Medicare Part A covers hospice for eligible people who choose comfort-focused care for a terminal illness and related conditions. The benefit has specific certification and care-arrangement rules. It does not mean Medicare pays every living expense or guarantees continuous bedside staffing.
Who qualifies?
- You have Medicare Part A.
- Your hospice doctor and regular doctor, if you have one, certify a life expectancy of six months or less.
- You accept comfort care instead of treatment intended to cure the terminal illness and related conditions.
- You sign a statement electing hospice for those conditions.
A person may continue receiving hospice beyond six months if the required recertifications confirm continued eligibility. Medicare provides two 90-day benefit periods followed by an unlimited number of 60-day periods, provided the requirements remain satisfied.
What the care plan may include
The hospice team coordinates appropriate nursing and medical services, equipment and supplies, aide services, counseling, and other covered support related to the terminal illness. Short-term inpatient care may be arranged when needed for symptom management. Inpatient respite care can give a caregiver a break for up to five days at a time on an occasional basis.
The team has a nurse and doctor available on call around the clock. That is not a promise of a person staying at your bedside 24 hours a day. Ask how urgent needs and changes in care will be handled.
Costs and arrangements
| Item | What to know |
|---|---|
| Covered hospice services | Generally no charge when provided through the Medicare-approved hospice. |
| Covered outpatient prescriptions for symptom management | A copayment of up to $5 per prescription can apply. |
| Inpatient respite | A 5% coinsurance can apply, capped at the inpatient deductible amount. |
| Ordinary room and board | Generally not covered; hospice-arranged qualifying inpatient or respite stays have separate rules. |
Coordinate care related to the terminal illness through the hospice team. Outside services that were not arranged may leave you responsible for costs. Covered care for unrelated conditions can continue under the applicable Medicare rules and cost sharing.
If you have Medicare Advantage
Original Medicare covers hospice-related care after the hospice election even if you remain enrolled in your Medicare Advantage plan. Your plan can continue covering eligible extra benefits and unrelated care under its rules. Keep paying required premiums and ask both the hospice and plan how billing will work.
You can choose to stop hospice. Discuss the change and effective date with your team, and do not sign a predated or undated cancellation form. If you later qualify, you may elect hospice again.
Related coverage questions
- Medicare Respite Care: The Hospice Benefit and Its Limits
- Advance Care Planning and Medicare: A Practical Starting Point
- Medicare Home Health Care: Services, Eligibility and Costs