Can you leave hospice if you get better?
Yes. The National Cancer Institute says you always have the option to stop hospice care if you choose.
The National Cancer Institute says the same from the other direction. People sometimes change their mind, switch to a different hospice provider, or have their situation change. Patients may also be discharged from hospice because their condition improved or because they resumed cancer treatment.
The 6-month rule is not a deadline
A lot of confusion comes from the certification standard. Most insurance plans, including Medicare, cover hospice once your attending doctor and the hospice medical director state that you have a life expectancy of 6 months or less, and you sign a statement choosing hospice.
That is a prediction, not a limit. Hospice care continues past 6 months as long as the hospice doctor recertifies your condition. Under Medicare the structure is two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods. Recertification after 6 months requires a face-to-face meeting with the hospice doctor or a hospice nurse practitioner.
NCI notes that many people wrongly believe hospice is only for the final days or weeks. It can provide support for months, and many families say afterward that they wish they had started earlier.
Trading back and forth is not free
Two limits shape the decision.
While the hospice benefit is active, Medicare will not cover treatment intended to cure your terminal illness, or drugs meant to cure rather than to control symptoms and pain. If you want curative treatment, that is the specific reason to step out of the benefit.
Clinical trials are the other one. NCI says it is rare for someone admitted to hospice to be eligible for a trial. Reasons include past medical care, current physical or mental condition, and the ability to travel to appointments. If a trial matters to you, ask before enrolling in hospice rather than after.
There is also a coordination rule that catches people out. Care you get as a hospital outpatient, as a hospital inpatient, or by ambulance is not covered unless your hospice team arranged it, or unless it is unrelated to your terminal illness. Contact your hospice team before getting any of those, or you may owe the whole bill.
Your hospice team and your insurer are the ones who can answer how this applies to your plan.
Sources
https://www.cancer.gov/about-cancer/advanced-cancer/care-choices
Want the full picture? Read our complete explanation: What Is Hospice Care? End-of-Life Comfort Care
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