Medicare covers hospice care when your doctor says you have six months or less to live
Yes, Medicare Part A covers hospice care at no cost to you beyond your regular Part A premium. You do not pay copayments, coinsurance, or deductibles for hospice services covered by Medicare. The program pays for medical care, medications related to your terminal illness, equipment, and support services — but only after your doctor and a hospice medical director both confirm that you are unlikely to live longer than six months.
Hospice is not the same as hospital care or nursing home care. It is a type of care focused on comfort and quality of life rather than cure. Medicare will pay for hospice whether you receive it at home, in a hospice facility, a hospital, or a nursing home. The key requirement is that you and your doctors agree that you want comfort-focused care instead of treatment aimed at extending your life.
Key Takeaways
- Medicare Part A covers all hospice services once your doctor certifies you have six months or less to live, with no copayments or deductibles.
- You must choose hospice care instead of curative treatment — you cannot receive both Medicare-covered hospice and Medicare-covered treatment for your terminal illness at the same time.
- A hospice medical director must review and agree with your doctor's assessment that you meet the six-month prognosis before Medicare will pay.
- You can change your mind and stop hospice care at any time; if you do, Medicare will resume covering curative treatment for your condition.
- Medicare covers hospice medications, equipment, visits from nurses and aides, counseling, and bereavement support for your family for up to 13 months after your death.
What Medicare hospice coverage includes
Medicare Part A pays for a broad range of services under hospice. These include visits from a hospice nurse, home health aide services, social work, chaplain or spiritual counseling, and medications prescribed for your terminal illness or related symptoms. Medicare also covers medical equipment like hospital beds, wheelchairs, oxygen, and wound care supplies.
Hospice also provides respite care — a short stay in a facility to give your family caregiver a break — for up to five days at a time. Medicare covers the cost of this respite stay. Additionally, Medicare pays for bereavement counseling for your family members for up to 13 months after your death, even though you are no longer receiving care.
What Medicare hospice does not cover includes treatments meant to cure your terminal illness, such as chemotherapy or radiation therapy. It also does not cover room and board if you live in a hospice facility — you pay that cost yourself, though some hospices offer financial information or work with Medicaid to cover it.
How to start Medicare hospice care
Your doctor must initiate the hospice conversation. When your doctor believes you are nearing the end of life and curative treatment is no longer the goal, they can discuss hospice as an option. You do not have to accept it — this is your choice to make. If you decide to pursue hospice, your doctor will write an order for hospice care.
Next, you will choose a Medicare-certified hospice provider. Your doctor may recommend one, or you can search for hospices in your area through Medicare.gov or by calling 1-800-MEDICARE. Once you have selected a hospice, the hospice medical director will review your medical records and your doctor's assessment. Both doctors must agree that you meet the six-month prognosis requirement before Medicare will begin paying.
After approval, the hospice team will meet with you and your family to discuss your care plan, your wishes, and what to expect. This is also when you sign consent forms. The hospice team can typically begin services within a few days.
The six-month prognosis requirement
Medicare requires that both your doctor and the hospice medical director certify that you are unlikely to live longer than six months if your illness runs its normal course. This is not a may provide — some people live longer than six months, and some live shorter. The six-month timeframe is a medical judgment, not a important date.
If you live longer than six months, you can continue receiving Medicare-covered hospice care as long as the hospice medical director recertifies every 60 days that you still meet the prognosis. The recertification process is routine; the hospice team handles it. You do not need to reapply or contact Medicare yourself.
If your condition improves and your doctors believe you no longer meet the six-month prognosis, Medicare will stop covering hospice services. At that point, you can return to curative treatment, and Medicare will cover that instead.
Choosing between hospice and curative treatment
When you elect hospice, you are choosing to focus on comfort rather than cure. This means Medicare will not pay for treatments aimed at extending your life — such as chemotherapy, dialysis, or aggressive interventions in a hospital. However, you can still receive treatment for symptoms and pain, and you can still go to the hospital if you need emergency care.
This choice is not permanent. You can stop hospice care at any time and return to curative treatment. If you do, Medicare will resume covering treatment for your terminal illness. Some people choose hospice, then change their mind weeks or months later. That is allowed, and there is no penalty.
Your family may have opinions about this decision, but it is ultimately yours to make. Hospice staff and your doctor can help you think through what matters most to you — whether that is more time, more comfort, more time with family, or something else.
What happens if you do not have Medicare Part A
Hospice coverage is part of Medicare Part A, which covers hospital and skilled nursing care. If you have Medicare Part B only (doctor and outpatient services), Medicare will not pay for hospice. However, if you are enrolled in a Medicare Advantage plan (Part C), that plan must cover hospice the same way Original Medicare does, though you should check your plan documents or call your plan to confirm the details.
If you have Medicaid in addition to Medicare, Medicaid may also help pay for hospice services, particularly room and board in a hospice facility. Each state's Medicaid program has different rules, so contact your state Medicaid office or your hospice social worker to learn what is available in your state.
If you do not have Medicare or Medicaid, some hospices offer care on a sliding fee scale based on your income, or they may work with charitable organizations to help cover costs. Ask the hospice directly about financial information options.
Questions to ask your doctor and hospice team
Before you decide on hospice, it is reasonable to ask your doctor: "Do you think I am close to the end of my life?" "What does the six-month prognosis mean in my case?" "What will happen if I choose hospice instead of more treatment?" "Can I change my mind later?" These conversations help you make a decision that matches what matters to you.
Once you have chosen a hospice, ask the hospice team: "What services will you provide?" "How often will nurses visit?" "What happens if I need help at night or on weekends?" "What is included in bereavement support for my family?" "What is your policy if I want to stop hospice care?" Getting these answers upfront prevents confusion later.
Frequently Asked Questions
Does Medicare pay for hospice if I am still getting chemotherapy or other cancer treatment?
No. When you elect hospice, Medicare stops paying for curative treatment for your terminal illness. You cannot receive both at the same time under Medicare. However, you can stop hospice and resume curative treatment whenever you choose, and Medicare will cover it again.
What if I live longer than six months on hospice?
You can continue receiving Medicare-covered hospice care. The hospice medical director recertifies your prognosis every 60 days. As long as the doctor believes you still meet the criteria, Medicare keeps paying. The six-month estimate is not a cutoff date.
Do I have to pay anything out of pocket for hospice?
Medicare Part A covers hospice services with no copayments or deductibles. You may pay out of pocket only for services not related to your terminal illness, or for room and board if you live in a hospice facility. Ask your hospice about costs before you start care.
Can my family get counseling after I die?
Yes. Medicare covers bereavement counseling for your family members for up to 13 months after your death. The hospice team provides this, and your family does not pay for it.
What if I change my mind and want to stop hospice?
You can stop hospice care at any time, for any reason. There is no penalty. Medicare will resume covering curative treatment for your condition. Tell your hospice team and your doctor as soon as you decide.