life in patients’ final days, weeks and months. The holistic approach focuses on physical, emotional and spiritual health. 

Types of Pulmonary Disease That May Warrant Hospice Care

There are several types of pulmonary disease that can turn fatal. For each disease below, hospice care can step in to improve your loved one’s comfort and quality of life, and to help prepare them for life’s final transition. 

When curative treatments no longer work, the chronic pulmonary diseases that may require hospice care include:

  • Chronic Obstructive Pulmonary Disorder (COPD)
  • Chronic Bronchitis
  • Emphysema
  • Pulmonary Fibrosis
  • Cystic Fibrosis
  • End-Stage Tuberculosis
  • Bronchiectasis

Benefits of Hospice Care for Late-Stage Pulmonary Disease

Making the decision to start hospice care can be extremely emotional for families. Some may want to put it off as long as possible to avoid saying goodbye. But prolonging the inevitable may result in worse health outcomes for your loved one. Enrolling in pulmonary disease hospice as soon as your loved one is eligible can elevate their quality of life, because they’ll have access to the many services that pulmonary disease hospice offers.

Maximized Comfort and Improved Quality of Life

Early hospice admission gives your hospice care team more time to support your loved one’s comfort as they prepare for the end of their life. Rather than prolonging difficult curative treatments that are no longer working, care shifts to pain relief and managing other symptoms like labored breathing, chronic cough and respiratory infections. Dietary support helps meet your loved one’s nutritional needs. All of these measures together lead to improved quality of life during your loved one’s final months.

Greater Access to Providers

Your loved one’s pulmonary disease hospice care team will consist of doctors, nurses, social workers, mental health counselors, dietitians, physical and occupational therapists, home health aids, volunteers and other healthcare experts with specialized training in end-of-life care. Enrolling in hospice care once your loved one is eligible gives them access to these specialists sooner and with more visits than if they were admitted at later stages.

Emotional and Spiritual Support

The end of life can bring up several difficult and complex emotions. Grief, anger, anxiety and despair are all common at this time for both those who are dying and their families. Many people also experience spiritual concerns — even those who weren’t previously religious. Pulmonary disease hospice offers access to both mental health counselors and faith leaders to address any emotional or spiritual worries your loved one or family may have.

Caregiver Relief

Caregiving can take a major toll on both mental and physical health. Pulmonary disease hospice provides important resources that can help relieve the burden of caregiving, including care assistance, counseling and respite services which will allow you to take breaks to focus on your own health and wellbeing.

Flexible Care Options

Earlier admission to pulmonary disease hospice allows more time to develop an individualized care plan. Facilitates can make more informed decisions about end-of-life care, including the option to receive care at home. This may not be possible with later-stage hospice admissions, as the illness may become too severe to manage outside of a healthcare setting.

Pulmonary Disease Hospice Coverage

If you’re new to hospice care, you may have questions about costs and insurance coverage.

Many hospice patients are eligible for full hospice care coverage through Medicare and Medicaid. For those who don’t qualify for government-run insurance programs, private insurance companies may also cover some hospice costs.

Medicare and Medicaid

Under the Medicare Hospice Benefit, the full cost of hospice care is covered for those who qualify for Medicare (adults in the U.S. age 65 and older). Medicaid also offers a similar benefit in many states. Check with your state Medicaid agency for more information on eligibility requirements and hospice coverage.

Private Insurance

Some private health insurers will provide coverage or reimbursement for pulmonary disease hospice costs. This coverage will vary by provider and plan. Each insurer has their own guidelines for how they reimburse for costs. Contact your insurer for more information on pulmonary disease hospice coverage.

CIGNA Hospice Coverage

Coverage for hospice care under CIGNA is subject to the terms, conditions, and limitations of each benefit plan, per the insurer’s 2023 Medical Coverage Policy. When the benefit coverage for hospice care is applicable, hospice services are considered medically necessary when all the below criteria are met:

  • The individual is terminally ill and expected to live twelve months or less.
  • Potentially curative treatment for the terminal illness may be part of the prescribed plan of care.
  • The individual or appointed designee has formally consented to hospice care (i.e., care which is directed mostly toward palliative care and symptom management).
  • The hospice services are provided by a certified/accredited hospice agency with care available 24 hours per day, seven days per week.

The list below includes some of the other top health insurance providers in the U.S., and the information they provide on hospice coverage.

Pulmonary Disease Hospice: Three Oaks Hospice Can Help

Late-stage pulmonary disease is an incredibly challenging condition for both patients and their families. When curative treatments are no longer working, Three Oaks is here to make sure your loved one is cared for with compassion, and their comfort and peace are prioritized during their final months. 

If you have any questions about eligibility for pulmonary disease hospice and how your family can take advantage of the many benefits hospice care offers, please get in touch with our staff. We’re here to provide any information and guidance you may need. Reach out to a Three Oaks Hospice location near you or contact us online today. 

References

Frequently Asked Questions

Here are some frequently asked questions about pulmonary disease hospice.

There’s no way to determine exactly how long any one person will live with COPD. Consult with your doctor if you have any questions on your life expectancy with pulmonary disease. In general, patients qualify for hospice care when their physician estimates that they have six months or less to live. Many patients live less than six months, while others go on to live beyond this period. Individuals who live longer than six months can remain in hospice care as long as their doctor recertifies that their illness is terminal.

Most long-term pulmonary diseases are terminal. COPD and lung cancer are among the most common lung conditions that are always fatal.

While every person’s experience with end-stage pulmonary disease is unique, there are some telltale signs that the end may be near. These include: worsening breathing troubles, constant wheezing, inability to catch your breath for a very long time, crackling sound when breathing, extreme fatigue and weight loss. In addition to these, signs that death is close include a rapid but weak heartbeat, a drop in body temperature, decreased blood pressure and mottled skin that’s turned blue or purple in color.

Respiratory failure is the major cause of death with COPD. This occurs when the lungs can’t get enough oxygen into the blood. Other common causes of death with COPD include heart failure, pulmonary infection, pulmonary embolism and lung cancer.

Categories

Popular Resources