Yes, Medicare pays for hospice care. The benefit is covered under Medicare Part A, and it covers the vast majority of hospice services with very little out-of-pocket cost to you. To qualify, two physicians must certify that you have a terminal illness with a life expectancy of six months or less, and you must agree to receive comfort-focused care rather than curative treatment for that illness.
Who Qualifies for the Hospice Benefit
Three conditions must be met for Medicare to cover hospice care. First, your hospice doctor and your regular doctor (if you have one) must certify that you’re terminally ill with a life expectancy of six months or less if the disease runs its normal course. Second, you agree to accept palliative care, meaning the focus shifts to comfort and quality of life rather than trying to cure the illness. Third, you sign an election statement formally choosing hospice care.
That election statement is more than a simple signature. It identifies which hospice program will provide your care and which physician will serve as your attending doctor. It also acknowledges that you understand hospice is palliative, not curative, and that Medicare will no longer pay for treatments aimed at curing your terminal illness. The hospice is required to explain your cost-sharing responsibilities and to tell you about any services it considers unrelated to your terminal condition.
What Happens After Six Months
A six-month prognosis does not mean your coverage expires in six months. If you’re still alive and still terminally ill, you can continue receiving hospice care indefinitely. Medicare structures the benefit in periods: two initial 90-day periods, followed by an unlimited number of 60-day periods after that.
Starting with the third benefit period, a hospice physician or nurse practitioner must have a face-to-face visit with you and document clinical findings that support a continued life expectancy of six months or less. This recertification is required for every subsequent 60-day period. As long as you continue to meet the criteria, coverage continues with no lifetime cap.
Four Levels of Hospice Care
Medicare recognizes four distinct levels of hospice care, each designed for different situations.
- Routine home care is the most common level. It covers patients whose symptoms are generally stable and well controlled. Care is typically provided in your home, which can include a family member’s home, an assisted living facility, or a nursing home.
- Continuous home care is a crisis-level service for short-term management when pain or other symptoms spiral out of control. It’s still delivered in the home but involves more intensive, around-the-clock nursing.
- General inpatient care is also crisis-level care for uncontrolled symptoms, but it takes place in an inpatient setting like a hospital or skilled nursing facility. It’s meant to be short-term until symptoms are stabilized.
- Respite care is unique because it’s based on the caregiver’s needs, not the patient’s symptoms. Medicare covers a temporary stay in a nursing home, hospice facility, or hospital so that your primary caregiver can rest. Each respite stay is limited to five consecutive days.
What Medicare Covers
Under the hospice benefit, Medicare covers nursing visits, doctor services, medical equipment like hospital beds and wheelchairs, medical supplies, medications for pain and symptom management related to the terminal illness, home health aide services, physical and occupational therapy, speech therapy, social work services, and dietary counseling. Short-term inpatient care for symptom crises and respite stays are also included.
Medicare also requires hospice programs to provide bereavement counseling to family members and friends for at least one year after the patient dies. This support is built into the benefit at no additional cost.
What You Still Pay Out of Pocket
Hospice care under Medicare is nearly free, but not completely. You may owe a small copayment for each prescription drug related to pain management and symptom control, typically no more than $5 per medication. For inpatient respite care, you pay 5% of the Medicare-approved amount for each respite stay. Beyond those two costs, there are no deductibles or copayments for hospice services.
One important gap: Medicare does not pay for room and board. If you live in a nursing home or assisted living facility, you’re still responsible for your regular room and board charges. Medicare covers the hospice medical services layered on top of that living arrangement, but not the housing itself. The exception is during a general inpatient stay or respite stay at an approved facility, where the facility costs are included in the hospice benefit.
Coverage for Non-Hospice Medical Needs
Electing hospice does not mean you lose all other Medicare coverage. You waive Medicare payment for treatments aimed at curing your terminal illness, but Medicare Part A and Part B continue to cover conditions unrelated to your terminal diagnosis. If you have diabetes and your hospice diagnosis is lung cancer, for example, Medicare still covers your diabetes care. You keep paying your Part B premium and any standard cost-sharing for those unrelated services.
The hospice is required to give you an addendum listing any conditions, services, or drugs it considers unrelated to your terminal illness. This matters because those unrelated items are billed through regular Medicare, not through hospice, and they may carry normal Medicare copays and deductibles.
How Medicare Advantage Plans Handle Hospice
If you’re enrolled in a Medicare Advantage plan, hospice coverage works differently than most of your other benefits. When you elect hospice, your hospice care is paid directly by Original Medicare (Part A), not by your Medicare Advantage plan. Your MA plan continues to cover services unrelated to your terminal illness, but the hospice benefit itself flows through traditional Medicare.
CMS tested a model starting in 2021 that allowed certain Medicare Advantage plans to include hospice directly in their benefits package, aiming to reduce the fragmentation of having two payers involved at end of life. That pilot program, called the Hospice Benefit Component of the Value-Based Insurance Design model, ended on December 31, 2024. CMS cited operational challenges and limited participation. For now, the standard arrangement applies: hospice goes through Original Medicare regardless of your MA plan.
Switching or Leaving Hospice
You can change your designated hospice provider once during each benefit period. You can also revoke your hospice election at any time and return to standard Medicare coverage, including curative treatments. If your condition later worsens or you change your mind, you can re-elect hospice. There is no penalty for leaving and coming back.
While you’re enrolled with one hospice, Medicare will not pay for hospice care from a different provider unless your designated hospice arranged that care. This is why the election statement specifically names which hospice will manage your care.