Does Medicare cover hospice?

You must have Part A. You must also meet all three of these tests:

• Your hospice doctor and your regular doctor (if you have one) certify that you have 6 months or less to live if your illness runs its normal course.
• You accept comfort care instead of care to cure your illness. Comfort care is also called palliative care.
• You sign a form that chooses hospice instead of other Medicare treatment for your illness. It is called the Hospice Election Statement. It names your hospice, your start date, and the doctor you pick to oversee your care.

You do not have to give up your regular doctor. You can choose them to help oversee your hospice care.

In short: two doctors say you have 6 months or less, you choose comfort over a cure, and you sign the form.

Once hospice starts, it should cover all you need for your illness. Your care team sets up a plan of care. It can include:

• Doctor and nurse care, with a nurse and doctor on call all day and night
• Drugs for pain and symptoms
• Medical equipment for pain and symptoms, and supplies like bandages or catheters
• Home health aide and homemaker help
• Physical, occupational and speech therapy
• Social work, diet advice, and spiritual and grief counseling for you and your family
• Short hospital stays to control pain or symptoms
• Respite care: a stay of up to 5 days in a facility, so your caregiver can rest

Hospice does not cover:

• Treatment or drugs meant to cure your illness
• Care from a hospice you did not choose
• Room and board. That is true at home, in a nursing home, or in a hospice facility. The exception is a short stay the hospice team sets up.
• ER visits, hospital stays, or ambulance rides the hospice team did not set up, if they are for your terminal illness

For more on where care happens, see Medicare care settings and respite care.

You pay nothing for hospice care from a Medicare-approved hospice. You may still owe a few small costs:

• Drugs: up to $5 for each prescription for pain or symptom relief.
• Respite care: 5% of the Medicare-approved amount. This copay cannot be more than the $1,736 Part A deductible for 2026.
• Room and board: the full cost, if you live in a nursing home or assisted living.
• Care for other health problems: Original Medicare still pays for care not related to your terminal illness. You pay the usual deductible and coinsurance for it.

The hospice must tell you if a drug or service is not covered, and why. You can ask for a written list of what the hospice will not cover. It must give you the list within 3 to 5 days.

• If you have a Medigap plan: most plans pay all of your hospice copays. Plans K and L pay part.
• If you have Medicaid too: ask your state Medicaid office if it helps with nursing home room and board.

Hospice comes in benefit periods. You get two 90-day periods, then an unlimited number of 60-day periods. There is no cap on the total time.

After 6 months, a hospice doctor or nurse practitioner must see you in person. Then the hospice doctor must certify again that you are still terminally ill. As long as that keeps happening, hospice keeps going.

You can also stop hospice at any time. Maybe you feel better, or you want to try treatment to cure your illness. You sign a form with your end date. Your regular Medicare coverage starts again. If you qualify later, you can go back to hospice.

No one should ask you to sign a form to stop hospice when you start it. Only you can choose to stop.

You can also switch to a different hospice once in each benefit period.

You do not need to leave your plan to get hospice. Here is how it works:

• Original Medicare pays for hospice and all care for your terminal illness once hospice starts.
• Your plan must help you find a Medicare-approved hospice near you.
• Your plan still covers care that is not related to your terminal illness, as long as you pay your premium.
• Your plan keeps covering its extras, like dental and vision.
• If you stop hospice, your plan starts again on the first day of the next month.

In short: Original Medicare pays for hospice, and your plan covers everything else.

1. Talk with your doctor. Ask if hospice is right for you now.
2. Pick a Medicare-approved hospice. You can compare hospices on Medicare.gov. Ask how staff respond after hours, and if they train family caregivers.
3. Get the doctor certification. The hospice doctor and your regular doctor sign off.
4. Sign the election form. Read it first. Check the start date and the doctor you chose.
5. Call your hospice team first before you go to the ER or call an ambulance. If they do not set it up, you might pay the full cost.