Medicare covers most of the cost of hospice care when a doctor says you have six months or less to live
Medicare Part A pays for hospice services once your doctor and a hospice medical director both agree that you are in the final stages of a terminal illness. You do not pay a monthly premium for hospice, and Medicare covers the full cost of most services — doctors, nurses, medications related to your terminal condition, equipment, and counseling. You will pay nothing for hospice-covered services, though you may have small out-of-pocket costs for some items.
The catch is that choosing hospice means you are choosing comfort care instead of curative treatment. Medicare will still pay for treatment of unrelated conditions — for example, if you have diabetes, Medicare covers that care — but it will not pay for aggressive treatment aimed at curing your terminal illness. This is a real choice with real consequences, and it is one you make with your doctor, not something Medicare decides for you.
Key Takeaways
- Medicare Part A covers hospice care at no cost to you once two doctors agree your terminal illness will likely end your life within six months.
- Covered services include nursing care, doctors, medications for your terminal condition, medical equipment, counseling, and aide services — all paid in full by Medicare.
- You can stop hospice care at any time and return to curative treatment, and Medicare will resume covering those treatments.
- Hospice can be provided at home, in a nursing facility, hospital, or dedicated hospice center, and Medicare covers all settings the same way.
- You are responsible for any costs related to treatment of conditions unrelated to your terminal illness, just as you would be under regular Medicare.
What Medicare pays for in hospice
Medicare Part A covers the full cost of hospice services with no deductible and no copay. The services included are: nursing care provided by registered nurses and licensed practical nurses; doctor visits; medications prescribed for your terminal condition; medical equipment and supplies like oxygen, wheelchairs, and hospital beds; home health aide services; counseling for you and your family, including grief counseling after death; and inpatient respite care — a short hospital or facility stay so your regular caregiver can rest.
Medications are covered only if they treat symptoms of your terminal illness or manage pain. If you take a blood pressure medication unrelated to your hospice diagnosis, that cost falls to you under your regular Medicare Part D prescription drug plan, the same as it would if you were not in hospice. The same rule applies to other treatments: Medicare hospice covers what relates to your terminal condition, and your regular Medicare coverage applies to everything else.
Bereavement counseling is covered for your family members for up to 13 months after your death. This is one of the few hospice benefits that extends beyond the patient and is often overlooked by families who could use the support.
Where you can receive hospice care
Hospice can be delivered in your home, in a nursing home, in a hospital, or in a dedicated hospice facility. Medicare covers the full cost in all four settings. Most hospice care happens at home, with nurses and aides visiting on a schedule you and your hospice team set. If you live alone or your caregiver becomes overwhelmed, you can move to a facility without losing coverage or restarting the process.
If you are already in a nursing home or hospital when you choose hospice, Medicare continues to pay the facility to provide your room and board, and the hospice agency provides the medical care. You do not pay the facility separately. If you are at home, Medicare does not pay for room and board — only the medical services — so you continue to pay your rent or mortgage as usual.
How the six-month timeline works
The six-month rule is a medical judgment, not a hard important date. Your doctor estimates whether your condition will likely end your life within that time. If you live longer than six months, you can continue in hospice as long as your doctor still believes you are in the final stages of your illness. Medicare will recertify your hospice care every 60 days in the first year, then every 90 days after that. If you improve or your condition changes, your doctor may recommend returning to curative care, and Medicare will cover that instead.
The six-month estimate is also not a prediction of exactly when you will die. Some people live weeks, some live months longer than expected. The point is that hospice is for people whose illness is no longer expected to improve, not for people pursuing treatment aimed at a cure.
What you pay out of pocket
You pay nothing for hospice-covered services. However, you remain responsible for costs unrelated to your terminal condition. If you have a regular Medicare Part B copay for an unrelated doctor visit, you still owe it. If you take a medication for a chronic condition that is not part of your hospice diagnosis, your Part D plan applies and you pay your usual copay or coinsurance.
Some hospice agencies offer services that Medicare does not cover — for example, certain complementary therapies or services beyond what Medicare defines as hospice. If a hospice team recommends something not covered, they must tell you the cost upfront. You can choose to pay for it yourself, or decline. This is rare, and most hospice care is fully covered.
How to start hospice care
Your doctor initiates the hospice conversation. Once you and your doctor agree that hospice is right for you, your doctor refers you to a hospice agency. You can choose which agency provides your care — you are not locked into one. The hospice agency will contact you, explain their services, and ask you to sign a consent form. You do not need to contact Medicare; the hospice agency handles all the paperwork with Medicare on your behalf.
Before hospice begins, you will meet with the hospice team — usually a nurse, social worker, and doctor — to discuss your goals, your symptoms, and what care looks like. This is the time to ask questions about what is and is not covered, where you will receive care, and how often staff will visit. If you are unhappy with the agency, you can switch to a different one at any time.
Stopping hospice and returning to curative care
You can stop hospice care whenever you choose. If you decide you want to pursue treatment aimed at curing your illness, you tell your hospice team and they discharge you. Medicare when ready resumes covering curative treatment under your regular Part A and Part B benefits. There is no penalty, no waiting period, and no loss of coverage. Your doctor will need to document that you are no longer in the final stages of your illness, but that is a medical conversation, not a Medicare process.
Some people stop hospice temporarily — for example, to try a new treatment — and then return to hospice later. This is allowed. Each time you enter hospice, Medicare requires two doctors to agree on the six-month prognosis, but the process is the same as the first time.
Frequently Asked Questions
Does Medicare cover hospice for children?
Yes. Medicare covers hospice for people of any age with a terminal illness expected to end life within six months. The same rules explore: no cost to the family, coverage of medical care and counseling, and the choice to stop at any time.
What if I want to continue seeing my regular doctor while in hospice?
You can. Your regular doctor can continue to see you and coordinate with your hospice team. However, if your regular doctor is not part of the hospice agency, Medicare pays the hospice agency for your care, not your doctor separately. Your doctor can be involved in your care plan without being the one billing Medicare.
Does Medicare cover hospice if I am in a hospital?
Yes. If you are hospitalized and you and your doctor decide on hospice, Medicare covers it. The hospital provides your room and board, and the hospice team provides medical care. You do not pay anything for either.
Can my family get paid to be my hospice caregiver?
Medicare does not pay family members to provide care. However, Medicare does pay for professional home health aides, nurses, and other staff. If a family member is your primary caregiver, you can use respite care — a covered benefit where you stay in a facility for a few days so your caregiver can rest.
What happens to my prescriptions when I start hospice?
Medications related to your terminal condition are covered by Medicare hospice at no cost. Medications for other conditions are covered by your Part D prescription drug plan, and you pay your usual copay. Talk to your hospice team about which medications fall into each category.