Medicare Part A covers hospice care, not Part B

Medicare Part A is the part that pays for hospice. Part B covers doctor visits and outpatient services, but hospice is bundled into Part A because it is an inpatient benefit — even though you receive it at home. If you have Part A, hospice is covered. If you do not have Part A, you will need to enroll or find another way to pay.

The coverage is straightforward once you are enrolled: Part A pays for the hospice team (nurses, aides, social workers, chaplains), medications related to your terminal condition, medical equipment, and bereavement counseling for your family after death. You pay nothing out of pocket for these services. There is no copay, coinsurance, or deductible for hospice under Part A.

One important detail: you must have a doctor's statement that you have six months or less to live, and you must choose to receive hospice care instead of curative treatment. This is not a decision Medicare makes for you — it is a choice you and your doctor make together.

Key Takeaways

  • Medicare Part A covers all hospice services, including nursing, aides, medications, equipment, and counseling — with no copay or deductible.
  • You must have Part A enrollment and a doctor's prognosis of six months or less to live to receive hospice coverage.
  • Choosing hospice means you are choosing comfort care over curative treatment, and you can change your mind at any time.
  • If you do not have Part A, you can enroll during the General Enrollment Period (January 1 to March 31 each year), though a late enrollment penalty may explore.
  • Hospice can be provided at home, in a nursing home, hospital, or hospice facility — Part A covers it in all settings.

How Part A hospice coverage works in practice

When you and your doctor decide hospice is right for you, your doctor refers you to a hospice agency. That agency handles everything: they send the nurses and aides, they manage your medications, they arrange the equipment you need. You do not bill Medicare yourself — the hospice agency does. Part A pays them directly.

The hospice team typically visits your home several times a week, though the schedule depends on your needs. If you are in a nursing home or hospital, the hospice team coordinates with that facility's staff. You can receive hospice services in any setting — your own home, a family member's home, a nursing facility, a hospital, or a dedicated hospice center.

Part A covers medications that manage your symptoms — pain, nausea, shortness of breath, anxiety. It does not cover medications meant to cure your terminal illness. It also covers medical equipment like hospital beds, wheelchairs, oxygen, and wound care supplies. If you need inpatient care for pain management or symptom control that cannot be handled at home, Part A covers a short stay in a hospice facility or hospital.

What happens if you do not have Part A

If you turned down Part A when you first became may be able to access for Medicare at 65, or if you let your enrollment lapse, you can still enroll. The General Enrollment Period runs from January 1 to March 31 each year, and coverage begins the first day of the month after you enroll.

However, if you enroll late — meaning you did not sign up during your initial may be able to access window or during a General Enrollment Period — you may owe a late enrollment penalty. This is a permanent increase to your Part A premium. The penalty is 10 percent of the standard premium for each full 12-month period you were may be able to access but did not enroll. If you were may be able to access for eight years and did not enroll, your penalty would be 80 percent on top of the regular premium.

If you need hospice before you can enroll in Part A, talk to the hospice agency about other payment options. Some agencies can work with Medicaid, private insurance, or out-of-pocket payment while you complete Part A enrollment.

Part B does not cover hospice, but it covers related services

Part B pays for doctor visits and outpatient care, but it does not pay for hospice itself. However, Part B does cover some services related to your end-of-life care that are separate from hospice. For example, if you see your regular doctor for a non-hospice reason while you are receiving hospice care, Part B covers that visit.

Part B also covers certain medications you pick up at a pharmacy that are not related to your terminal condition — for instance, a blood pressure medication you have taken for years. Part A hospice covers medications for symptom management of your terminal illness, and Part B covers other medications you may still need.

The key distinction: Part A is the hospice benefit itself. Part B is everything else Medicare covers that you might still use while receiving hospice.

Choosing hospice does not mean giving up all other Medicare coverage

A common worry is that choosing hospice means you lose access to other doctors or treatments. That is not true. You can still see your regular doctor. You can still go to the hospital if you have an acute problem unrelated to your terminal condition. You can change your mind about hospice at any time and go back to curative treatment.

What changes is the focus. When you are on hospice, the goal shifts from treating the underlying illness to managing pain and maintaining quality of life. But you are not locked in. If you decide you want to pursue treatment again, you can stop hospice and restart curative care. Part A will cover both.

Your hospice team — the nurse, social worker, and doctor — work with your regular doctors to make sure everything is coordinated. Part A pays for all of this coordination.

Hospice coverage in different settings

Part A covers hospice the same way regardless of where you receive it. If you stay in your own home, Part A pays the hospice agency. If you move to a nursing home and receive hospice there, Part A still pays — the nursing home's regular charges are separate, and Part A covers the hospice services on top of that. If you need inpatient hospice care in a dedicated facility or hospital, Part A covers that too.

The hospice agency will tell you what settings are available in your area. Many people receive hospice at home with family nearby. Others prefer a hospice facility where staff are present 24 hours a day. Part A covers both, so the choice is yours and your family's.

Bereavement support is included in Part A hospice coverage

After you pass away, Part A continues to cover bereavement counseling for your family for up to 13 months. This is provided by the hospice agency's social workers and chaplains. There is no additional cost, and your family does not need to be Medicare beneficiaries themselves to receive this support.

Bereavement services might include individual counseling, support groups, or spiritual care. The hospice agency will explain what they offer and how to access it.

Frequently Asked Questions

Do I have to pay anything out of pocket for hospice under Part A?

No. Part A hospice coverage has no copay, coinsurance, or deductible. You pay nothing for the hospice services themselves. You may have other Medicare costs unrelated to hospice — for example, Part B premiums or medications covered by Part B — but hospice itself is fully covered.

Can I receive hospice if I do not have a terminal diagnosis?

No. Medicare requires a doctor to certify that you have a terminal illness with a prognosis of six months or less to live. The hospice team and your doctor review this periodically. If you live longer than six months, you can continue receiving hospice as long as your doctor still believes the prognosis is appropriate.

What if I change my mind about hospice?

You can stop hospice at any time and resume curative treatment. Part A will cover both. There is no penalty for changing your mind. If you stop hospice and later want to restart it, you can do that too — your doctor just needs to recertify the terminal diagnosis.

Does Part A hospice cover medications for conditions other than my terminal illness?

Part A hospice covers medications related to managing symptoms of your terminal condition. Other medications — for blood pressure, diabetes, or other ongoing conditions — are typically covered by Part B if you have it, or you may pay out of pocket. Talk to your hospice team and doctor about which medications fall into each category.

If I am in a nursing home, does Part A cover both the nursing home and hospice?

Part A covers hospice services separately from nursing home care. If you are on Medicare and in a nursing home, Part A covers skilled nursing care up to 100 days per benefit period. Hospice is a separate benefit. The two can run at the same time, and Part A pays for both, though the rules about how long you can stay in the nursing home may change once you elect hospice.