Does Medicare cover hospice care?

The Medicare Hospice Benefit covers 100% of hospice services for a patient certified by two physicians as having a six-month-or-less life expectancy. It pays for nursing visits, hospice aides, medications related to the diagnosis, equipment, social work, chaplaincy, and bereavement support after the death. Curative treatment for the terminal illness stops; treatment of unrelated conditions continues.

The short answer

Yes, Medicare covers hospice care at 100%. It pays for nursing, hospice aides, medications related to the terminal diagnosis, equipment, supplies, social work, chaplaincy, short-term inpatient and respite care, and 13 months of bereavement support. The only co-pays are up to $5 per outpatient hospice prescription and 5% of inpatient respite stays.

What Medicare pays for

13 items

Hospice nurse visits
Typically two to five per week; more during active dying.
Covered
Home health aide visits
For personal care under the hospice plan.
Covered
Medical social services
Grief counseling, community resource coordination, family support.
Covered
Chaplaincy and spiritual care
If desired by the patient or family.
Covered
Medications for the terminal diagnosis
Delivered to home. Maximum $5 co-pay per outpatient prescription.
Covered
Durable medical equipment
Hospital bed, oxygen, wheelchair, commode, supplied by hospice.
Covered
Short-term inpatient care
For symptom control that cannot be managed at home.
Covered
Inpatient respite care
Up to 5 consecutive days, repeatable. 5% co-pay (capped).
Covered
Bereavement support after death
Counseling and support for family, up to 13 months after the death.
Covered
Curative treatment for the terminal diagnosis
Electing hospice means choosing comfort care for that diagnosis.
Not covered
Room and board in assisted living or nursing home
Hospice covers care; the residence cost is separate (Medi-Cal may cover for eligibles).
Not covered
24-hour-a-day at-home care
Hospice provides intermittent care; the family or hired caregivers cover the rest.
Not covered
Treatment from non-contracted providers (for terminal diagnosis)
Without prior approval from hospice agency.
Not covered

What “100% coverage” actually means

The Medicare Hospice Benefit is unusual in how comprehensive it is. The patient does not pay deductibles for hospice services. No co-insurance on visits. No co-pay on visits to the hospice agency. No charge for the hospital bed, oxygen concentrator, wheelchair, or other equipment the hospice supplies. No charge for the medical social worker, the chaplain, or the volunteer. No charge for the medications related to the terminal diagnosis when supplied through the hospice pharmacy.

The only out-of-pocket costs are two small ones: a maximum of $5 per outpatient hospice-related prescription, and 5% of the Medicare-approved amount for inpatient respite care, capped at the inpatient hospital deductible per benefit period. For most families, the total bill for hospice services across a several-month enrollment is well under $200.

What changes when hospice is elected

Two things change. First, curative treatment for the terminal diagnosis stops. That doesn’t mean treatment of symptoms stops, comfort medications, anti-nausea, anti-anxiety, pain control are all expanded. It means no more chemotherapy intended to cure the cancer, no more aggressive interventions intended to reverse the terminal disease. The goal of treatment is shifted from curing to comforting.

Second, the hospice agency takes over all care related to the terminal diagnosis. The team, physician, nurse, aide, social worker, chaplain, volunteers, coordinates everything. The attending physician continues to participate but the hospice nurse becomes the day-to-day contact for the family.

What does not change

Treatment of unrelated conditions continues normally. The patient’s cardiologist still manages the heart medication. The diabetes care continues. A broken bone gets set in the emergency room. Non-related Part D prescriptions continue. Hospice is for the terminal diagnosis; everything else carries on.

How the benefit periods work

Medicare hospice has unlimited benefit periods. The structure: an initial 90-day period, a second 90-day period, then unlimited 60-day periods after that. At the end of each period the hospice medical director re-certifies the terminal prognosis. As long as the certification is renewed, the patient continues.

Many hospice patients live longer than six months. Re-certification is routine. Patients who improve to the point that they no longer meet the terminal-prognosis criteria are discharged from hospice (a “live discharge”) and return to regular Medicare. They can re-elect hospice if their condition declines again.

What the family actually gets

Beyond the clinical visits, the practical experience for a family includes:

A 24/7 hospice phone line. A nurse on call. Most agencies make a same-day or next-day visit for any crisis.
The hospice agency supplies the equipment, hospital bed, oxygen, wheelchair, commode, briefs, within hours of admission.
Comfort medications are delivered to the home, often in a small “comfort pack” for the family to use under nurse guidance.
The hospice social worker helps coordinate end-of-life paperwork, hospital discharge if needed, funeral planning.
Volunteers can sit with the patient so the family caregiver can rest.
The chaplain visits if welcome; many families find this surprisingly meaningful regardless of religious background.
After the death, hospice bereavement counselors check in with the family for 13 months.

The most consequential thing to know

Hospice is the most expansive Medicare benefit. It is consistently under-elected (median US hospice length of stay is under three weeks; the benefit was designed for six months). The most common regret families voice afterward is electing hospice too late. Once a family member is in the final weeks of a terminal illness and the medical system is offering more interventions that the patient does not want, hospice is the alternative the family is looking for. Asking about it earlier is almost always better than asking about it later.

Related coverage and next steps

This page explains coverage and eligibility, not medical advice. Talk to a licensed clinician about care decisions, and to a benefits counselor about your specific plan. California Care Compass does not place referrals on Coverage pages.

Common questions

7 entries

Are there really no major co-pays?

Correct. The only Medicare hospice co-pays are up to $5 per outpatient hospice-related prescription and 5% of the Medicare-approved amount for inpatient respite care (capped at the hospital deductible). Everything else is covered at 100%. For most families the total out-of-pocket for hospice services is under $50 per month.

What does the six-month prognosis rule mean?

Two physicians, typically the attending and the hospice medical director, certify in writing that the patient's life expectancy is six months or less if the illness runs its normal course. The patient does not have to die within six months. Certifications renew in 90-day periods initially, then 60-day periods, indefinitely as long as eligibility holds.

Can I keep my regular doctor on hospice?

Yes. The attending physician continues to coordinate care for the terminal diagnosis alongside the hospice medical director. Treatment of unrelated conditions continues through the regular Part A and Part B systems with the patient's usual providers.

Can I leave hospice if I change my mind?

Yes. Revoking the hospice election is a simple written form. It takes effect immediately. Regular Medicare resumes. The patient can re-elect hospice later if eligibility still holds. There is no penalty.

What happens to non-related medications and treatments?

Non-related medications continue under Part D as usual. Treatment of unrelated conditions (a broken bone, a urinary tract infection unrelated to the cancer, etc.) continues under regular Medicare. Only the terminal-diagnosis treatment shifts to hospice management.

Does Medi-Cal cover hospice for non-Medicare patients?

Yes. Medi-Cal hospice covers the same scope of services for Medi-Cal-eligible patients without Medicare. For dual-eligible members, Medicare pays first and Medi-Cal picks up cost-sharing and covers nursing facility room and board when the hospice patient lives in a nursing home.

Is hospice only at home?

No. Hospice is a benefit that travels with the patient. About 55% of hospice care happens at home, but it can also be delivered in nursing facilities, assisted-living facilities, hospice houses, and inpatient hospice units.

Sources

01Centers for Medicare & Medicaid Services · Medicare hospice benefit coverage · accessed 2026-05-21
02Centers for Medicare & Medicaid Services · Medicare Benefit Policy Manual, Chapter 9, Hospice · accessed 2026-05-21
03National Hospice and Palliative Care Organization · Medicare Hospice Benefit overview · accessed 2026-05-21
04California Department of Public Health · Hospice agency licensing · accessed 2026-05-21
05California Department of Health Care Services · Medi-Cal hospice services · accessed 2026-05-21

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