Financial & Medicare
Understanding Hospice Costs
Complete guide to hospice costs, including what's covered by Medicare, Medicaid, and private insurance and what families may pay out-of-pocket.
Read guide →A comprehensive guide to what Medicare covers for hospice care and what you can expect to pay out-of-pocket.
Written and reviewed by a board-certified hospice & palliative medicine physician
Last reviewed:
If you have Medicare Parts A & B, the Medicare hospice benefit covers core hospice services related to your terminal illness with little to no out-of-pocket cost for most families. This includes nursing care, medications for symptom management, medical equipment, and more.
For outpatient prescription drugs provided through the hospice benefit, used for pain and other symptom management of your terminal illness (and related conditions), you may pay up to $5 per prescription.
When the patient enters inpatient respite care (up to 5 consecutive days per certification period) so a caregiver can rest, you may pay 5% of the Medicare-approved amount for each day of respite care under the hospice benefit. The total coinsurance cannot exceed the annual inpatient hospital deductible amount.
Many hospices may voluntarily waive or reduce these costs for families experiencing financial hardship—ask your hospice provider about their policy.
Medicare does NOT cover:
Medicare covers four distinct levels of hospice care, depending on the patient's needs:
Most common level. Patient receives care at home (or wherever they live). Nurse visits 1-3 times per week, with on-call support 24/7. All services and supplies are provided.
Typically ~95% of hospice days are at this level
Short-term intensive care at home. For brief crises, a nurse stays in the home for 8-24 hours to manage symptoms and avoid hospitalization. Returns to routine care once stable.
Used for short periods during symptom crises
Short-term inpatient care (up to 5 days per certification period). For symptoms that can't be managed at home, patient stays in inpatient hospice facility or hospital. Once stable, returns home.
Used for acute symptom management that requires facility resources
Caregiver relief. Patient stays in facility for up to 5 days so family caregivers can rest. Can be used once per certification period. Typically there is a small co-pay (5%).
Important: "6 months" is an estimate, not a deadline. If the patient lives longer, hospice care continues as long as the doctor continues to certify terminal illness. You won't lose benefits if your loved one lives beyond 6 months.
Medicare hospice benefits are organized into periods, with recertification required:
Initial certification period. Doctor must certify patient is terminally ill with 6 months or less prognosis.
Requires recertification by hospice medical director. If patient still meets criteria, care continues seamlessly.
After 180 days, benefits continue in 60-day periods with recertification. There is NO limit to how long you can receive hospice care as long as the doctor certifies you remain terminally ill.
A: Hospice care continues! As long as the doctor certifies the illness is still terminal, Medicare continues to cover all hospice services. Many patients receive hospice care for more than 6 months.
A: Yes, you can change providers at any time with just a phone call. You stay on Medicare hospice benefits; only the provider changes. There are no penalties or waiting periods.
A: You can revoke hospice benefits at any time and return to regular Medicare coverage for curative treatment. If you later choose hospice again, you can re-enroll with your remaining benefit periods.
A: No. If patient lives in assisted living or nursing home, you continue to pay rent/room charges. Hospice covers all medical care and supplies, but not housing costs.
A: Medicaid also covers hospice with benefits similar to Medicare. Most private insurance plans cover hospice as well. Check with your specific provider about coverage details.
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Financial & Medicare
Complete guide to hospice costs, including what's covered by Medicare, Medicaid, and private insurance and what families may pay out-of-pocket.
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