Medicare covers hospice care when a doctor certifies you have six months or less to live, and you choose comfort care over curative treatment
Medicare Part A pays for hospice services without a deductible or copay for most care. You will not pay for doctor visits, nursing, counseling, medications related to your terminal condition, or equipment like hospital beds and wheelchairs. The program covers up to 100 days of inpatient respite care — a break for your family caregiver — and pays for a volunteer to sit with you if your family needs relief.
The catch is that choosing hospice means you are choosing to stop treatment aimed at curing your illness. Medicare will not pay for both curative care and hospice at the same time. Once you enroll, you can change your mind and go back to regular Medicare coverage, but the switch takes time and your hospice benefits stop when ready.
Key Takeaways
- Medicare Part A covers hospice with no deductible or copay for most services, including nursing, doctors, medications for your terminal condition, and equipment.
- Your doctor must certify in writing that you have six months or less to live, and you must sign a form saying you choose comfort care instead of curative treatment.
- Hospice agencies are Medicare-certified providers, and Medicare pays them directly — you do not bill them yourself.
- You may owe a small copay (up to $5) for prescription drugs and respite care, but only if you have already met your Part A deductible for the year.
- If you change your mind and want to resume curative treatment, you can revoke hospice, but the process takes a few days and your coverage switches back to regular Medicare.
What Medicare Hospice Actually Covers
Medicare Part A pays for a team approach to end-of-life care. That team includes a doctor who oversees your care plan, nurses who visit your home or facility, a social worker, a chaplain or counselor, home health aides, and trained volunteers. All of these visits and services are covered with no copay.
Medications are covered if they treat symptoms of your terminal illness — pain, nausea, shortness of breath, anxiety. Medications to treat other conditions you have are also covered. Medical equipment and supplies — oxygen, a hospital bed, a wheelchair, wound dressings, incontinence supplies — are covered in full. Hospice agencies provide these items; you do not buy them yourself.
Inpatient respite care is a short hospital or nursing home stay (up to five consecutive days at a time) so your family caregiver can rest. Medicare covers this with no copay. Bereavement counseling for your family continues for up to 13 months after you die, at no cost.
What You Will Pay Out of Pocket
For most hospice services, you pay nothing. However, you may owe a small copay in two situations. If you need a prescription drug related to your terminal condition and you have already met your Part A deductible for the year, you may pay up to $5 per prescription. If you use respite care and have met your deductible, you may pay up to 5 percent of the Medicare-approved amount for that stay.
If you choose inpatient hospice care in a hospital or facility rather than at home, you may owe a copay of up to $200 per day for the first five days, then nothing after that. This is rare — most hospice care happens at home or in a nursing facility where you already live.
You do not pay the hospice agency directly. Medicare pays them, and they bill Medicare for the services they provide. If a hospice agency asks you for payment upfront or threatens to discharge you because of money, contact your state's hospice ombudsman or Medicare at 1-800-MEDICARE.
How to Enroll in Medicare Hospice
Your doctor must start the process by having a conversation with you about your prognosis and what hospice means. If you both agree that hospice is right for you, your doctor writes a certification stating that you have a terminal illness and six months or less to live. This certification goes into your medical record.
You then choose a hospice agency. Medicare-certified agencies are listed on Medicare.gov, and your doctor can recommend one. You sign a form called the "Hospice Election" that says you understand you are choosing comfort care instead of curative treatment, and you understand what that means for your Medicare coverage.
The hospice agency handles the paperwork with Medicare. You do not file anything yourself. The agency will ask for your Medicare card and will verify your coverage. Hospice services can start the same day you sign the election form, or within a few days depending on the agency's schedule.
The Six-Month Prognosis and What Happens After
The six-month timeline is a medical estimate, not a important date. Some people live longer than six months in hospice; others live shorter. If you are still alive after six months, your doctor can recertify you for another benefit period. Medicare allows unlimited recertifications as long as your doctor believes you still have a terminal illness and a prognosis of six months or less.
If your condition improves and your doctor believes you no longer have a terminal illness, you can revoke hospice and return to regular Medicare coverage. You must sign a form to revoke, and the change takes effect the day you sign it or the next day, depending on your hospice agency. Once you revoke, you lose hospice benefits when ready and go back to your regular Part A and Part B coverage with deductibles and copays.
If you revoke hospice and then later want to enroll again, you can — but your doctor must recertify that you have a terminal illness and six months or less to live. There is no limit to how many times you can enroll and revoke, but each time you switch, there is a gap in coverage while the paperwork processes.
Hospice at Home Versus Inpatient Hospice
Most Medicare hospice care happens at home — your own home, a family member's home, or a nursing facility where you already live. A nurse visits regularly, usually weekly or more often if you need it. You can call the hospice agency 24 hours a day if you have pain, nausea, or other symptoms that need attention. An on-call nurse can visit at night or on weekends.
Inpatient hospice care in a hospital or dedicated hospice facility is used when symptoms cannot be managed at home, or when family caregivers need a break. Medicare covers inpatient care, but it is less common because most people prefer to stay home. If inpatient care becomes necessary, your hospice agency arranges the transfer and handles all the billing.
What Happens to Your Other Medicare Coverage
When you enroll in hospice, your regular Medicare benefits change. You keep your Part A and Part B coverage, but you cannot use them for curative treatment of your terminal illness. For example, if you have cancer and enroll in hospice for cancer, Medicare will not pay for chemotherapy or radiation. However, Medicare will still cover treatment for other conditions — if you break your arm, Medicare Part A will cover the hospital stay to set it.
Your Part D prescription drug coverage continues, but the hospice agency provides drugs related to your terminal condition, so you will not use Part D for those. You can still use Part D for medications for other health problems.
If you have a Medicare Advantage plan (Part C), enrolling in hospice does not automatically end your plan, but your plan's coverage for curative treatment of your terminal illness stops. Talk to your plan before you enroll in hospice to understand how your coverage will change.
Frequently Asked Questions
Can I change my mind after I enroll in hospice?
Yes. You can revoke hospice at any time by signing a form. Your hospice benefits stop the day you sign or the next day, and your regular Medicare coverage resumes. If you want to enroll again later, your doctor must recertify that you have a terminal illness and six months or less to live.
Does Medicare cover hospice in a nursing home where I already live?
Yes. If you live in a nursing home and enroll in hospice, Medicare Part A covers the hospice services — nursing, doctors, counseling, equipment. You still pay the nursing home for room and board, just as you did before. The hospice agency and the nursing home coordinate your care.
What if my doctor says I have six months to live but I live longer?
Your doctor can recertify you for another benefit period. Medicare allows unlimited recertifications as long as your doctor documents that you still have a terminal illness and a prognosis of six months or less. There is no penalty for living longer than expected.
Will hospice cost me more than staying in the hospital?
No. Medicare covers hospice with no deductible and minimal copays. If you were in a hospital, you would owe a deductible and copays for each day. Hospice is designed to be less expensive for Medicare and to let you stay in a comfortable setting instead of a hospital.
Can my family still visit me in hospice?
Yes. Hospice encourages family visits at any time, day or night. The hospice team works with your family to support you and help them understand what to expect. Volunteers can also sit with you so family members can take breaks.