Medicare covers hospice care delivered in your home, but only under specific conditions
Yes, Medicare Part A covers hospice care in your home when a doctor certifies that you have a terminal illness with a life expectancy of six months or less. Medicare pays for the hospice services themselves — nursing visits, aide care, medications related to your terminal condition, medical equipment, and counseling — but not for room and board if you live with family, or for ongoing care after the hospice benefit ends.
The key requirement is that you must choose hospice care instead of curative treatment for your condition. Once you enroll in Medicare hospice, your Part A coverage for hospital stays and skilled nursing related to your terminal illness stops. You keep your Part B coverage for other medical needs, and you can leave hospice at any time if you change your mind or want to pursue treatment again.
Key Takeaways
- Medicare Part A pays for hospice services in your home when a doctor certifies a terminal diagnosis with six months or less to live.
- Covered services include nursing, aide care, medications for your terminal condition, medical equipment, and counseling — but not food, housing, or caregiver wages.
- You must choose hospice instead of curative treatment, though you can switch back to regular Medicare coverage if you change your mind.
- Your out-of-pocket costs are limited to small copayments for medications and respite care, typically $5 per prescription and up to five days of inpatient respite.
What Medicare hospice covers and what it does not
Medicare Part A pays for skilled nursing visits to your home, home health aide services for personal care, social work visits, chaplain services, and bereavement counseling for your family. It covers medications prescribed for symptom management and pain control related to your terminal condition, medical equipment like oxygen or a hospital bed, and short-term inpatient respite care — usually up to five days — so your family caregiver can rest.
Medicare does not pay for room and board if you live at home with family members. It does not pay wages for family members who provide care, though some hospice programs offer small stipends. It does not cover ongoing medical care unrelated to your terminal illness, such as treatment for diabetes or heart disease, unless that care is also part of managing your terminal condition. If you need inpatient hospice care in a facility because you cannot be cared for at home, Medicare covers that, but you will need to check whether the facility is Medicare-certified.
How to enroll in Medicare hospice at home
Your doctor must first refer you to hospice and certify that you have a terminal illness with a prognosis of six months or less. You then choose a Medicare-certified hospice provider. You can ask your doctor for recommendations, search the Medicare Hospice Compare tool on Medicare.gov, or call 1-800-MEDICARE to find providers in your area. Once you have chosen a provider, you sign an election form stating that you want hospice care instead of curative treatment for your terminal condition.
The hospice provider handles the paperwork with Medicare. They will ask about your medical history, current medications, and your preferences for care — such as whether you want to die at home or in a facility, and what level of intervention you want near the end of life. This is also when you name a healthcare proxy or power of attorney if you have not already done so. The entire enrollment process usually takes a few days to a week.
Your out-of-pocket costs for hospice care
Your costs are capped under Medicare hospice. You pay a copayment of up to $5 per prescription for medications related to your terminal condition, though many hospice programs waive this. If you use inpatient respite care — a short hospital or facility stay so your family can rest — you pay up to $5 per day for up to five days per benefit period. You do not pay for the nursing visits, aide care, equipment, or counseling.
If you have a Medigap or Medicare Advantage plan, check with your plan to see whether it covers the small copayments. Some plans do; others do not. If you have Medicaid in addition to Medicare, Medicaid may cover costs that Medicare does not, such as room and board in a facility or wages for a family caregiver, depending on your state's rules.
What happens if you change your mind about hospice
You can leave the Medicare hospice benefit at any time and return to regular Medicare coverage. If you leave, you regain coverage for curative treatment, hospital stays, and skilled nursing care related to your terminal illness. You can also switch to a different hospice provider if you are unhappy with your current one — you straightforward notify your current provider and enroll with a new one.
If your condition improves and your doctor believes you no longer meet the six-month prognosis, Medicare will discharge you from hospice. You then return to regular Part A and Part B coverage. Some people are discharged and later re-enroll if their condition worsens again. There is no penalty for any of these changes.
Finding a Medicare-certified hospice provider
Not all hospice agencies are Medicare-certified. To confirm that a provider accepts Medicare, you can search Medicare Hospice Compare at Medicare.gov, call 1-800-MEDICARE, or ask your doctor. When you contact a provider, ask whether they serve your area, what services they offer, whether they have staff available 24 hours a day, and how they handle emergencies after hours.
You can also ask whether the provider is part of a larger health system or independent, how long they have been in business, and whether they can provide references from families who have used their services. Some hospice providers specialize in certain conditions, such as cancer or dementia, so if you have specific needs, ask whether they have experience with your diagnosis.
How the six-month prognosis works
The six-month life expectancy is an estimate, not a may provide. Some people live longer than six months after enrolling in hospice; others live shorter. Your doctor makes the prognosis based on your medical condition, how quickly it is progressing, and your overall health. The hospice medical director will review this prognosis and may adjust it as your condition changes.
Medicare requires that your doctor recertify your prognosis every 90 days for the first year, then every 60 days after that. If at any point your doctor or the hospice medical director believes you no longer meet the six-month prognosis, they will discuss this with you and your family. You are not automatically discharged — the decision is made together — but Medicare will not continue to pay for hospice if the prognosis no longer fits.
Frequently Asked Questions
Can I use hospice at home if I live alone?
Yes. Hospice services are designed to support people living alone, though you will need someone to check on you regularly or be available by phone. The hospice team can coordinate with family, friends, or volunteers. If you cannot be safely cared for at home alone, the hospice provider can discuss inpatient facility options or help arrange additional support.
Does Medicare hospice cover pain medication?
Yes. Medicare covers all medications prescribed for symptom management and pain control related to your terminal condition. This includes strong opioids like morphine. You pay a copayment of up to $5 per prescription, though many hospice programs waive this. Medications unrelated to your terminal illness are not covered under the hospice benefit.
What if my family wants me to continue treatment instead of choosing hospice?
The choice to enroll in hospice is yours alone. Your doctor can explain the benefits of hospice and what it means to stop curative treatment, but you make the final decision. If you are unsure, you can ask for time to discuss it with family or a counselor. You can also leave hospice at any time if you change your mind and want to pursue treatment again.
Will hospice help my family after I die?
Yes. Medicare hospice includes bereavement counseling and support for your family for up to 13 months after your death. This may include individual counseling, support groups, or referrals to grief resources. The hospice social worker or chaplain can discuss what is available through your provider.
Can I use hospice if I have Medicare Advantage instead of Original Medicare?
Yes, but the process is different. Medicare Advantage plans must cover hospice, but you work with your plan's hospice network. Call your plan to ask which hospice providers are in-network and how to enroll. Some Medicare Advantage plans have restrictions on which providers you can use, so check before you choose.