How Can I Pay for Care?
As a recognized medical specialty, Supportive Palliative Care interdisciplinary team services are covered by Medicare, Medicaid and commercial insurance plans. Hospice is a Medicare and Medicaid benefit and is covered by many commercial insurance plans as well. Services are available for veterans from the Department of Veterans Affairs.
How Can I Plan For a Serious Illness?
Living wills/advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make medical decisions for yourself. Advance directives are your preserved voice for desired choices which instruct your medical team and caregivers based on your goals and wishes.
By planning ahead, you are more likely avoid unwanted or unnecessary suffering and relieve caregivers of decision-making burdens during moments of crisis or grief. You also help reduce confusion or disagreement about the choices you would want people to make on your behalf.
Advance directives are not only for older adults. Unexpected end-of-life situations can happen at any age, so it's important for all adults to prepare these documents. Ideally, you should do so in conversation with your loved ones and medical providers. (Visit the Texas Hospital Association to learn more (link is external)[B(1]) For further questions on actual form completion, talk to your health care provider and/or a member of your health care team[B(2].
Texas Health and Human Servicesprovides advance directives on its website. They include:
- Directive to Physicians and Family or Surrogates, also called a living will, lets you communicate your wishes about the type of medical treatment you want if you are terminally or irreversibly ill and are unable to make your wishes known because of your illness or injury.
- Medical Power of Attorneygives the person you name the authority to make any and all health care decisions for you in accordance with your wishes, including religious and moral beliefs, when you are no longer capable of making those decisions for yourself.
- Texas Out-of-Hospital Do Not Resuscitate (DNR) [B(3]is an order, separate from a living will or medical power of attorney, signed by a doctor and the patient or surrogate allowing you to refuse certain treatments such as chest compression, defibrillation, or intubation if your heart stops or you stop breathing when outside the hospital. These orders apply only in the state of Texas and are specific to a variety of locations where health care professionals may be called to provide assistance, including long-term care facilities, in-patient hospice facilities, private homes, hospital outpatient or emergency departments, physician’s offices, and vehicles during transport. [B(4]
- Declaration for Mental Health Treatmentlets you decide about 3 mental health treatments - psychoactive medication, convulsive therapy and emergency mental health treatment.
There also are two other issue you may wish to consider:
- The legislature has recently passed new law impacting patient or surrogate consent for in hospital Do Not Attempt Resuscitation (DNAR[B(5]) orders. Rules related to that legislation are pending. Until further notice please check with your local health care institution or provider. If you are certain you would not want CPR in the setting of a terminal or irreversible illness, we recommend adding that to your living will. If you believe you would not want CPR attempted in any situation, consider completing an Out of Hospital DNR form.
- Statutory Durable Power of Attorneylets the person you designate take certain actions regarding your finances/property, but does not give the person rights to make healthcare decisions for you. This is the only directive that requires an attorney to complete with the patient.
[B(1]
[B(2]Other links to consider:
[B(3]Or consider OODNR as the acronym
[B(4]From definition for “Out-of-hospital setting” in Section 166.081(7) of the Texas Advance Directives Act, Health and Safety Code, Chapter 166.
[B(5]Add: also known as DNR