Medicare covers hospice care when a doctor believes you have six months or less to live, and you choose comfort care instead of treatment aimed at cure
Yes, Medicare Part A covers hospice. The coverage is broad — it includes nursing visits, doctor care, medications related to your terminal condition, medical equipment, counseling, and aide services. You do not pay a copay or coinsurance for hospice services themselves. What matters most is that your doctor and the hospice medical director both agree that your condition is terminal, and that you sign a form saying you want hospice instead of curative treatment.
The "six months or less" rule is a guideline, not a hard important date. Doctors estimate how long someone might live based on their diagnosis and how their body is responding. Some people live longer than that estimate; some live shorter. Medicare does not discharge you if you pass the six-month mark. What does happen is that your doctor and the hospice team review your condition every so often — usually every 60 days — and if you are getting better or your condition has changed, they may recommend stopping hospice and going back to regular Medicare coverage.
Key Takeaways
- Medicare Part A pays for hospice care when a doctor certifies you are terminally ill, with no copays or coinsurance for hospice services.
- You must choose hospice care instead of curative treatment, though you can change your mind and go back to regular Medicare at any time.
- Hospice covers nursing, doctor visits, medications for your condition, equipment, counseling, and aide help — but not room and board if you are in a facility that is not a hospice residence.
- You choose which hospice agency provides your care; Medicare does not assign you to one.
- If you live longer than six months, Medicare continues to cover hospice as long as your doctor recertifies that you remain terminally ill.
What Medicare Hospice Coverage Actually Includes
Medicare Part A pays for a defined set of services. A hospice nurse can visit your home to manage pain, check on your symptoms, and teach family members how to help. A doctor — either your own or the hospice medical director — oversees your care plan. Medications prescribed for your terminal illness are covered, including pain medication and anti-nausea drugs. Medical equipment such as a hospital bed, oxygen, or a wheelchair comes at no cost to you.
Counseling is included: social workers and chaplains (or other spiritual counselors) can visit to help you and your family talk through what is happening. Home health aides can help with bathing, dressing, and personal care. Bereavement counseling for your family continues for about a year after you die. Inpatient respite care — a short hospital or hospice stay to give your family a break — is covered for up to five days at a time.
What Medicare hospice does not cover is room and board if you are living in a nursing home, assisted living facility, or other residential setting. If you are in your own home, there is no room-and-board charge. If you are in a hospice residence (a facility run by the hospice agency itself), Medicare covers the hospice services but not the cost of the bed and meals — though some hospice agencies absorb that cost or work with Medicaid to cover it.
How to Start Hospice Through Medicare
Your doctor must refer you. This is the first step — you cannot start hospice on your own. Talk to your doctor about whether hospice might be right for you. If your doctor agrees, they will write an order and send it to a hospice agency. If you do not have a doctor, or your doctor is not willing to refer you, you can ask a hospital social worker, a nurse, or a family member to help you find a doctor who will evaluate you for hospice.
You then choose which hospice agency you want. Medicare does not assign you to one. You can ask your doctor for recommendations, call your local Area Agency on Aging, or search the Medicare Hospice Compare tool on Medicare.gov to see which agencies serve your area and what families say about them. Once you have chosen an agency, they will schedule an intake visit. A hospice nurse and social worker will come to your home (or wherever you are), talk with you about your wishes, review your medical history, and explain what hospice care looks like.
You will sign consent forms, including one that says you understand you are choosing comfort care over treatment aimed at cure. You can change your mind at any time — if you decide you want to go back to regular Medicare and try treatment again, you can. Your hospice coverage ends, and your regular Medicare benefits resume.
The Role of Your Doctor and the Hospice Medical Director
Two doctors must agree that you are terminally ill before Medicare will pay. Your own doctor (if you have one) makes the first information. The hospice medical director — a doctor employed by or contracted with the hospice agency — makes the second. They review your medical records, your diagnosis, and your current condition, and they sign off that you meet Medicare's definition of terminal illness.
After you start hospice, your care plan is reviewed regularly. Every 60 days, the hospice medical director and your doctor (or the hospice doctor if you do not have your own) must recertify that you still have a terminal illness. If your condition improves or changes — for example, if a new treatment becomes available and you want to try it — either you or your doctor can ask to stop hospice. There is no penalty for stopping, and you can restart later if you change your mind again.
What Happens If You Live Longer Than Six Months
The six-month estimate is not a limit. Medicare will continue to pay for hospice as long as your doctor recertifies every 60 days that you remain terminally ill. Some people live in hospice for a year or more. Others live only a few weeks. The timeline depends on your specific illness and how your body responds.
What does change after the first 60 days is the paperwork. Your doctor must document why they still believe you are terminal — what symptoms you have, how your condition has progressed, and why curative treatment is no longer appropriate. This recertification is required by Medicare, but it is usually done by phone or review of your chart; you do not have to do anything. If at any point your doctor believes you are no longer terminally ill, they will discuss that with you and the hospice team, and you can decide whether to continue hospice or switch back to regular care.
Costs You Might Still Owe
Hospice services covered by Medicare have no copay or coinsurance. However, you are still responsible for your Part B deductible if you have not met it yet — though most people on hospice have already met their deductible. You also still pay your Medicare Part B premium (the monthly amount deducted from your Social Security check).
If you are in a nursing home or assisted living facility and want hospice, the facility's room-and-board charges are your responsibility unless Medicaid covers them. Some hospice agencies will negotiate with the facility or help you understand what Medicaid might cover. Ask the hospice intake coordinator about this before you start.
Medications not related to your terminal condition are still covered under your regular Medicare prescription drug plan (Part D), not by hospice. For example, if you are on hospice for advanced cancer but also take a blood pressure medication, that blood pressure medication is covered by Part D, not hospice.
Choosing a Hospice Agency and What to Ask
You have the right to choose which hospice agency provides your care. Start by asking your doctor for recommendations, or use the Medicare Hospice Compare tool at Medicare.gov to see agencies in your area. You can also call your local Area Agency on Aging — they keep lists of hospice providers and can tell you which ones have good reputations locally.
When you talk to an agency, ask how often nurses visit, whether they are available 24/7 if you have an emergency, what their experience is with your specific diagnosis, and whether they have chaplains, social workers, and aides on staff. Ask whether they have worked with your insurance (if you have Medicaid or a Medicare Advantage plan in addition to Original Medicare). Ask what families say — many agencies have reviews online, and you can also ask your doctor or hospital social worker what they have heard.
You do not have to decide when ready. It is reasonable to talk to two or three agencies before you choose. Once you start with one agency, you can switch to another if you are not satisfied, though it is best to do this early rather than after weeks of care.
Frequently Asked Questions
Can I have hospice at home, or do I have to go to a facility?
Most hospice care happens at home. Medicare covers hospice services whether you are in your own home, a family member's home, a nursing home, or a hospice residence. If you are at home, there is no room-and-board cost. If you are in a facility, the facility's daily charges are separate from hospice and are your responsibility unless Medicaid covers them.
What if I change my mind and want to stop hospice?
You can stop hospice at any time, for any reason. Your regular Medicare coverage resumes when ready. If you later decide you want hospice again, your doctor can refer you again. There is no limit to how many times you can start and stop.
Does Medicare cover hospice if I have a Medicare Advantage plan?
Yes. Medicare Advantage plans must cover hospice the same way Original Medicare does. However, you should call your plan before you start to make sure the hospice agency you choose is in their network, or to understand any differences in how they handle the coverage.
Who pays for my funeral or cremation?
Medicare hospice does not cover funeral or cremation costs. Those are your responsibility or your family's. Some hospice agencies can connect you with funeral homes or cremation services and help you understand costs, but the payment comes from your estate or family funds.
Can my family stay with me in hospice?
Yes. Hospice is designed to include family. Most agencies encourage family to be present and teach family members how to help with comfort care. If you are in a hospice residence, family can usually visit at any time, and some agencies allow family to stay overnight.