When your loved one is facing a terminal diagnosis, you may be worried about preserving their quality of life in their remaining time. Hospice care can be a great option to support your loved one’s needs. As you’re preparing to lose a loved one and your heart and mind are overcome with grief, even thinking about money can be challenging. Keep in mind, however, that while there may be costs for hospice care in a nursing home, there are multiple ways for your loved one to cover these expenses.
Our free tool provides options, advice, and next steps based on your unique situation.
Medicare commonly covers hospice care nursing home costs for seniors who live in a nursing home or skilled nursing facility, as long as they’re already enrolled in Medicare Part A and meet the eligibility requirements. However, hospice care recipients who don’t have public or private insurance coverage will need to pay for services out of pocket.
The provider of a person’s hospice care at home or in a facility also affects how they’re able to pay for those services. Hospice services may be delivered through small hospice units in the nursing home or through outside providers, such as home health agencies, hospice respite homes, veterans nursing homes, and community-based hospices.[01]
Our free tool provides options, advice, and next steps based on your unique situation.
Multiple government-run programs pay for hospice care received in a nursing home.
If your loved one already has Medicare, it will likely cover hospice.
Medicare pays for hospice care if a person meets these requirements:
According to Medicare’s official webpage on hospice care, “You can usually get Medicare-certified hospice care in your home or other facility where you live, like a nursing home.”[02]
While Medicare covers many expenses associated with hospice care, it doesn’t cover room and board in a nursing home. However, Medicare may cover other nursing home expenses. Medicare also won’t cover curative treatments once your loved one starts hospice care.
As of 2018, there were more than 4,600 Medicare certified hospices operating in the United States.[03] However, it’s important to note that hospice providers are not required to accept Medicare.
Some states may offer hospice support through Medicaid. The hospice benefit is considered an optional state plan service, so it’s not automatically available in all states.[04]
To find out if your loved one’s state offers Medicaid hospice benefits, contact the local Medicaid office in your loved one’s state.
If your loved one served in the U.S. military, is a surviving spouse or child, or the spouse of a veteran, they may be qualified to receive VA benefits that help pay for hospice care.
Military-connected individuals who are eligible for TRICARE can likely receive some coverage for hospice care in a skilled nursing facility through this Department of Defense program. TRICARE may cover pain control, home health aide services, and counseling services.[06]
Treaties between sovereign Indian nations and the United States have helped secure federal funding to provide health services for American Indians and Alaska Natives.
There may be tribally operated hospice programs available to eligible people in limited locations in the Southwest and Midwest. These programs may operate with a home health services arm and may be able to provide services in nursing home locations.[07]
Additionally, these providers may offer culturally appropriate supports, such as traditional healers on their interdisciplinary hospice care teams.[08]
If your loved one is eligible and interested in this type of hospice support, they should contact their local tribally operated hospice program or the Indian Health Service for more information.
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Because Medicare generally covers basic hospice care, people rarely need to pay significant amounts out of pocket. However, if your loved doesn’t qualify for public programs, or if they choose to receive hospice-related services not covered by Medicare, they’ll need to explore ways to cover hospice costs privately.
Here are some private-pay options that can help cover any services related to hospice care.
If your loved one has savings, stocks, bonds, a 401(k), or an IRA, they can likely pull money from these to pay for the costs of hospice care in the nursing home.
Your loved one may be able to sell their life insurance policy at a lowered rate in exchange for cash through a viatical settlement. This type of settlement is typically only for people with life-threatening diagnoses or serious chronic conditions. The cash received from this settlement can be used however your loved one sees fit, including paying for hospice care.[09]
If your loved one has private insurance, their policy may cover some or all of the expenses related to hospice care in a nursing home. Each policy varies, so it’s a good idea for your loved one to verify benefits with their insurance provider. Be sure to ask if copays or coinsurance apply to hospice care under their insurance plan.
Your loved one can ask their hospice care provider if they offer a sliding scale for payments or reduced payments for people with limited financial resources. Some providers may offer this option without advertising it on their website, so it doesn’t hurt to ask.
If you and your family members feel led to help your loved one pay for care, you may be able to pool together your financial resources to cover their hospice expenses.
Your parent may be able to sell their home or apply for a reverse mortgage to use the equity to pay for hospice care. They may also be able to raise funds by renting their home.
The Hospice Help Foundation provides grants to people in hospice who are in dire financial need. These grants typically help pay for services that aren’t covered by insurance. This organization only accepts grant applications from the hospice program that’s providing hospice care to a patient, which means your loved one cannot apply directly.
If your parent feels comfortable starting a GoFundMe campaign, that may be another way to raise funds to pay for their hospice care. It’s important to note that not all people in hospice will be OK with publicly asking for donations to support their hospice care, so it’s essential to have a person’s approval prior to starting a campaign for them.
American Cancer Society. (2019, May 10). How and where is hospice care provided and how is it paid for?
Centers for Medicare & Medicaid Services. Hospice care.
National Hospice and Palliative Care Organization. (2020, August 20). NHPCO facts and figures: 2020 edition.
Centers for Medicare & Medicaid Services.Hospice benefits.
U.S. Department of Veterans Affairs. (2023, February 15). Hospice care.
Defense Health Agency. (2022, March 20). Hospice care.
Centers for Medicare & Medicaid Services. LTSS research: Hospice inventory: Hospice in Indian Country.
Centers for Medicare & Medicaid Services. LTSS research: Literature review: Hospice in Indian Country.
Life Insurance Settlement Association. (2020, October 13). What is a viatical settlement?
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