Medicare Advantage covers hospice, but the coverage works differently than it does under Original Medicare
Yes, Medicare Advantage plans cover hospice care. However, the way that coverage works is set by federal law, not by your individual plan. When you need hospice, Medicare automatically switches you from your Advantage plan to Original Medicare (Part A and Part B) for your hospice services. Your plan cannot change this, reduce it, or add restrictions to it. This means your hospice coverage is the same whether you have an Advantage plan or Original Medicare — but understanding how the switch happens and what you pay will help you avoid surprises.
The reason for this rule is that hospice is a specialized service focused on comfort rather than cure, and Medicare treats it as a benefit that should be consistent across all beneficiaries. Once your doctor and you decide hospice is right for you, the hospice provider will handle the paperwork to move your coverage. You do not have to do this yourself.
Key Takeaways
- When you start hospice, you automatically move from your Medicare Advantage plan to Original Medicare for hospice services only — your plan cannot deny or limit this coverage.
- Medicare Part A covers all hospice services, including nursing, doctor visits, medications, equipment, and aide services, with no copayments or coinsurance for hospice-related care.
- You continue to pay your Advantage plan premium while on hospice, but you do not pay separately for hospice services covered by Part A.
- Your hospice provider must be Medicare-certified, and you can change hospice providers or stop hospice at any time.
- After hospice ends, you return to your Medicare Advantage plan for all other medical services.
How the coverage switch works when you start hospice
When your doctor determines that you have a terminal illness and a life expectancy of six months or less, and you and your doctor decide hospice is the right choice, the hospice provider takes the lead. The hospice agency will verify that you are a Medicare beneficiary and will notify Medicare that you are electing hospice care. This triggers an automatic enrollment in the Medicare hospice benefit under Part A.
You do not sign up for anything new or contact Medicare yourself. The hospice provider handles the administrative work. At that point, your Medicare Advantage plan steps back for hospice-related services only. All other medical care — doctor visits for non-hospice reasons, specialist appointments, prescriptions not related to your terminal condition — continues under your Advantage plan if you choose to keep it active.
Some people worry about losing their Advantage plan coverage. You do not lose it. Your plan remains active for services outside the hospice benefit. However, most people on hospice do not pursue aggressive medical treatment, so the distinction becomes less practical.
What Medicare Part A covers for hospice
Once you are on the Medicare hospice benefit, Part A covers the full cost of hospice services with no copayments or coinsurance for services related to your terminal illness. This includes nursing care, doctor visits, medications for symptom management and pain relief, medical equipment (such as a hospital bed or oxygen), home health aide services, counseling (including spiritual and grief counseling), and respite care (short-term inpatient care to give your family a break).
The only cost you may see is a copayment for prescription drugs. You pay up to $5 per prescription for drugs related to your terminal condition, and up to $5 per day for inpatient respite care. These are the only out-of-pocket costs for hospice services.
Hospice is designed to be delivered in your home, but Medicare also covers inpatient hospice care in a hospice facility, hospital, or nursing home if that becomes necessary. The level of care adjusts based on your needs.
What happens to your Advantage plan premium and other coverage
You continue to pay your Medicare Advantage plan premium while you are on hospice. This may seem odd since you are not using the plan for hospice services, but the premium obligation does not pause. However, you can drop your Advantage plan at any time without penalty, even mid-year, once you are enrolled in hospice. This is one of the few situations where Medicare allows a plan change outside the annual enrollment period.
If you keep your Advantage plan active, it continues to cover non-hospice medical services. For example, if you need a dental cleaning or an eye exam unrelated to your terminal condition, your plan would cover it according to your plan's rules. In practice, most people on hospice do not pursue these services, but the coverage remains available.
Original Medicare Part B (doctor and outpatient services) also remains active for non-hospice care. You continue to pay the Part B premium.
Choosing a hospice provider and changing your mind
You have the right to choose which Medicare-certified hospice provider cares for you. Your doctor can recommend one, your hospital social worker can provide options, or you can search the Medicare Hospice Compare tool on Medicare.gov to see which providers are certified in your area and read their inspection results. You are not locked into your first choice — you can switch to a different hospice provider at any time.
You can also stop hospice care at any time if you change your mind or if your condition improves. If you stop hospice, you return to your Medicare Advantage plan for all services. There is no penalty for stopping, and you can restart hospice later if needed.
Your hospice provider must be Medicare-certified. If you are considering a hospice that is not certified, it will not be covered by Medicare, and you would pay out of pocket.
What happens after hospice ends
If you stop hospice or if your hospice care ends for any reason, you return to your Medicare Advantage plan for all medical services. Your plan coverage resumes as it was before hospice. If you dropped your Advantage plan while on hospice, you would need to re-enroll during the next annual enrollment period (October 15 to December 7) or during a may have access to life event, unless you are still within a special enrollment window.
If you recover and your doctor determines that you no longer meet the hospice criteria (life expectancy of six months or less), Medicare will end your hospice benefit. You then return to regular Medicare coverage under your Advantage plan or Original Medicare, depending on what you have chosen.
Frequently Asked Questions
Will my Medicare Advantage plan deny hospice coverage?
No. Federal law requires all Medicare Advantage plans to cover hospice, and the coverage is automatic. Your plan cannot deny, delay, or limit hospice services once you are enrolled in the Medicare hospice benefit. The coverage is identical to what you would receive under Original Medicare.
Do I have to stay in my Advantage plan while on hospice?
No. You can drop your Advantage plan at any time once you start hospice, even outside the normal enrollment period. You can keep it if you want coverage for non-hospice services, but there is no requirement to stay enrolled.
What if my hospice provider is not in my Advantage plan's network?
It does not matter. Once you are on the Medicare hospice benefit, your hospice services are covered by Part A, not by your Advantage plan's network. Your plan's network rules do not explore to hospice care. The hospice provider only needs to be Medicare-certified.
Will I have to pay for hospice medications?
You may pay a small copayment. Medications related to your terminal condition are covered by Medicare Part A with a copayment of up to $5 per prescription. Medications unrelated to your terminal condition would be covered under your Advantage plan or Part D if you have it, with your plan's normal copayments.
Can I switch hospice providers if I am unhappy?
Yes. You can change to a different Medicare-certified hospice provider at any time. You do not need permission from your doctor or Medicare. straightforward contact the new hospice provider and let them know you want to transfer your care.