Does Medicare Cover Hospice Care?

What Is the Medicare Hospice Benefit?

The Medicare Hospice Benefit is a program under Medicare Part A that covers end-of-life comfort care for people with a terminal illness. When a patient elects hospice, they agree to focus care on comfort and quality of life rather than curative treatment for their terminal diagnosis.

Hospice care can be provided at home, in a nursing facility, in an assisted living facility, or in a dedicated hospice inpatient facility. Medicare covers the hospice services regardless of where the patient lives.

The benefit was created to reduce the financial and logistical burden on families during one of life's most difficult periods. Understanding it fully helps families make informed decisions quickly when it matters most.

What Does Medicare Cover for Hospice Care?

Medicare hospice coverage includes a comprehensive set of services. Here is a complete breakdown:

Medical Services

• Physician services — visits and oversight from the hospice medical director and the patient's attending physician
• Nursing care — regular visits from registered nurses to manage symptoms, assess pain, and coordinate care
• Nurse practitioner services — as the attending clinician of record in eligible cases

Medications

• Prescription drugs for symptom control — medications related to the terminal diagnosis (pain management, anti-nausea, anxiety, and more) are covered
• Medicare may charge a small copay of up to $5 per prescription for outpatient symptom-control drugs under the hospice benefit
• Medications unrelated to the terminal diagnosis are generally not covered under the hospice benefit but may be covered by Medicare Part D

Equipment and Supplies

• Hospital beds and pressure-relief mattresses
• Wheelchairs and walkers
• Oxygen equipment and supplies
• Bedside commodes
• Wound care and medical supplies related to the terminal diagnosis

Support Services

• Home health aide and homemaker services — help with bathing, dressing, grooming, and light housekeeping
• Social worker services — help navigating financial, legal, and emotional challenges
• Counseling — dietary counseling and mental health support
• Spiritual care — chaplain services for patients and families of any or no faith background
• Volunteer support — trained volunteers for companionship and respite

Bereavement Support

• Grief counseling and bereavement services for family members — covered for up to 13 months after the patient's death

The 4 Levels of Medicare Hospice Care

Medicare defines four levels of hospice care. The hospice team determines which level is appropriate based on the patient's needs at any given time. Patients can move between levels as their condition changes.

Medicare Hospice Eligibility Requirements

To qualify for Medicare hospice benefits, all of the following must be true:

1. Enrolled in Medicare Part A — the patient must have Medicare Part A coverage
2. Terminal diagnosis — a physician must certify that the patient has a terminal illness with a life expectancy of 6 months or less if the disease runs its normal course
3. Two-physician certification — both the hospice medical director and the patient's attending physician must certify eligibility
4. Elect the hospice benefit — the patient (or their legal representative) must sign a statement choosing comfort-focused care over curative treatment for the terminal diagnosis
5. Medicare-certified provider — care must be provided by a Medicare-certified hospice organization

How Long Does Medicare Cover Hospice?

Medicare hospice coverage is organized into benefit periods with physician recertification at each stage. There is no lifetime limit on the number of benefit periods a patient can receive.

At each recertification after the first two 90-day periods, a hospice physician or nurse practitioner must conduct an in-person visit to document continued eligibility. If a patient improves and no longer qualifies, they can be discharged from hospice — but they can re-enroll later if their condition declines again.

If a patient lives longer than 6 months: Coverage continues as long as eligibility is recertified. There is no penalty for outliving the initial prognosis — the 6-month threshold is a clinical estimate, not a hard cutoff.

Changing hospice providers: Patients may change to a different Medicare-certified hospice provider once during each benefit period.

Does Medicare Advantage Cover Hospice?

Yes — but with an important distinction. Since January 2021 under the VBID (Value-Based Insurance Design) model, Medicare Advantage plans are required to cover hospice at the same level as traditional Medicare Part A.

However, the mechanics work differently from other Medicare Advantage benefits:

• The actual hospice benefit is administered through traditional Medicare — not through your Medicare Advantage plan — even while you remain enrolled in the Advantage plan
• Your Medicare Advantage plan may cover additional services alongside traditional Medicare hospice (called "supplemental benefits")
• The hospice provider bills Medicare directly, not your Advantage plan

Medicare and Medicaid Together (Dual Eligibility)

Many hospice patients — particularly those in nursing homes — are eligible for both Medicare and Medicaid. This is called "dual eligibility" and can significantly reduce what families pay out of pocket.

• Medicare covers hospice services — nursing, medications, equipment, and support services as described above
• Medicaid may cover room and board in a nursing facility, which Medicare hospice does not cover. This is one of the most important financial benefits for dual-eligible patients in nursing homes.
• Dual-eligible patients generally pay $0 for hospice services and may have their nursing home room and board largely covered by Medicaid

Each state administers Medicaid differently. Confirm dual-eligibility coverage and Medicaid room-and-board coverage with the hospice provider and your state Medicaid office before enrollment.

Medicare Hospice Coverage by Diagnosis

Medicare hospice covers patients with any terminal diagnosis — not just cancer. Here is what coverage looks like for the most common conditions:

Cancer

Cancer is the most common hospice diagnosis. Patients with terminal cancer who have a physician-certified prognosis of 6 months or less qualify fully. The hospice benefit covers pain management, anti-nausea medications, comfort-focused care, and family support. See the cancer hospice guide →

Dementia and Alzheimer's Disease

Medicare covers hospice for advanced dementia when a physician certifies a prognosis of 6 months or less. For dementia, this typically means the patient can no longer walk independently, speaks fewer than six meaningful words, requires assistance with all daily activities, and has had recent complications such as aspiration pneumonia, urinary tract infection, or significant weight loss. See the dementia hospice guide →

Heart Failure and COPD

Patients with end-stage heart failure or COPD qualify when they have repeated hospitalizations, declining function despite optimal treatment, and a physician-certified prognosis of 6 months or less. These are among the most under-enrolled diagnoses in hospice — many families and physicians wait too long to consider it. See the heart failure and COPD hospice guide →

Other Terminal Diagnoses

Medicare hospice is available for any terminal condition including end-stage kidney disease, liver failure, ALS, stroke, Parkinson's disease, and others. The determining factor is the prognosis — not the diagnosis itself.

What Does Medicare NOT Cover in Hospice?

• Room and board — if the patient is in a nursing home or assisted living, Medicare hospice does not cover the daily room-and-board cost. Medicaid may cover this for eligible patients.
• Curative treatment for the terminal diagnosis — once hospice is elected, Medicare will not pay for treatments aimed at curing the terminal illness. Curative treatment for other conditions remains covered.
• Emergency room visits and hospitalizations for issues related to the terminal diagnosis, unless arranged by the hospice team. Unrelated emergencies may still be covered by Medicare Part A or Part B.
• Medications unrelated to the terminal diagnosis — these may be covered by Medicare Part D separately.

How to Enroll in Medicare Hospice: Step by Step

1. Talk to your physician — ask whether the patient's condition qualifies for hospice and whether the timing is right. Many families and physicians wait longer than necessary.
2. Choose a Medicare-certified hospice provider — use BestHospice.com to find verified providers near you. Confirm the provider is Medicare-certified before enrolling.
3. The hospice provider obtains physician certification — the hospice medical director and the patient's attending physician must both certify the terminal prognosis. The hospice provider handles this paperwork.
4. Sign the hospice election form — the patient or legal representative signs a statement choosing comfort-focused care and acknowledging they are giving up curative Medicare coverage for the terminal diagnosis.
5. Care begins — most hospice providers begin within 24–48 hours of the election. Equipment (hospital bed, oxygen, medications) is delivered to the home, and the first nursing visit is scheduled.

Medicare Hospice vs. Other Payers

Frequently Asked Questions — Medicare and Hospice

Find a Medicare-Certified Hospice Provider Near You

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