Money is often the question nobody wants to say out loud. When someone you love is very sick, worrying about bills can feel wrong. But it’s normal, and it’s worth getting a clear answer early so cost doesn’t drive the decision.
So, does Medicare cover hospice? Yes. For most people, Medicare covers hospice care in full, and families pay little or nothing for the care itself. There are a few real exceptions, though, and the biggest one (the cost of living in a facility) surprises a lot of families. This guide walks through who qualifies, what the Medicare hospice benefit pays for, what it doesn’t, how long coverage lasts, and what you might still owe. It’s written for adult children, spouses, and caregivers who are trying to make a good choice under pressure, and it matters because knowing the rules ahead of time can save you from an unexpected bill at the hardest possible moment.
The Short Answer: Yes, Medicare Covers Hospice Care
Hospice is covered under Medicare Part A (Hospital Insurance). According to Medicare.gov, you pay nothing for hospice care when you get it from a Medicare-approved hospice provider. In other words, Medicare covers up to 100% of covered services, including nurses, doctor visits, equipment, supplies, and comfort medications.
That’s what people mean when they talk about “the Medicare hospice benefit.” It’s a package of covered benefits built around comfort, not cure. Once your loved one chooses hospice, the hospice care team manages the terminal illness and related conditions, and Medicare pays the hospice provider directly.
There are small costs, like a copay of up to $5 per prescription for outpatient drugs. And some things simply aren’t part of the hospice benefit at all. We’ll cover each one below so nothing catches you off guard.
Who Qualifies for the Medicare Hospice Benefit
To get Medicare hospice coverage, your loved one must have Part A (most people with Medicare Parts A and B already do) and meet three conditions, per Medicare’s eligibility rules:
- A terminal diagnosis. The hospice doctor and their regular doctor or primary care provider (if they have one) certify that the person is terminally ill, with a life expectancy of six months or less if the illness runs its normal course.
- A choice for comfort. They accept comfort care, also called palliative care, instead of care meant to cure the illness and related conditions.
- A signed election. They sign a statement choosing hospice care instead of other Medicare-covered treatments for the terminal illness.
Here’s a point that eases a lot of minds: six months is an estimate, not a deadline. Doctors can’t predict the future, and Medicare knows that. If someone lives longer, coverage can continue as long as they still qualify (more on that in the benefit periods section).
If you’re not sure whether hospice is the right fit yet, our guide on hospice vs. palliative care explains how the two differ. Many people with a serious illness get palliative care first and move to hospice later.
The Hospice Election Statement
Before any hospice services begin, your loved one (or their legal representative) signs a “Hospice Election Statement.” Medicare.gov explains that this document names the hospice providing care, the start date, and the person’s attending medical professional, which can be their own doctor or a nurse practitioner they trust. It also explains what the hospice benefit covers.
Signing it doesn’t lock anyone in forever. It simply starts the hospice benefit. You can also ask the hospice for an addendum that lists any items, drugs, or services it won’t cover because they aren’t related to the terminal illness. That list is a useful planning tool, so it’s worth asking for.
What the Medicare Hospice Benefit Pays For
Once the hospice benefit starts, Medicare says your hospice benefit “should cover everything you need” for the terminal illness and related conditions. The hospice care team builds a plan of care with you and your family, and that plan can include any of the services below, as listed in the official Medicare Hospice Benefits booklet.
The Hospice Care Team and Its Services
Hospice is a team effort. The hospice medical team usually includes a hospice physician, nurses, a hospice aide, a social worker, a chaplain, and trained volunteers. Your loved one’s own physician can stay involved as the attending medical professional.
Covered hospice services include doctor services, nursing care, medical equipment like a hospital bed, wheelchair, or walker, and medical supplies like bandages and catheters. Hospice aide and homemaker services are covered too, which helps with bathing, grooming, and light household tasks. So are physical therapy, occupational therapy, speech-language services, social worker visits, and dietary counseling.
Emotional and spiritual care matter just as much. Grief counseling is part of the benefit for both the patient and the family, and Medicare-certified hospices offer bereavement support to loved ones after a death. Here at St. Margaret’s, our bereavement program continues for up to 13 months, because grief doesn’t end on a schedule.
Prescription Drugs for Pain Relief and Symptom Management
Comfort is the whole point of hospice, so medications for pain relief and symptom control are covered. That includes drugs for pain, nausea, shortness of breath, anxiety, and other symptoms tied to the hospice diagnosis. Medicare covers these prescription drugs through the hospice, and you pay a copayment of up to $5 for each prescription for outpatient drugs used for pain and symptom management.
What about medicines for other conditions, like a blood pressure pill? If a drug isn’t related to the hospice diagnosis, the hospice may not cover it. In that case, it may be covered by Medicare Part D, with your plan’s usual copay. Ask the hospice which medications they’ll handle, so you know exactly what to expect.
Short-Term Inpatient Care and Respite Care
Most hospice care happens at home, but sometimes symptoms get too hard to manage there. If the hospice team determines your loved one needs short-term inpatient care for pain and symptom management, the hospice arranges it, and Medicare pays for the stay. That care can happen in a hospice inpatient facility, a Medicare-participating hospital, or a skilled nursing facility.
Caregivers need rest, too. Inpatient respite care lets your loved one stay in a Medicare-certified facility for up to five days at a time while you recharge, according to the Medicare hospice booklet. You can use respite more than once, but only occasionally. For respite stays, you may pay 5% of the Medicare-approved amount, capped at the inpatient hospital deductible. Taking a break isn’t selfish. It helps you keep showing up for the person you love. If you want to learn more, read our guide to understanding respite care.
What Medicare Won’t Cover Once Hospice Starts
This is the part families most often miss. Choosing hospice changes how Medicare handles care for the terminal illness. According to Medicare.gov, once the hospice benefit starts, Medicare won’t pay for the following.
Treatment Intended to Cure the Illness
Hospice is comfort care, so Medicare won’t cover treatment intended to cure the terminal illness or related conditions. That also includes prescription drugs meant to cure your illness instead of easing symptoms. If your loved one wants to try curative treatment again, like a new round of chemotherapy, they can stop hospice and go back to regular Medicare coverage. Talk with the doctor first.
It’s also important to know that care for the terminal illness must come from the hospice you chose. Medicare won’t pay for the same type of hospice care from a different hospice unless you formally change your hospice provider.
Room and Board
Here’s the big one. Medicare does not cover room and board, whether hospice happens at home or in a facility. If your loved one lives in a nursing home, an assisted living facility, or an inpatient hospice facility, the hospice benefit pays for the hospice services, but not the daily cost of the room, meals, and housekeeping. Room and board in nursing facilities can add up quickly, so plan for it.
There are two exceptions. If the hospice care team determines a short-term inpatient stay is needed for symptom control, or arranges a respite stay, Medicare covers the facility stay for that period. Outside of those, room and board is usually paid privately, through long-term care insurance, or by Medicaid for people who qualify. If your loved one may qualify, Medicare.gov explains how Medicaid can help, and the Louisiana Medicaid office can confirm eligibility. Our article on paying for senior care walks through more options.
Thinking about hospice inside a nursing facility specifically? Our guide to hospice in a nursing home explains how that setup works day to day.
ER Visits, Hospital Care, and Ambulance Transportation
Medicare won’t cover care you get as a hospital outpatient (like an emergency room visit), care as a hospital inpatient, or ambulance transportation, unless the hospice arranges it or it’s unrelated to the hospice diagnosis. That’s why the first call in a medical crisis should go to the hospice, not 911. Hospices are available by phone 24 hours a day, every day.
We know that feels backward. Calling 911 is a lifelong habit. But the hospice nurse can often come to the house, adjust medications, or arrange inpatient hospital care if it’s truly needed, and that keeps the care covered. If you skip that call, you might have to pay the entire cost of the hospital care.
What You’ll Pay: Copays and Other Costs
Let’s put the costs in one place. Under Original Medicare (Medicare Parts A and B), here’s what families usually pay with a Medicare-certified hospice provider, based on Medicare.gov:
- Hospice services: $0. Nursing, physician services, aides, equipment, supplies, counseling, and therapy are covered by Medicare.
- Prescriptions for comfort: Up to $5 per prescription for comfort medications.
- Inpatient respite care: 5% of the Medicare-approved amount, never more than the Part A inpatient hospital deductible ($1,736 in 2026, per Medicare’s cost page).
- Room and board: Not covered, except during hospice-arranged short-term inpatient or respite stays.
- Care for unrelated conditions: Normal Medicare deductibles and coinsurance apply.
So how much will Medicare pay overall? For the hospice care Medicare covers, it pays the full cost. Hospice care through Medicare is one of the most complete benefits in the whole program. The real budgeting question for most families is the daily cost of living in a facility, plus any medications or services unrelated to the hospice diagnosis.
How Long Medicare Covers Hospice: Benefit Periods Explained
Medicare hospice coverage comes in benefit periods. You can get hospice care for two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods. That means there’s no lifetime cap on hospice as long as your loved one keeps qualifying.
At the start of the first period, the hospice doctor and the regular doctor certify the terminal diagnosis. After that first six months, the hospice medical director or another hospice physician recertifies the diagnosis at the start of each new period. Medicare.gov notes this recertification follows a face-to-face visit with a hospice physician or nurse practitioner. In plain terms: the hospice doctor recertifies that your loved one is still terminally ill, and care continues.
What if someone’s health stabilizes or improves? Sometimes that happens, and it’s good news. If they no longer meet the criteria, they’re discharged from hospice and go back to regular Medicare coverage. If their health declines again later, they can return to hospice.
Health Problems Unrelated to the Terminal Illness
Choosing hospice doesn’t mean giving up all other care. Original Medicare (Medicare Parts A and B) still pays for conditions that aren’t part of the hospice diagnosis. For example, if someone in hospice for heart failure falls and breaks a wrist, regular Medicare can cover that treatment. You’ll owe the usual deductible and coinsurance for unrelated care.
If there’s any doubt about whether something is related, call the hospice before getting care. They can tell you who pays, and they’ll coordinate with other doctors. That one phone call can prevent a surprise bill.
Medicare Advantage Plans and Hospice
If your loved one has a Medicare Advantage plan, the rules are a little different, but hospice is still covered. A Medicare Advantage plan is a private alternative to Medicare Parts A and B, yet once hospice starts, Original Medicare pays for everything related to the terminal illness, even if they stay in the Medicare Advantage plan, according to the Medicare hospice booklet.
They can keep the plan as long as they pay its premiums. The plan then continues to cover conditions not related to the hospice diagnosis, plus extras like dental or vision, and drugs not related to the hospice diagnosis if the plan includes drug coverage. If they’re in a plan and want to start hospice, the plan must help them find a Medicare-certified hospice in the area.
Where Hospice Care Happens
Hospice can happen at home or in a facility. Medicare says hospice is usually given wherever the patient calls home, whether that’s a private house, an assisted living apartment, or a room in a nursing home. When symptoms need closer attention, short-term care can happen in an inpatient hospice facility, a hospital, or a skilled nursing facility.
At St. Margaret’s, we offer both. Our in-home hospice care brings the team to you across the New Orleans area, and our in-facility hospice care is offered in our household-model communities, where hospice patients live in a warm, homelike setting with nursing on site around the clock.
Revoking Hospice or Changing Providers
Your loved one can revoke hospice care at any time to return to standard treatments. They simply sign a form with the date their hospice care will end. Nobody should pressure them to sign it, and they shouldn’t sign it until they actually want hospice to stop.
If you or your loved one later decide to try to cure your illness again, revoking is how you do it. After revoking, they go back to the Medicare coverage they had before. If they qualify later, they can elect hospice again. They also have the right to change hospice providers once during each benefit period, which is helpful if the fit isn’t right or the family moves.
How to Get Started With a Medicare-Certified Hospice
Medicare only pays for hospice from a Medicare-certified hospice program, so start there. You can compare Medicare-approved hospice care in your area on Medicare Care Compare, which shows quality ratings and family survey results. Then call two or three hospices and ask how quickly they can start, how they handle after-hours calls, and what they cover in your loved one’s setting.
You don’t need to wait for a doctor to bring it up. Before starting hospice, Medicare also covers a one-time consultation with a hospice medical director or hospice doctor to talk through options, even if you decide not to start hospice yet. If talking about this with a parent feels hard, our guide on how to talk to a parent about hospice may help you find the words.
St. Margaret’s has cared for New Orleans families since 1889, and we’re a Medicare-approved hospice provider. Our team can review your loved one’s coverage and benefit periods with you at no charge, with no pressure. Call our hospice team at (504) 373-5923 or schedule a visit.
Frequently Asked Questions About Medicare and Hospice
Does Medicare Cover Hospice in a Nursing Home?
Yes. Medicare covers hospice services for someone living in a nursing home, the same as at home. What it doesn’t cover is the nursing home’s room and board. That cost is usually paid privately or by Medicaid if your loved one qualifies.
Does Medicare Cover Hospice in Assisted Living?
Yes. The hospice team visits the assisted living facility and Medicare pays for the hospice services. Rent and the facility’s monthly fees aren’t covered by Medicare.
How Long Will Medicare Pay for Hospice?
As long as your loved one stays eligible. Coverage runs in two 90-day periods, then unlimited 60-day periods, with a hospice physician recertifying the diagnosis at the start of each one.
Does Medicare Cover a Hospice Inpatient Facility?
Medicare covers a stay there when the hospice team arranges a short stay to get pain or other symptoms under control, or for a respite stay. Long stays for living purposes count as everyday living costs, which aren’t covered.
Can You Get Curative Treatment While on Hospice?
Not for the terminal illness. If your loved one wants curative treatment again, they can revoke hospice and return to regular Medicare. Treatment for unrelated health problems can continue while on hospice.
Is Hospice the Same as End-of-Life Care?
Hospice is one form of end-of-life care, focused on comfort for people with a life expectancy of six months or less. Our article What Is Hospice Care? explains it in more detail.
You Don’t Have to Figure This Out Alone
Does Medicare cover hospice? For most families, yes, and it covers more than people expect: the team, the comfort medications, equipment, supplies, counseling, and short stays when symptoms or caregivers need extra support. The main gaps are room and board, treatment meant to cure the illness, and care the hospice didn’t arrange.
If you’re weighing hospice for someone you love, the next step is simple: make one phone call. Ask a Medicare-certified hospice to review the coverage with you. The hospice care Medicare provides is broad, and at St. Margaret’s, we’re glad to help you sort through it, kindly and clearly. Reach our hospice team at (504) 373-5923.
