Medicare and Hospice Benefits

Making decisions about hospice care for a loved one can feel overwhelming. Between the emotional challenges of end-of-life care and the complexity of Medicare rules, it’s easy to feel unsure about what’s covered and when hospice is appropriate.

This guide explains how the Medicare hospice benefit works, who qualifies, what services are covered, and how long care can last.

Who Qualifies for Medicare Hospice Care?

Hospice care focuses on comfort, dignity, and quality of life, not curing a terminal illness. Under Original Medicare Part A, a patient qualifies for hospice care if:

  • A physician certifies a terminal illness with a life expectancy of six months or less

  • The patient chooses palliative (comfort-focused) care instead of curative treatment

  • The patient signs a hospice election statement

Patients may leave hospice at any time if they decide to pursue curative treatment again.

Medical Conditions That May Qualify for Hospice

While cancer is the most common diagnosis among hospice patients, many other serious illnesses can qualify, including:

  • Dementia and Alzheimer’s disease

  • Congestive heart failure

  • Stroke

  • End-stage renal disease (ESRD)

  • Liver disease

  • Parkinson’s disease

  • Multiple sclerosis

  • Huntington’s disease

  • Advanced diabetes complications

  • AIDS

If a loved one has a different terminal condition and a prognosis of six months or less, a physician or hospice provider can help determine eligibility.

What Medicare Covers During Hospice Care

Medicare’s hospice benefit is comprehensive and designed to reduce out-of-pocket costs for patients and families. Covered services typically include:

  • Physician and nursing services

  • Prescription drugs for pain and symptom management

  • Medical equipment (hospital beds, wheelchairs, walkers)

  • Medical supplies (bandages, catheters, wound care items)

  • Hospice aides and homemaker services

  • Physical, occupational, and speech therapy

  • Social worker support

  • Dietary counseling

  • Grief and bereavement counseling for patients and families

  • Short-term inpatient care for pain or symptom management

  • Short-term respite care for caregivers

All care is coordinated by a Medicare-approved hospice provider.

What Medicare Does Not Cover in Hospice

When a patient elects hospice care, Medicare no longer covers treatments intended to cure the terminal illness. Medicare also does not cover:

  • Room and board in a private home, assisted living facility, or nursing home

  • Care from providers not arranged by the hospice team

  • Emergency room visits, hospital stays, or ambulance services not approved by hospice

  • Medications or treatments intended to cure the illness

To avoid unexpected costs, families should work closely with the hospice care team when arranging services.

Note: Some Medicare Advantage plans may offer additional benefits beyond what Original Medicare covers during hospice care.

How Long Can Someone Receive Hospice Care?

Hospice care begins with two 90-day benefit periods. After that, patients may continue receiving hospice care in unlimited 60-day benefit periods, as long as a physician recertifies that the patient remains terminally ill.

There is no maximum time limit for hospice care as long as eligibility requirements continue to be met.

Frequently Asked Questions About Medicare Hospice Benefits

Does Medicare cover hospice care?
Yes. Medicare Part A includes a hospice benefit for eligible patients who choose comfort-focused care.

What disqualifies someone from hospice under Medicare?
Patients are not eligible if they do not have a terminal illness or if their life expectancy exceeds six months.

When is hospice care appropriate?
Hospice care is appropriate when a patient has a terminal diagnosis, declining physical function, difficulty with daily activities, or significant unintentional weight loss.

How long does hospice care usually last?
Hospice care is initially certified for six months, but patients can continue receiving care if a physician recertifies eligibility.

Getting Help With Medicare and Hospice Decisions

Understanding Medicare hospice benefits can help families make informed decisions during a difficult time. Working with a physician and a Medicare-approved hospice provider ensures that your loved one receives compassionate, coordinated care focused on comfort and quality of life.