Medicare Part B and Hospice: The Basic Answer
Medicare Part B does not cover hospice care itself. Instead, Medicare Part A — the hospital insurance portion — covers hospice services when you meet specific conditions. Part B covers some individual services you might receive while in hospice, but the hospice program as a whole is a Part A benefit.
This matters because it changes how you pay and what paperwork you need. If you are enrolled in Part B only and not Part A, you will not have hospice coverage through Original Medicare. If you have both parts, Part A takes the lead, and you pay a small copay for medications and respite care rather than the full cost.
Key Takeaways
- Medicare Part A, not Part B, covers the hospice program itself, including nursing, aide services, and equipment.
- You must have a doctor certify that you have six months or less to live and choose to stop curative treatment to use hospice benefits.
- Part B may cover certain services like doctor visits or imaging if they are not related to your terminal condition, but this is rare in hospice.
- You pay nothing for hospice services covered by Part A, except a small copay for medications and up to five days of respite care.
- If you have a Medicare Advantage plan instead of Original Medicare, your hospice coverage depends on your specific plan — contact your plan directly to confirm.
What Part A Covers in a Hospice Program
When you are admitted to hospice through Medicare Part A, the program covers nursing visits, home health aide services, social work, chaplain services, and counseling for you and your family. It also covers medications related to your terminal condition, medical equipment like oxygen or a hospital bed, and short-term inpatient care if your symptoms become hard to manage at home.
Part A pays for up to five days of respite care per year — a stay in a facility so your family caregiver can rest. You pay a copay of about $5 per day for respite care, though this amount can change each year. For medications and medical supplies, you typically pay nothing if they are ordered by your hospice team and relate to your terminal diagnosis.
The hospice agency itself bills Medicare Part A directly. You do not submit claims or pay upfront and wait for reimbursement. The agency handles the paperwork with Medicare.
When Part B Might Cover Something During Hospice
Part B rarely covers services while you are in an active hospice program, because hospice is designed to be comprehensive. However, Part B could cover a doctor visit or test if it is completely unrelated to your terminal condition — for example, treatment for a broken arm or a dental problem. This is uncommon because most people in hospice focus on comfort care, not treatment of new or separate conditions.
If you need a service and are unsure whether Part A or Part B covers it, ask your hospice team or call Medicare at 1-800-MEDICARE. They can tell you which part applies and what you will owe.
How to Know If You may have access to for Hospice Under Part A
Medicare Part A covers hospice only when two conditions are met. First, your doctor and a hospice medical director must both certify that you have a terminal illness and six months or less to live. Second, you must sign a form saying you choose comfort care and are not seeking curative treatment for your terminal condition.
You do not have to be at home to use hospice — you can receive it in a nursing home, assisted living facility, or hospital. The location does not change Part A coverage. What matters is that you have Part A active and meet the medical criteria.
If your condition improves or stabilizes, you can leave hospice and return to regular Medicare coverage. If you live longer than six months, you can stay in hospice as long as your doctor recertifies that you still have a terminal illness.
Medicare Advantage Plans and Hospice Coverage
If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your hospice coverage works differently. Most Advantage plans must cover hospice the same way Original Medicare does — through Part A benefits — but the details vary by plan. Some plans may require you to use a hospice provider in their network, or they may have different copays or rules about which services are covered.
Before you need hospice, contact your Advantage plan and ask exactly what it covers. Get the answer in writing if possible. If your plan does not cover hospice or has restrictions you do not accept, you have the right to switch to Original Medicare during the annual enrollment period or during a special enrollment period triggered by a life event.
What You Pay for Hospice Under Part A
If you have Medicare Part A, you pay nothing for most hospice services — nursing, aides, social work, chaplain visits, medications for your terminal condition, and medical equipment are all covered at no cost to you. You do pay a copay for respite care (about $5 per day, up to five days per year) and for medications that are not related to your terminal diagnosis.
You do not pay a Part A deductible for hospice. Part A deductibles explore to hospital and skilled nursing stays, not to hospice. This is one reason Part A coverage is valuable: hospice is a low-cost benefit once you have Part A active.
When to Talk to Your Doctor About Hospice
Hospice is not something Medicare forces on you. You choose it when you and your doctor agree that curative treatment is no longer the goal. Many people wait too long to have this conversation, which means they miss weeks or months of hospice support that could have helped them and their families.
If you or a family member has a serious illness and is not getting better, ask your doctor: "What would happen if we stopped trying to cure this and focused on comfort instead?" or "Do you think hospice might help us right now?" Your doctor can explain whether you meet the six-month prognosis and what hospice would look like for your situation.
You can also ask for a hospice consultation without committing to the program. A hospice nurse can visit, explain what services are available, and answer questions. This helps you decide whether hospice is right for you.
Frequently Asked Questions
If I choose hospice, can I still see my regular doctor?
Yes. Your regular doctor can continue to see you, though the hospice team will take the lead on managing your terminal condition. Many people keep their regular doctor involved because of the long relationship. Hospice and your doctor can work together.
Does hospice mean I have to die at home?
No. Hospice is a type of care, not a place. You can receive hospice at home, in a nursing home, in a hospital, or in a hospice facility. Medicare Part A covers hospice services wherever you are, as long as the location is appropriate for hospice care.
What happens if I live longer than six months?
You can stay in hospice. Your doctor will recertify your terminal diagnosis, and Medicare will continue to cover services. There is no time limit on hospice as long as your doctor confirms you still have a terminal illness.
Can I change my mind and leave hospice?
Yes, at any time. If you decide you want to pursue curative treatment again, you can revoke your hospice election and return to regular Medicare coverage. Your doctor and hospice team can explain what this means for your care plan.
Does Part B cover hospice if I do not have Part A?
No. Part B does not cover hospice under any circumstances. If you have Part B only, you would need to purchase Part A or enroll in a Medicare Advantage plan to have hospice coverage. Contact Medicare at 1-800-MEDICARE to learn about your options.