Medicare covers hospice care when a doctor says you have six months or less to live
Medicare Part A pays for hospice care without a copay or deductible once you meet two conditions: a doctor must certify that you are terminally ill with a life expectancy of six months or less, and you must choose to receive hospice instead of curative treatment. Medicare then covers the full cost of hospice services — nursing, doctors, medications for comfort, counseling, and equipment — through your hospice provider.
The six-month timeline is an estimate, not a important date. Some people live longer than six months after starting hospice; others live shorter. If you live past six months, you can continue receiving hospice as long as your doctor recertifies that you still meet the criteria. If your condition improves and you want to pursue treatment again, you can leave hospice and return to regular Medicare coverage.
Key Takeaways
- Medicare Part A covers all hospice costs with no copay or deductible once a doctor certifies you have six months or less to live.
- You must choose hospice care instead of curative treatment, but you can change your mind and leave hospice at any time.
- Hospice covers nursing, doctors, medications, equipment, and counseling — but not room and board if you live in a facility that is not a hospice residence.
- Your hospice provider must be Medicare-certified, and you should ask your doctor or hospital social worker for a referral to one in your area.
- If you live longer than six months, your doctor can recertify you to continue hospice coverage.
What Medicare hospice coverage includes
Medicare Part A pays for a broad range of services once you are enrolled in a Medicare-certified hospice program. These services include visits from nurses and doctors, medications related to your terminal illness and comfort care, medical equipment such as wheelchairs and oxygen, home health aide services, and counseling for you and your family — including grief counseling after death.
The hospice team also arranges for inpatient care if you need it. If your symptoms cannot be managed at home, Medicare covers a short hospital stay in a hospice inpatient facility or a contracted hospital bed. This is different from general hospital care and is part of your hospice benefit.
One important limit: if you live in a nursing home or assisted living facility, Medicare hospice covers the hospice services but not the room and board charges from the facility itself. You or your family remain responsible for the facility's daily rates. If you move to a dedicated hospice residence (a freestanding hospice facility), Medicare covers both the care and the room and board.
How to start hospice through Medicare
The first step is a conversation with your doctor. Your doctor must be the one to initiate the hospice discussion and make the referral. If you or a family member think hospice might be right, ask your doctor directly: "Do you think I might benefit from hospice care?" or "How much time do you think I have left?" Your doctor can then refer you to a hospice provider.
Your hospital social worker, discharge planner, or oncology nurse can also help arrange a hospice referral if you are in a hospital or receiving cancer treatment. Many hospice providers have intake coordinators who will come to your home or hospital to explain the program and answer questions before you decide.
Once you choose a Medicare-certified hospice provider, you sign a consent form stating that you understand you are choosing comfort care instead of curative treatment. This does not mean you cannot change your mind — you can leave hospice at any time and return to regular Medicare coverage if your condition improves or if you want to try treatment again.
The difference between hospice and palliative care
Palliative care focuses on comfort and managing symptoms but does not require a terminal diagnosis or a choice between comfort care and treatment. You can receive palliative care while still pursuing curative treatment, and Medicare covers it through Part B (doctor visits) and Part A (inpatient stays). Palliative care is often available earlier in an illness.
Hospice care is a specific Medicare benefit that requires a terminal diagnosis and a choice to focus on comfort rather than cure. It is more comprehensive than palliative care and covers more services at no cost to you. If your doctor says you have six months or less to live and you want to focus on comfort, hospice is usually the better choice because of the broader coverage and the lack of copays.
What happens if you live longer than six months
The six-month prognosis is a medical estimate based on your condition at the time you enroll. Some people live much longer. If you are still alive after six months and still meet the criteria for hospice (meaning your condition has not improved and you still have a terminal illness), your doctor can recertify you. Medicare will continue to cover your hospice care for another benefit period.
Recertification happens automatically if your hospice provider submits the paperwork, but you should ask your hospice team whether recertification has been completed. If your condition improves significantly — for example, if you respond well to treatment or your symptoms resolve — you may no longer meet the criteria, and your hospice coverage would end. At that point, you would return to regular Medicare coverage.
Costs you may still owe
Medicare hospice covers the full cost of hospice services with no deductible or copay for covered services. However, you may have out-of-pocket costs in a few situations. If you live in a nursing home or assisted living facility, you remain responsible for the facility's room and board charges. If you need medications or treatments unrelated to your terminal illness, those may not be covered by hospice and could be billed to you.
You also keep your Medicare Part B premium, which continues to be deducted from your Social Security check. Some people choose to keep supplemental insurance (Medigap) or Medicare Advantage plans while on hospice, though this is optional. Ask your hospice provider and your Medicare plan what costs, if any, you might see.
Choosing a hospice provider
Medicare requires that your hospice provider be Medicare-certified. You have the right to choose which certified provider you want, and your doctor can help you find one. Ask your doctor, hospital social worker, or call your state hospice organization to find providers in your area. Many areas have multiple options, and you can interview providers before deciding.
When choosing, ask about their availability (do they have staff available 24/7?), their experience with your condition, whether they can serve you in your home or if they have inpatient facilities, and what languages they speak. You can also ask whether they are part of a larger health system or independent. All of these factors affect the quality of care you receive.
Frequently Asked Questions
Can I stay in my home while on hospice?
Yes. Most hospice care happens at home, and Medicare covers all services provided there. Your hospice team visits regularly, and you can call 24/7 if you need help. If symptoms become hard to manage at home, hospice can arrange an inpatient stay in a hospice facility or hospital bed.
What if I change my mind and want to leave hospice?
You can leave hospice at any time and return to regular Medicare coverage. You do not need permission or a reason. If you want to pursue treatment again, tell your hospice provider and your doctor, and they will help you transition back to curative care.
Does hospice mean I have to stop all medications?
No. Hospice covers medications that help with comfort and manage symptoms of your terminal illness. Medications for other conditions may continue if they support your comfort. Your hospice doctor will review all your medications and adjust them based on your goals.
Will hospice help my family after I die?
Yes. Medicare hospice includes grief counseling and bereavement support for your family for up to 13 months after your death. This is provided by the hospice team at no cost.
What if my doctor will not talk about hospice?
You can bring it up yourself or ask another doctor — your primary care doctor, a specialist, or a palliative care doctor. You can also call your local hospice organization or your state health department for information about hospice in your area and how to start a conversation with your medical team.