Does Medicare Pay for Hospice Care?

Yes. Original Medicare, consisting of Part A and Part B, will cover all hospice services related to a patient’s terminal illness as long as they meet specific conditions.

Hospice services covered by Medicare include a patient’s hospice care team, medical equipment, medications for pain and symptom management, counseling, and more. Whether seniors choose to receive hospice care at a facility or opt for hospice care at home, Medicare will cover a majority of the costs.

Hospice care teams typically feature a variety of specialists, including doctors, nurses, social workers, therapists, and homemakers. Grief counselors will also meet with families for up to 13 months following the death of a loved one.

In addition to professional staff, hospice coverage with Medicare includes medical supplies needed for pain and symptom management, such as hospital beds, mobility aids, catheters, oxygen tanks, and other essentials. As of 2023, prescriptions that aim to manage symptoms of a terminal illness, but that don’t aim to cure them, are also covered with a $5 out-of-pocket copayment.

If your parent is enrolled in Medicare, hospice services will be covered as long as they meet the following requirements: ^[01]

• Enrolled in Medicare Part A
• Received a terminal diagnosis from a primary care physician or hospice doctor
• Opted for comfort care from a Medicare-approved provider
• Signed an official statement choosing hospice care and committed to no longer receiving preventative treatments for the terminal condition

Let our care assessment guide you

Navigating a parent’s Medicare policy can be challenging, and you’ll likely have plenty of questions before you’re ready to call in hospice care. Here are some commonly asked questions surrounding Medicare hospice coverage:

1. Does Medicare cover 24-hour in-home hospice care?

Yes, Medicare covers 24/7 hospice care, but only for illnesses that require skilled nursing services.

If your loved one’s condition can be treated at home, Medicare plans do include continuous home hospice services. This means that a hospice nurse or aide will regularly visit a patient’s home, and that family caregivers will have access to an on-call hospice staff member 24 hours a day. However, it’s rare for most hospice recipients to receive 24-hour care.

2. Does Medicare cover hospice care at home?

Yes, Medicare will cover in-home hospice care for eligible patients.

Routine in-home support is the most common type of hospice care. While some choose to receive hospice care in a facility, many seniors find that receiving care at home brings an added sense of comfort.

3. Does Medicare cover hospice care in a nursing home?

Yes, Medicare will cover hospice care in a Medicare-certified nursing home.

Medicare staff can help families identify certified local providers. Some hospice providers also have their own facilities where patients can receive inpatient hospice services.

4. Does Medicare pay for hospice in an assisted living facility?

Yes, hospice care provided at an assisted living community will be covered by Medicare.

Talk to your loved one’s assisted living facility director to confirm whether they offer hospice services on-site. Be aware that some states — including Idaho, Mississippi, Montana, and North Dakota — don’t allow hospice services to be provided in assisted living communities.

Read more:The Benefits of Hospice in Memory Care Facilities

Talk with a Senior Living Advisor

5. Is short-term respite care for hospice patients covered by Medicare?

Yes, Medicare will cover respite care for up to five days at a time in a Medicare-certified facility.

If family caregivers are unavailable and a terminally ill senior needs short-term inpatient support, respite care is an option for Medicare recipients. However, be prepared for out-of-pocket costs. As of 2023, Medicare recipients or their families will be expected to pay for 5% of all inpatient respite care costs.

6. How long will Medicare pay for hospice care?

Hospice services are only available for individuals who are terminally ill and have less than six months to live. If a patient outlives this time frame, they’ll be evaluated again after the initial six months, and Medicare-covered hospice care will extend for another six months as long as the prognosis remains the same. This can be extended until death.

If a senior’s illness goes into remission and a doctor determines that they’re no longer terminally ill, Medicare hospice benefits will end. Keep in mind that an individual can revoke hospice benefits if they decide to try curative care again.

Read more:Does Medicare Cover Palliative Care at Home?

When considering your parent’s hospice needs, take into account that the following services won’t be included as part of their Medicare benefits:

• Curative care. As part of hospice Medicare coverage, patients must agree not to seek out preventative prescriptions or curative care for their terminal illness. Any related services, supplies, or prescriptions will no longer be covered by Medicare once an individual accepts hospice benefits. However, for seniors enrolled in a Medicare Advantage Plan, treatments for nonterminal illnesses will continue to be covered. If your loved one has other conditions that require extra treatments or additional prescriptions, staying enrolled in their Advantage Plan is essential to ensure coverage remains.
• Room and board in a care facility. If your parent’s condition cannot be managed at home and they require inpatient treatments, talk to their Medicare representative about room and board coverage. Unless short-term care takes place in a Medicare-approved facility and has been arranged by your hospice provider, room and board costs aren’t covered.
• Medical services not arranged by the hospice care team. Any treatments for a person’s terminal illness not prescribed or recommended by hospice will not be covered. This includes hospital treatments (inpatient or outpatient) and ambulance transportation. Be aware that emergency services, unless arranged by the hospice team, are out-of-pocket costs to patients.

Read more:What is Hospice Care at Home? Services, Payment, and What to Expect

Medicare will directly pay the hospice provider for your parent’s care. As long as patients are paying their monthly Medicare premiums, there will be minimal or no out-of-pocket costs.

Be sure to talk to your loved one’s hospice provider about what services are offered at additional rates. Medicare staff are available by phone and via chat 24/7 to answer any questions and help out with policy information.