Yes, Medicare covers hospice care at home under Part A, but only when a doctor certifies you are terminally ill with six months or less to live
Medicare Part A pays for hospice care delivered in your home, a hospice facility, a hospital, or a nursing home — but the coverage comes with a specific condition. A doctor must document that you have a terminal illness and a life expectancy of six months or less. This is not a prediction of exactly when death will occur; it means the doctor believes the disease will likely cause death within that timeframe if it follows its natural course.
When you choose hospice, you are also choosing to stop pursuing curative treatment for your terminal condition. Medicare will not pay for both hospice and active treatment aimed at curing or reversing the illness at the same time. You can still receive treatment for pain, symptoms, and conditions unrelated to the terminal diagnosis.
Home hospice is the most common setting, and Medicare covers the full cost of the hospice team's visits, medications related to your terminal condition, medical equipment, and counseling — with no copayments or deductibles for hospice services themselves.
Key Takeaways
- Medicare Part A covers hospice care at home when a doctor certifies a terminal illness with a life expectancy of six months or less.
- You must choose hospice instead of curative treatment for your terminal condition, though you can still treat unrelated illnesses and manage pain.
- Home hospice services covered by Medicare include nursing visits, aide care, medications for symptom management, equipment, and grief counseling — with no out-of-pocket costs for these services.
- Your doctor or hospital social worker can refer you to a Medicare-certified hospice provider, or you can contact one directly to discuss whether you meet the requirements.
- If your condition improves and you no longer meet the six-month prognosis, you can leave hospice and return to curative treatment without losing Medicare coverage.
What Medicare hospice coverage actually includes
Medicare Part A covers the full cost of services provided by a Medicare-certified hospice provider. This means no copayment, coinsurance, or deductible for hospice-related care. The coverage includes nursing care from a registered nurse or licensed practical nurse, home health aide services for personal care and hygiene, social work and counseling, chaplain services, and bereavement support for your family after death.
Medications prescribed to manage pain and symptoms of your terminal illness are covered. Medical equipment such as a hospital bed, oxygen, wheelchairs, and wound care supplies are included. Hospice also covers short-term inpatient care if symptoms cannot be managed at home, and respite care — a brief hospital or facility stay to give your family caregiver a break.
What Medicare hospice does not cover: treatment aimed at curing or reversing the terminal illness, hospitalization for aggressive treatment, dialysis, chemotherapy, or radiation therapy for the terminal condition. If you need treatment for a separate, non-terminal condition — such as antibiotics for an infection or surgery for a broken bone — Medicare may cover that through Part A or Part B, depending on the setting and your situation.
How to start the hospice process
The first step is a conversation with your doctor about whether hospice is right for you. Your doctor does not have to initiate this; you or a family member can bring it up. If your doctor agrees that you have a terminal illness with a prognosis of six months or less, they will write an order for hospice care.
Your doctor, hospital social worker, or discharge planner can refer you to a specific hospice provider, or you can contact a Medicare-certified hospice agency directly. To find providers in your area, call 1-800-MEDICARE or visit Medicare.gov and search for hospice providers by location. When you contact a hospice agency, they will send a nurse to assess whether you meet Medicare's criteria and discuss what services they offer.
Once you have chosen a provider and the initial assessment is complete, you will sign a consent form. The hospice agency will coordinate with your doctor to confirm the terminal diagnosis and prognosis. Medicare coverage begins on the date the hospice provider receives the signed physician order — not the date you call or visit.
The six-month prognosis requirement and what happens if you live longer
The "six months or less" requirement is based on the doctor's medical judgment, not a may provide. Some people live longer than the initial prognosis; others live shorter. If you live beyond six months, Medicare can continue to cover your hospice care as long as your doctor recertifies that you still have a terminal illness and a life expectancy of six months or less.
Recertification happens at specific intervals: the first recertification occurs after 90 days, then every 60 days after that. Your hospice provider handles the paperwork with your doctor; you do not have to reapply. If at any point your condition improves significantly — for example, if a treatment works better than expected — your doctor may determine you no longer meet the prognosis requirement. At that point, you can leave hospice and return to curative treatment without losing Medicare coverage.
If you choose to leave hospice before death, you can do so at any time. Medicare will stop paying for hospice services, but your Part A and Part B coverage for other care continues normally.
Your costs and what you pay out of pocket
There is no copayment, coinsurance, or deductible for hospice services covered by Medicare Part A. This applies to nursing, aide care, social work, chaplain services, bereavement counseling, medications for symptom management, and medical equipment related to your terminal condition.
You may have out-of-pocket costs in limited situations. If you need a medication or service that is not related to your terminal illness — such as a prescription for high blood pressure or a dental procedure — that cost may fall under Part B or may not be covered at all, depending on what it is. Some hospice providers charge a small copayment (usually $5 per prescription) for non-pain medications, though many waive this fee.
If you are in a hospice facility rather than at home, you may be charged up to one day's room and board cost if you stay longer than 14 days in a row, though this is rare and many facilities do not charge it. Ask your hospice provider about their specific charges before you enroll.
Choosing between home hospice and facility-based hospice
Home hospice means the hospice team comes to you — typically a nurse visit once or twice a week, more often if symptoms worsen, plus aide visits for bathing and personal care. You remain in your own home with family nearby. This requires a family member or paid caregiver to be present most of the time, since the hospice team does not provide 24-hour in-home care.
A hospice inpatient facility is a dedicated hospice residence where you live full-time and receive 24-hour nursing care. Medicare covers the full cost. This option works if you live alone, if symptoms are hard to manage at home, or if your family caregiver needs relief. Some hospice agencies operate their own facilities; others partner with hospitals or nursing homes that have hospice units.
You can move between settings. Many people start at home and move to a facility if pain or symptoms become difficult to control, or if the caregiver becomes exhausted. Medicare covers both, so the choice is based on what works best for you and your family, not on cost.
Common reasons Medicare denies or stops hospice coverage
Medicare may deny hospice coverage if a doctor does not certify a terminal illness, if the prognosis is longer than six months, or if the person is still pursuing curative treatment for the terminal condition. Some claims are denied because the paperwork is incomplete — for example, the physician order is missing or the doctor's signature is not on file.
Coverage can stop if your condition improves and your doctor determines you no longer meet the six-month prognosis. This is not a penalty; it straightforward means you no longer fit the definition of terminal illness under Medicare rules. You can return to hospice later if your condition declines again.
If you disagree with a denial or a decision to stop coverage, you have the right to appeal. Your hospice provider can help you file an appeal, or you can contact 1-800-MEDICARE to request a review.
Frequently Asked Questions
Can I choose hospice and still see my regular doctor?
Yes. Your regular doctor can remain involved in your care, and the hospice team will coordinate with them. However, your primary medical direction comes from the hospice medical director once you enroll. If you want your regular doctor to oversee your care instead, discuss this with the hospice agency before you enroll.
What if my family disagrees about choosing hospice?
The decision to pursue hospice is yours alone, not your family's. If you have the mental capacity to make medical decisions, your choice stands. If family members have concerns, a social worker or chaplain from the hospice team can meet with everyone to discuss what hospice does and does not do, which often helps clarify misconceptions.
Does Medicare cover hospice if I have a secondary insurance plan?
Yes. Medicare Part A is the primary payer for hospice services. If you have a secondary insurance plan such as Medigap or a retiree plan, it may cover some costs, but Medicare covers the full hospice benefit first. Contact your secondary insurer to ask what they cover.
Can I change hospice providers if I am not satisfied?
Yes. You can switch to a different Medicare-certified hospice provider at any time. Notify your current provider in writing, and contact the new provider to arrange the transfer. Medicare coverage continues without interruption.
What happens to my Medicare coverage if I leave hospice?
Your Part A and Part B coverage resumes normally. You can pursue curative treatment again, and all standard copayments and deductibles explore to non-hospice care. If your condition declines later, you can return to hospice without penalty.