Medicare Hospice Covers End-of-Life Care When Your Doctor Says You Have Six Months or Less to Live
Medicare hospice is a benefit that pays for comfort care — not curative treatment — when you and your doctor agree that you are in the final stages of a terminal illness. The program covers medical services, medications, equipment, and support for both you and your family. Medicare pays the hospice provider directly, and you typically pay nothing out of pocket for covered services.
The catch is that choosing hospice means you stop pursuing treatments meant to cure or extend your life. You can still receive pain relief, symptom management, and emotional support. If your condition improves or you change your mind, you can leave hospice and return to standard Medicare coverage.
Key Takeaways
- Medicare hospice covers doctor visits, nursing care, medications, medical equipment, counseling, and respite care — all related to your terminal diagnosis.
- You must have a doctor's written statement that you have a terminal illness with a prognosis of six months or less to live.
- You choose a Medicare-certified hospice provider, and your regular Medicare coverage pauses while you are on hospice.
- You pay nothing for hospice services covered by Medicare, though you may pay a small copay for medications and respite care in some cases.
- If you recover or want to pursue curative treatment again, you can revoke hospice and return to standard Medicare coverage.
What Services and Supplies Medicare Hospice Covers
Medicare hospice covers a wide range of services centered on comfort and quality of life. These include doctor visits, nursing care (including 24-hour on-call availability), medical social work, counseling, and spiritual care. The program also pays for medications related to your terminal condition, medical equipment like hospital beds and wheelchairs, and supplies such as wound dressings and incontinence products.
Hospice also covers respite care — short-term inpatient care that gives your family caregiver a break. Medicare covers up to five consecutive days of respite care per stay. Additionally, the program pays for bereavement counseling for your family for up to 13 months after your death.
What hospice does not cover: treatments meant to cure your illness, hospitalization for curative care, or services unrelated to your terminal diagnosis. If you need surgery or chemotherapy, those fall outside hospice and would require you to revoke the benefit and return to standard Medicare.
Who Can Receive Medicare Hospice
To receive Medicare hospice, you must meet three conditions. First, you must be enrolled in Medicare Part A. Second, your doctor and the hospice medical director must agree in writing that you have a terminal illness with a life expectancy of six months or less if the illness runs its normal course. Third, you must sign a statement saying you understand that choosing hospice means you are not pursuing curative treatment for that illness.
The six-month prognosis is not a hard important date. If you live longer than six months, you can continue hospice as long as your doctor recertifies that you still meet the criteria. Some people remain on hospice for a year or more. Conversely, if your condition improves unexpectedly, you can leave hospice at any time.
How to Start Medicare Hospice and Choose a Provider
The process begins with a conversation between you and your doctor. Your doctor must write an order for hospice care and document that you have a terminal illness. You then choose a Medicare-certified hospice provider — you can ask your doctor for recommendations, or you can search the Medicare Hospice Compare tool on Medicare.gov to see providers in your area and their performance ratings.
Once you have chosen a provider, the hospice agency will contact you to schedule an intake appointment. During intake, they will review your medical history, discuss your wishes and goals, and explain what services they provide. You will sign consent forms, including the statement that you understand hospice is comfort-focused care, not curative treatment.
After intake, your hospice team — which typically includes a doctor, nurse, social worker, and chaplain — will develop a care plan tailored to your needs. Your regular Medicare coverage pauses while you are on hospice, though you keep your Medicare card and your Part B coverage for services unrelated to your terminal illness.
What You Pay for Hospice Services
Medicare hospice is covered at no cost to you for most services. You do not pay a copay, coinsurance, or deductible for doctor visits, nursing, medications, equipment, or counseling related to your terminal diagnosis. This is one of the most generous benefits Medicare offers.
There are two small exceptions. If you use respite care, you may be charged a copay of up to five percent of the Medicare payment for that stay, though many hospice providers waive this fee. If you need a medication that is not related to your terminal illness — for example, a blood pressure medication for a chronic condition — you may owe a copay under your Part D prescription drug plan.
If you have supplemental insurance (Medigap) or a Medicare Advantage plan, those policies may also contribute to your hospice costs, though in most cases there is nothing left for you to pay after Medicare covers the service.
How Hospice Affects Your Other Medicare Coverage
When you start hospice, your regular Medicare benefits pause. You cannot use Medicare to pay for hospital stays, doctor visits, or treatments for your terminal illness while you are on hospice. However, you keep your Medicare coverage for services unrelated to your terminal diagnosis — for example, if you break your arm, Medicare will still cover the emergency room visit and treatment.
If you decide to leave hospice and pursue curative treatment again, you can revoke the hospice benefit at any time. Your regular Medicare coverage resumes when ready. There is no penalty for changing your mind, and you can re-enroll in hospice later if your condition changes.
Your Part D prescription drug plan remains active while you are on hospice, but the hospice provider will manage medications related to your terminal illness. Any medications not related to your terminal diagnosis will be covered under your Part D plan as usual.
Common Reasons People Leave Hospice or Change Providers
Some people leave hospice because their condition improves or stabilizes longer than expected. Others revoke hospice because they or their family decide to pursue additional treatment. A smaller number switch to a different hospice provider if they are unhappy with the care or support they are receiving.
If you want to leave hospice, you can notify your provider verbally, though it is wise to follow up in writing. Your regular Medicare coverage resumes the day you revoke hospice. If you switch providers, the new hospice agency will handle the paperwork with Medicare — you do not need to contact Medicare directly.
If you are unhappy with your hospice provider, you have the right to change. You can ask your doctor for a referral to another Medicare-certified hospice, or you can use the Medicare Hospice Compare tool to research other options in your area. The transition typically takes a few days.
Frequently Asked Questions
Does Medicare hospice cover care at home, in a nursing home, or in a hospital?
Medicare hospice covers care in all three settings. Most hospice care happens at home, with nurses and aides visiting regularly. If you live in a nursing home or assisted living facility, hospice services can be provided there. Hospice can also arrange inpatient care in a hospital or hospice facility if your symptoms become difficult to manage at home.
What happens if I live longer than six months?
You can stay on hospice as long as your doctor recertifies that you still have a terminal illness. Medicare will continue to cover your care. There is no time limit — some people remain on hospice for a year or longer. If your condition improves significantly, your doctor may recommend leaving hospice.
Can my family be present during hospice care?
Yes. Hospice encourages family involvement and provides support for both you and your loved ones. The hospice team includes social workers and chaplains who can help your family understand what to expect and process their feelings. Bereavement counseling is also covered for your family for up to 13 months after your death.
Do I have to use a specific hospice provider, or can I choose?
You choose your hospice provider. Medicare does not assign you to a particular agency. You can ask your doctor for recommendations, search the Medicare Hospice Compare tool, or contact your local Area Agency on Aging for suggestions. If you are unhappy with your choice, you can switch to a different Medicare-certified provider.
What if I change my mind about hospice?
You can revoke hospice at any time, for any reason, with no penalty. Your regular Medicare coverage resumes when ready. If your condition worsens again and you want to return to hospice, you can re-enroll. There is no limit to how many times you can change your mind.