Key Takeaways
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Medicare does cover hospice care, but only under specific conditions and with limitations that often surprise beneficiaries and families.
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Out-of-pocket costs, non-covered services, and the requirement to give up curative treatment are rarely discussed but can significantly impact care decisions.
What Hospice Care Means Under Medicare
Hospice care is specialized support for people with terminal illnesses, focusing on comfort instead of curing the condition. Medicare provides hospice coverage through Part A, but only if certain conditions are met. Understanding what counts as “hospice” under Medicare helps you prepare emotionally, financially, and practically.
To qualify for hospice coverage, all the following must be true:
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You are enrolled in Medicare Part A.
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A hospice doctor and your own doctor (if you have one) certify that you’re terminally ill, with a life expectancy of six months or less.
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You accept palliative care instead of curative treatment.
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You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your illness.
Once enrolled in hospice care, you can still receive Medicare coverage for unrelated health needs through Parts A and B. But this shift from active treatment to comfort care is a major pivot, and the details matter.
What Medicare Pays For in Hospice
Medicare covers most of the core hospice services, including:
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Visits from doctors, nurses, and hospice aides
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Medical equipment like wheelchairs or hospital beds
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Pain relief and symptom management drugs
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Social work and counseling
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Spiritual and grief counseling
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Short-term inpatient respite care
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Short-term inpatient care for symptom control
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Homemaker and aide services for personal care
These services are designed to support you and your family holistically, typically delivered at home or in a facility like a hospice house or nursing home.
Recertification Matters
Hospice coverage is not indefinite. Initially, you’re certified for two 90-day periods. After that, you’re recertified every 60 days. A hospice doctor must confirm that you still have a life expectancy of six months or less. If your condition stabilizes or improves, Medicare may no longer cover hospice.
What Medicare Doesn’t Cover
Here’s where things get less transparent. Several services and supports commonly associated with end-of-life care are not covered:
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Curative Treatments: If you choose hospice, Medicare stops covering treatments intended to cure your terminal illness.
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Room and Board: If you receive hospice care at home or in a facility that isn’t a hospital or Medicare-approved hospice center, Medicare doesn’t cover housing or meals.
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Emergency Room or Ambulance Services: For issues related to your terminal illness, emergency care isn’t typically covered unless you revoke hospice.
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Non-Hospice Providers: Care from providers outside your hospice team is usually not covered.
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Out-of-pocket Costs for Drugs: Medicare may require a small copayment for outpatient drugs for symptom control (typically no more than $5 per prescription).
These gaps can catch you and your caregivers off guard, especially if you expect hospice to cover all facets of your end-of-life needs.
Giving Up Curative Treatment: A Required Trade-Off
Perhaps the biggest emotional and medical hurdle is that to receive Medicare-covered hospice care, you must stop treatments aimed at curing your terminal illness. This includes chemotherapy, radiation, or surgery specifically intended to treat the terminal diagnosis.
This decision isn’t always easy. Some people feel pressured into choosing hospice too early or worry they’re giving up. Medicare requires you to sign an election statement to start hospice, acknowledging that you’re switching to palliative care.
If you change your mind later, you can revoke hospice and return to standard Medicare coverage. You can also re-enroll in hospice again as long as you meet eligibility requirements.
Hospice Isn’t Just at Home
Medicare’s hospice benefit is often associated with in-home care, but it also covers inpatient services in certain settings:
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A Medicare-certified hospice inpatient facility
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A Medicare-approved nursing facility or hospital
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Inpatient respite care (to give family caregivers a break)
However, you may face uncovered room and board costs unless you’re in a short-term stay for symptom management or respite purposes.
Additional Costs You May Face
While hospice care under Medicare is mostly covered, you still might face some expenses:
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Up to 5% of the cost for outpatient medications for pain or symptom management
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A 5% copayment for inpatient respite care
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Full payment for room and board in a nursing facility if it’s not for short-term symptom control
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Costs for care from non-hospice providers
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Equipment or services not authorized by the hospice team
These costs might seem small individually, but they can add up, especially over several months.
What Happens After Six Months?
Medicare does not cut off hospice care automatically at six months. As long as the hospice doctor continues to certify that you are terminally ill, you can remain on hospice indefinitely. There’s no set cap on the number of days you can receive hospice care, but continuous recertification is essential.
It’s important to know that your hospice provider is required to perform a face-to-face visit with you before the third benefit period (the third 60-day period) and every 60 days thereafter to determine ongoing eligibility.
Support for Caregivers
Medicare also provides some support for your family caregivers through the hospice benefit:
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Bereavement counseling for up to 12 months after your death
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Training for caregivers on how to help with your daily needs
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Limited respite care coverage to give caregivers a break
However, ongoing financial support or extended home health coverage for caregivers is not part of Medicare’s hospice benefit.
Choosing the Right Hospice Provider
You have the right to choose your hospice provider, as long as it is Medicare-certified. Not all hospice organizations offer the same services, staffing levels, or support systems. Some operate as standalone nonprofits, others are part of larger healthcare systems. Medicare doesn’t cover services from non-certified providers.
Before choosing, it’s wise to ask:
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Is the provider Medicare-certified?
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What services do they offer, and are they available 24/7?
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How do they handle emergencies?
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Do they provide both home and inpatient care?
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What support is available for family members?
Can You Leave Hospice?
Yes. You can choose to stop hospice care at any time. If you do, Medicare resumes covering your standard benefits, including curative treatments and hospital care. You can re-enter hospice later if you continue to qualify.
There’s no penalty for revoking or re-electing hospice care. The process simply involves notifying your provider and completing the appropriate paperwork.
Keep Medicare Part B Active
Even when you’re on hospice under Part A, it’s critical to keep your Medicare Part B active. This covers:
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Services unrelated to your terminal illness (e.g., treatment for diabetes, injuries)
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Durable medical equipment not related to hospice
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Outpatient doctor visits not associated with your hospice provider
If you drop Part B, you could face gaps in your coverage for other health needs.
It’s Not All Talked About—But You Deserve to Know
Hospice under Medicare is a compassionate benefit—but it comes with strings attached. Understanding the trade-offs, exclusions, and technicalities can help you or your loved one make more informed decisions.
When choosing hospice, it’s not just about care—it’s about navigating an emotional, financial, and administrative path that impacts the end of life. Knowing the limitations means fewer surprises and better preparation.
To explore your options further or if you’re unsure how Medicare hospice fits into your health plan, get in touch with a licensed agent listed on this website for professional advice tailored to your needs.
