Yes, Medicare covers hospice care under Part A (Hospital Insurance) at little to no cost to the patient. If you have a terminal illness with a life expectancy of six months or less, Medicare will pay for nearly all hospice services, including nursing care, medications for symptom relief, medical equipment, and counseling for both you and your family. Your out-of-pocket costs are limited to small copayments for prescription drugs and respite care.
Who Qualifies for the Hospice Benefit
To receive Medicare-covered hospice care, two conditions must be met. First, you need to be enrolled in Medicare Part A. Second, two physicians must certify that you have a terminal illness with a prognosis of six months or less if the disease follows its expected course. One of those physicians is typically the hospice medical director; the other is usually your personal doctor.
Choosing hospice also means agreeing to shift the focus of your care from curative treatment to comfort care. When you elect the hospice benefit, you waive your right to have Medicare pay for treatments aimed at curing your terminal illness. Medicare still covers treatment for any other health conditions unrelated to your terminal diagnosis. If you break your arm or need care for diabetes that isn’t connected to your hospice diagnosis, standard Medicare benefits still apply for those issues.
What Medicare Covers
The hospice benefit is unusually broad compared to most Medicare coverage. Your hospice team builds a personalized plan of care, and Medicare pays for the services in that plan. Covered services include:
- Doctor services from both the hospice physician and your own attending doctor
- Nursing care provided in your home or residence
- Prescription drugs for pain relief and symptom control
- Medical equipment like wheelchairs, walkers, and hospital beds
- Medical supplies such as bandages and catheters
- Hospice aide and homemaker services for help with daily activities
- Physical, occupational, and speech therapy
- Social worker services
- Dietary counseling
- Grief and loss counseling for both you and your family
- Short-term inpatient care when pain or symptoms can’t be managed at home
- Short-term respite care to give your caregivers a break
Respite care allows your primary caregiver time to rest. Medicare covers inpatient respite stays of up to five consecutive days at a time in a hospital, hospice facility, or nursing home. Grief counseling for family members continues after a patient’s death, which is unusual for Medicare. It’s one of the few situations where Medicare pays for services provided to someone other than the enrolled beneficiary.
What You Pay Out of Pocket
For most hospice services, you pay nothing. There are only two exceptions. For prescription drugs related to pain and symptom management, you may owe a copayment of up to $5 per medication. For inpatient respite care, you pay 5% of the Medicare-approved amount for each stay.
There are no deductibles for hospice care, and no coinsurance for nursing visits, equipment, or any of the other core services. This makes the hospice benefit one of the most financially generous programs Medicare offers.
How Benefit Periods Work
Medicare structures hospice coverage in defined benefit periods rather than as open-ended enrollment. The first benefit period lasts 90 days. The second also lasts 90 days. After that, you can receive an unlimited number of 60-day benefit periods for as long as you continue to meet the eligibility criteria.
At the start of each benefit period, a physician must recertify that your illness remains terminal. Starting with the third benefit period, a hospice physician or nurse practitioner must also conduct a face-to-face visit with you to assess your condition. This visit must happen within 30 days before the new period begins. The recertification process exists to confirm that hospice remains the appropriate level of care, but there is no cap on how many benefit periods you can receive. Patients who live longer than initially expected can stay on hospice indefinitely as long as recertification continues.
You Can Change Your Mind
Electing hospice is not a permanent decision. You can revoke your hospice benefit at any time and return to standard Medicare coverage, including curative treatments. If you later decide you want hospice again, you can re-enroll as long as you still meet the eligibility criteria. This flexibility matters because some patients improve unexpectedly, want to try a new treatment, or simply feel they made the decision too early.
When you revoke hospice, you lose the remainder of that benefit period. For example, if you’re 30 days into a 90-day period and revoke, those remaining 60 days don’t carry over. Your next hospice election, if you choose to re-enroll, starts a new benefit period.
What Hospice Does Not Cover
Medicare will not pay for curative treatments related to your terminal illness once you’ve elected hospice. If you have lung cancer and choose hospice, Medicare won’t cover chemotherapy aimed at treating that cancer, though it would still cover pain management or radiation used purely for comfort.
Room and board is another common point of confusion. If you receive hospice care at home, which most people do, this isn’t an issue. But if you live in a nursing home, Medicare’s hospice benefit does not cover your room and board there. It covers the hospice services you receive in that facility, but the cost of the room itself would need to come from Medicaid, long-term care insurance, or out-of-pocket payment. The exception is short-term inpatient stays specifically for symptom management or respite care, where Medicare does cover the full cost of the stay.
You can also ask your hospice provider for a written list of any items, services, or medications they’ve determined are unrelated to your terminal illness. This helps you understand which of your healthcare needs still fall under regular Medicare and which are handled through hospice.
Medicare Advantage and Hospice
If you’re enrolled in a Medicare Advantage plan, hospice is the one major benefit that bypasses your plan entirely. When you elect hospice, that coverage comes directly from Original Medicare (Part A), not from your Medicare Advantage insurer. Your Advantage plan continues to cover services unrelated to your terminal illness, but all hospice-specific care is billed through traditional Medicare. You don’t need to switch plans or disenroll from Medicare Advantage to receive the hospice benefit.