Medicare Hospice Care: What It Covers and How to Access It

Hospice care is one of Medicare's most comprehensive benefits -- and one of the least understood. Many families struggle with end-of-life care costs that Medicare would have covered, simply because they didn't know the hospice benefit existed or waited too long to use it.

Hospice is a philosophy of care focused on comfort and quality of life rather than curative treatment. It's for people with a terminal illness who have decided to stop pursuing treatments aimed at curing the disease and focus instead on managing symptoms and pain.

Hospice care can be provided at home, in a hospice facility, in a nursing home, or in a hospital.

To qualify for Medicare hospice coverage, you must:

1. Be enrolled in Medicare Part A
2. Have a terminal illness with a life expectancy of 6 months or less (as certified by two doctors)
3. Choose comfort care over curative treatment for the terminal illness
4. Receive care from a Medicare-certified hospice program

Important: Choosing hospice does not mean giving up. You can leave hospice at any time if you decide to pursue curative treatment, and you can return to hospice later if needed.

Medicare covers virtually all hospice-related care at no cost to you:

Medical care: Doctor and nurse practitioner visits, nursing care, medical social services

Symptom management: Medications for pain relief and symptom control related to the terminal illness

Equipment and supplies: Hospital bed, wheelchair, oxygen, bandages, and other medical equipment

Aide and homemaker services: Help with personal care (bathing, dressing) and light housekeeping

Therapy services: Physical, occupational, and speech therapy for comfort

Spiritual care: Chaplain services and spiritual counseling

Grief counseling: For the patient and family, including bereavement support for up to 13 months after the patient's death

Short-term inpatient care: For pain or symptom management that can't be managed at home

Respite care: Short-term inpatient care to give family caregivers a break (up to 5 consecutive days)

Hospice does not cover treatments intended to cure the terminal illness. It also does not cover room and board in a nursing home (though it covers the hospice services provided there), or care from providers not affiliated with your hospice team.

Medicare hospice is organized into benefit periods:

• Two 90-day periods
• Followed by unlimited 60-day periods

At the start of each period, a hospice doctor must recertify that you still have a terminal prognosis. There's no limit on how long you can receive hospice care as long as you continue to qualify.

1. Talk to your doctor about whether hospice is appropriate
2. Choose a Medicare-certified hospice program (your doctor or hospital social worker can provide referrals)
3. Sign a statement choosing hospice care instead of curative treatment for your terminal illness
4. Have your doctor and hospice medical director certify your prognosis

Many families wait too long to choose hospice -- sometimes only days before death -- missing weeks or months of comfort care and support. Research consistently shows that hospice patients often live longer and with better quality of life than similar patients who continue aggressive treatment.

Having this conversation early, while there's still time to benefit fully from hospice care, is one of the most important things families can do.

We do not offer every plan available in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.