Does Medicare Cover Hospice?
If you or a loved one has a terminal illness, it may be time for hospice care, a type of palliative care that focuses on making you as comfortable as possible in your final phase of life. Entering hospice care can seem scary, and navigating both grief and care options can be difficult for many families as end of life looms.
It may be a relief to know that Medicare Part A, or hospital insurance, covers hospice care — but there are some limitations. Read on to learn the details about the Medicare hospice benefit.
[READ: How Do You Comfort a Dying Parent?]
Who Qualifies for Medicare’s Hospice Benefit?
Hospice care is meant for someone with a terminal illness who’s moved from actively treating their disease to relying on palliative interventions intended to keep them comfortable in their final days, weeks or months.
To qualify for this coverage, you need to meet specific criteria. You must:
— Have Medicare Part A coverage, whether through original Medicare or a Medicare Advantage plan
— Have a terminal illness with a life expectancy of six months or less as certified by a hospice doctor and your regular doctor
— Terminate curative treatment and accept palliative care only for your ailment
— Sign a statement that reflects your choice of hospice care rather than curative treatment
If at a later date you decide to pursue additional curative treatment — perhaps a new clinical trial has been launched and you want to try that — you can opt out of hospice and seek treatment. But that terminates the hospice benefit from Medicare.
Conditions that typically qualify a person for hospice care include:
— AIDS
— Cancer
— Congestive heart failure
— Diabetes
— Dementia
— Heart valve disorders
— Huntington’s disease
— Liver disease
— Stroke
[READ: What Is an Accelerated Death Benefit and How Does It Work?]
How Long Can I Stay in Hospice Care?
Once you have met the conditions for hospice care, Medicare coverage begins.
| Benefit phase | Duration | Recertification requirement |
| Initial period | 90 days | You doctor must certify at the start that you have a terminal illness and qualify for hospice. |
| Second period | 90 days | Your doctor must recertify in a face-to-face meeting that you are still eligible for hospice before this period can begin. |
| Subsequent periods | 60 days | Your doctor will need to recertify your eligibility at the end of each 60-day period for coverage to continue. You can receive an unlimited number of these 60-day periods. |
You can stop hospice care at any time, such as if your health improves or your illness goes into remission. Your doctor might also discharge you from hospice if your life expectancy has increased to longer than six months.
If you leave hospice care, you’ll need to sign a form that lists the end date of care. Your doctor can recertify you later if your life expectancy falls to six months or less again in the future, at which point you’ll be eligible for the hospice benefit again.
What Does Medicare Pay for in Hospice Care?
Medicare provides comprehensive coverage for services rendered in hospice care, and once you’re on the benefit, it should cover everything you need, including:
Clinical care
— Doctor services
— Medications for pain and symptom management
— Nursing care
— Short-term inpatient care for pain or symptom management
Support services and equipment
— Dietary counseling
— Durable medical equipment for pain relief and symptom management
— Grief and loss counseling for both patient and family members
— Homemaker services and hospice aides
— Physical and occupational therapy services
— Social services
— Speech-language pathology services
— Up to five consecutive days of inpatient respite care at a Medicare-approved facility, offered on an occasional basis
— Other services to manage pain and symptoms as recommended by the hospice care team
Your hospice care team — which consists of your regular doctor, hospice doctor, nurse, social workers and other therapists and volunteers — will work with you and your family to develop a tailored plan to meet your palliative care needs.
[READ: How to Pay for Nursing Homes With Hospice Care: Payment Options]
What Does Medicare Exclude From Its Hospice Care Coverage?
While Medicare covers a wide range of hospice services, there are some that Medicare doesn’t cover:
— Treatments or medications with curative intent or those not related to your terminal condition. If, for example, you’ve been receiving chemotherapy or radiation treatment for cancer, you’ll need to stop that treatment before entering hospice.
— Room and board if you’re receiving care in your home or if you live in a nursing home or hospice inpatient facility
— Care received from a provider who’s not part of the hospice team or that wasn’t arranged by the hospice team
— Care as a hospital outpatient (e.g., emergency room visits), care as a hospital inpatient or ambulance transportation unless it’s arranged by the hospice team or is unrelated to your terminal illness
To avoid any surprise bills, always check with your hospice team before scheduling any doctor’s appointments or accessing other services that may not be covered.
You can continue taking medications that are used to treat conditions or symptoms that are not directly related to the terminal condition. For example, people in hospice care can continue to taking medication to treat high blood pressure. Such medications are typically covered under your Medicare Part D plan or your Medicare Advantage plan if it includes a prescription drug benefit.
Are There Any Costs to Using Medicare’s Hospice Benefit?
There are some costs with Medicare’s hospice benefit, but most people who get care from a Medicare-approved hospice provider won’t have to pay anything. (You can check a provider’s status by asking the doctor directly or checking with your state hospice organization or state health department.)
If you enrolled in original Medicare, for instance, you may have a $0 premium for Medicare Part A, says Cindy George, a senior personal finance editor at GoodRx, a free website and mobile app that tracks prescription drug prices and provides coupons and discounts on medications.
That’s because you paid into the system during your working years. However, George notes that if you didn’t work long enough to qualify for a $0 premium Medicare Part A, monthly premiums in 2026 range from $311 to $565 depending on how long you paid Medicare taxes.
If you have Medicare Advantage, you’ll need to continue paying your monthly premium — which varies depending on the specifics of your plan — but hospice care is included and will be covered.
Out-of-pocket costs related to hospice care include:
— Prescription copayments. A copayment of up to $5 for each prescription you’re given for pain and symptom management, according to Medicare.gov. In rare cases, the hospice benefit might not cover a specific medication, but your Medicare Part D plan might. Ask your hospice provider to check that your prescriptions will be covered, and if there’s a medication you need that isn’t covered, ask if an alternative, covered medication is available.
— Respite care copayments. If you use the inpatient respite care benefit, you may be responsible for paying 5% of the Medicare-approved amount of this care. However, your copay can’t exceed the inpatient hospital deductible for the year.
— Deductible and coinsurance for conditions not related to the terminal illness. If you have or develop other health problems that aren’t related to your terminal condition, those are typically covered under original Medicare, but you’ll need to pay any applicable deductibles and coinsurance. In 2026, the deductible for each inpatient hospital benefit period is $1,736 before original Medicare kicks in.
— Room and board. Medicare will not cover your living costs. So whether you’re living at home or in a nursing home or other facility when you opt into hospice care, you’ll still be responsible for paying for your room and board out of pocket.
You can ask your hospice provider to make a list of the services, medications and other items you use that aren’t related to your terminal illness so you’ll know which costs you’ll be responsible for and which are covered under the hospice benefit. For any item that isn’t deemed part of hospice care, your provider must include an explanation for why it’s not covered, and they must give you this list within three to five days of your request. They must also provide the list to your nonhospice providers at your request.
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Does Medicare Cover Hospice? originally appeared on usnews.com
Update 01/05/26: This story was published at an earlier date and has been updated with new information.