Yes, Medicare covers hospice care under Part A (Hospital Insurance) at little to no cost to the patient. The benefit is designed to cover virtually everything related to a terminal illness, from nursing visits and medications to medical equipment and emotional support for the whole family. Most people pay nothing out of pocket for the core services, though small copayments apply for prescription drugs and respite care.
Who Qualifies for the Hospice Benefit
To receive Medicare hospice coverage, two doctors must certify that a patient has a terminal illness with a life expectancy of six months or fewer, assuming the disease runs its normal course. One of those physicians is typically the patient’s own doctor, and the other is the medical director of the hospice program. The patient must also sign a statement choosing comfort-focused hospice care instead of curative treatment for their terminal condition.
This doesn’t mean coverage ends after six months. If a patient is still alive at the end of that period and a physician recertifies that they remain terminally ill, the benefit continues. There is no hard cutoff. Medicare structures this as a series of benefit periods: two initial 90-day periods, followed by an unlimited number of 60-day periods. Before the third benefit period and each one after that, a hospice physician or nurse practitioner must have a face-to-face visit with the patient to confirm they still meet the criteria. That visit must happen within 30 days before the new period begins.
What Medicare Covers
The hospice benefit is unusually comprehensive compared to other parts of Medicare. It takes a team-based approach that addresses medical, physical, social, emotional, and spiritual needs. Covered services include doctor visits, nursing care, medical equipment like hospital beds and wheelchairs, medical supplies, prescription drugs for pain and symptom management, home health aide services, physical and occupational therapy, speech therapy, social work services, dietary counseling, grief and loss counseling for both the patient and family, and short-term inpatient care when needed.
Once you elect hospice, your care team works with you and your family to build a personalized plan. That plan determines what combination of services you receive and how often. The hospice provider coordinates everything, so you’re not managing multiple providers or bills on your own.
Four Levels of Hospice Care
Medicare recognizes four distinct levels of hospice care, and coverage applies to all of them.
- Routine home care is the most common level. The patient is generally stable, symptoms like pain or nausea are under control, and care is provided at home. This is what most people picture when they think of hospice.
- Continuous home care kicks in during a crisis, when pain or symptoms become uncontrolled and need intensive, short-term management. Care is still delivered at home, but a nurse may be present for extended hours.
- General inpatient care is also for crisis situations with uncontrolled symptoms, but it takes place in a hospital, skilled nursing facility, or hospice inpatient unit. It’s short-term and ends once symptoms are stabilized.
- Respite care is unique because it’s based on caregiver needs, not patient symptoms. Medicare covers a short stay in an approved facility so that a family caregiver can rest. Each respite stay is limited to five consecutive days.
What You’ll Pay Out of Pocket
For most hospice services, you pay nothing. There is no deductible for the hospice benefit. The two exceptions are prescription drugs and respite care. For medications related to pain and symptom management, you may owe a copayment of no more than $5 per prescription. For respite care, Medicare charges 5% of the Medicare-approved amount for each day you use it.
These costs are small relative to what the benefit covers, and many hospice programs work with families to minimize even these charges. If you have a Medigap (Medicare Supplement) policy, it may cover the copayments entirely.
How Medicare Advantage Plans Handle Hospice
This is where things get slightly more complicated. If you’re enrolled in a Medicare Advantage plan and you elect hospice, your hospice services are paid by Original Medicare (fee-for-service), not by your Medicare Advantage plan. Your MA plan remains responsible for supplemental benefits and any care unrelated to your terminal illness, but the hospice benefit itself flows through traditional Medicare Part A.
CMS had been testing a model that allowed certain Medicare Advantage plans to manage hospice benefits directly, but that program was terminated at the end of 2024. So for now, the split arrangement remains the standard: Original Medicare pays for hospice, your MA plan covers everything else.
What Hospice Coverage Does Not Include
Electing hospice means choosing comfort care over curative treatment for your terminal diagnosis. Medicare will not pay for treatments intended to cure the terminal illness once you’re enrolled in hospice. If you have a separate, unrelated medical condition, Medicare still covers treatment for that condition the same way it normally would.
Room and board is generally not covered. If you live at home, there’s nothing extra to pay. But if you reside in a nursing home, you’re still responsible for room and board costs. Medicare hospice covers the hospice services delivered to you in that facility, not the cost of living there. The exception is during short-term inpatient stays for symptom crises or respite care, where the facility costs are included.
Emergency room visits and hospitalizations related to your terminal illness are also not covered outside the hospice plan of care. If a crisis occurs, the first call should go to your hospice team, who can arrange the appropriate level of care. Going to the ER on your own for hospice-related symptoms could result in charges Medicare won’t cover under the hospice benefit.
You Can Change Your Mind
Electing hospice is not a permanent, irreversible decision. You can revoke your hospice election at any time and return to standard Medicare coverage, including curative treatments. If your condition later worsens or you decide comfort care is the right choice again, you can re-enroll in hospice. There is no penalty for switching back and forth, and you don’t lose any Medicare benefits by having been in hospice previously.