Medicare covers hospice services when a doctor certifies you have six months or less to live, and you choose comfort care instead of treatment aimed at cure.

Medicare Part A pays for hospice as a covered benefit, meaning there is no deductible and you pay nothing out of pocket for the services Medicare includes. The program covers nursing care, doctor visits, medications related to your terminal condition, medical equipment, counseling, and aide services in your home or in a hospice facility. You do not have to be homebound, but hospice is designed for people who have decided to focus on comfort rather than aggressive treatment.

The catch is that choosing hospice means stepping back from curative care. Once you enroll, Medicare will not pay for treatments meant to cure your illness or extend your life — only for comfort. You can change your mind and leave hospice at any time, and your Medicare coverage for other treatments resumes when ready. Many people stay in hospice for weeks or months; others for just days.

Key Takeaways

  • Medicare Part A covers all hospice services with no deductible or copay when a doctor certifies a terminal diagnosis with six months or less to live.
  • Hospice covers nursing, doctor visits, medications for your condition, equipment, counseling, and aide services, but not treatments meant to cure the illness.
  • You can enroll in hospice while still living at home, in a nursing facility, assisted living, or in a hospice inpatient facility.
  • You can leave hospice and resume curative treatment at any time without losing your Medicare coverage.
  • Your doctor must refer you to hospice; you cannot refer yourself, though you can ask your doctor about it.

How the Six-Month Prognosis Works

A doctor must certify that you have a terminal illness and are expected to live six months or less if the illness runs its natural course. This is not a may provide — some people live longer, and some shorter. The six-month window is a medical judgment, not a important date. If you live past six months, you can stay in hospice as long as your doctor continues to certify that your condition is terminal.

The certifying doctor can be your primary care physician, an oncologist, a cardiologist, or any doctor treating your condition. For the first 90 days, one physician must sign the certification. After that, a hospice medical director or physician can recertify you every 60 days. The hospice agency handles the paperwork; you do not have to submit anything yourself.

What Medicare Hospice Covers

Medicare Part A pays for all of these services with no copay:

  • Nursing care provided by a registered nurse or licensed practical nurse, available 24/7
  • Doctor visits and care coordination
  • Medications for pain and symptoms related to your terminal condition
  • Medical equipment such as hospital beds, wheelchairs, oxygen, and wound care supplies
  • Home health aide services for personal care and hygiene
  • Counseling for you and your family, including grief counseling after death
  • Spiritual care from a chaplain or clergy of your choice
  • Short-term inpatient care if symptoms cannot be managed at home
  • Respite care — a few days in a facility so your family caregiver can rest

Medications are covered only if they treat symptoms of your terminal condition. Pain medication, nausea relief, and breathing aids are covered. A medication to lower your blood pressure or manage diabetes would not be covered unless it directly eases your symptoms. Hospice pharmacies typically deliver medications to your home.

Where You Can Receive Hospice Care

You do not have to move to receive hospice. Most people stay in their own home, and Medicare covers all services there. If you live in a nursing home or assisted living facility, hospice services come to you — the facility does not have to discharge you. Some people choose to move to a hospice inpatient facility, which is a dedicated building or unit where staff are present around the clock.

Inpatient hospice is used when symptoms are hard to control at home, when you have no family caregiver, or when you straightforward prefer it. Medicare covers inpatient stays for symptom management and respite care. The length of stay varies; some people stay a few days, others weeks. You pay nothing for inpatient care under Medicare Part A.

How to Enroll in Medicare Hospice

You cannot enroll yourself. Your doctor must refer you to a hospice agency, and you must agree to the referral. Start by talking to your doctor about your prognosis and what hospice offers. If your doctor agrees that hospice is appropriate, they will provide a referral or help you choose an agency.

You then contact the hospice agency, which sends a nurse to assess you and explain the program. The agency handles all paperwork with Medicare. You sign a consent form stating that you understand you are choosing comfort care over curative treatment. Once Medicare receives the physician certification, your coverage begins. The whole process typically takes a few days.

You have the right to choose which hospice agency serves you, even if your doctor recommends one. Ask your doctor, hospital social worker, or call your State Health Insurance information Program (SHIP) for a list of agencies in your area. Compare agencies on their services, availability, and whether they have experience with your condition.

What Happens to Other Medicare Coverage

When you enroll in hospice, Medicare stops paying for treatments meant to cure your illness. This includes chemotherapy, radiation, surgery, dialysis, and hospitalization for your terminal condition. However, Medicare continues to cover other services unrelated to your hospice diagnosis. If you have heart disease and enroll in hospice for cancer, Medicare still covers heart medication and cardiology visits.

If you need hospitalization for something unrelated to your terminal condition — a broken bone, an infection, an accident — Medicare Part A covers that hospital stay. You would temporarily leave hospice, receive hospital care, and can return to hospice afterward if you wish.

Prescription drugs not related to your hospice condition are covered under your Medicare Part D plan, not by hospice. You continue to pay your Part D premiums and copays for those medications.

Leaving Hospice or Changing Your Mind

You can leave hospice at any time for any reason. There is no penalty, and your Medicare coverage for other treatments resumes when ready. If you want to pursue curative treatment again, your doctor can refer you back to regular Medicare-covered care. Some people leave hospice because their condition improves; others because they want to try treatment; others because they change their mind about the approach.

If you leave hospice and later want to return, your doctor can refer you again. Each time you enroll, a physician must certify that you have a terminal condition with six months or less to live. There is no limit to how many times you can enroll and leave.

Questions to Ask Your Doctor

Before enrolling in hospice, ask your doctor these questions:

  • What is my diagnosis, and why do you think my life expectancy is six months or less?
  • What symptoms should I expect, and how will hospice help manage them?
  • Can I stay in my home, or do you recommend inpatient care?
  • Will I still see you, or will a hospice doctor take over my care?
  • Can I leave hospice if I change my mind?
  • Which hospice agencies do you recommend, and why?
  • What happens to my other medications and treatments?

Frequently Asked Questions

Do I have to pay anything for hospice if I have Medicare?

No. Medicare Part A covers all hospice services with no deductible, copay, or coinsurance. You pay nothing for nursing, medications, equipment, or counseling. If you have a Medigap or Medicare Advantage plan, they do not charge you either. Hospice is fully covered.

What if I live longer than six months?

You can stay in hospice as long as your doctor continues to certify that your condition is terminal. The six-month estimate is not a cutoff. If you live one year, two years, or longer, Medicare continues to cover hospice services as long as recertification happens every 60 days.

Can I get hospice if I am in a nursing home?

Yes. Hospice services are provided to you in the nursing home. The nursing home does not discharge you. Medicare covers hospice, and the nursing home continues to provide room and board, which you pay for separately. Hospice adds nursing, counseling, and comfort care on top.

What if my family disagrees with my choice to enroll in hospice?

The decision is yours alone. Your family can attend counseling sessions with the hospice team to understand what hospice offers and what to expect. Many families find that hospice allows them to spend meaningful time together without the stress of aggressive treatment. Hospice social workers and chaplains can help families talk through concerns.

Can I change hospice agencies?

Yes. You can switch to a different hospice agency at any time. Contact the new agency, and they will handle the transfer with Medicare. There is no penalty or waiting period. If you are unhappy with your current agency, you have the right to choose another.