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What Is Hospice Care?

A guide for Texas families

Written and reviewed by Dr. G, a board-certified hospice & palliative medicine physician

Last reviewed:

12 min read

What Is Hospice?

Hospice care is specialized medical care for people with a terminal illness. It focuses on comfort and quality of life. Instead of trying to cure the illness, hospice manages pain and symptoms. It also supports the patient and their family emotionally, spiritually, and practically. [1,2]

Hospice is a kind of care that most commonly happens in the home but can happen wherever the patient prefers. [1] People often choose hospice when treatments have stopped working, or when the burdens of treatment outweigh the benefits. [1]

To receive hospice, a doctor must certify that the patient has a medical condition with a life expectancy of six months or less if the illness runs its normal course. The patient then decides on comfort care instead of treatment to cure the illness and signs a statement choosing hospice.

Hospice is a type of palliative care. Both focus on comfort and quality of life for people with serious illness, but hospice is for the final months of life. [4] Palliative care can begin as early as diagnosis and can be given along with treatment for the illness. Hospice is for when life-prolonging treatments are no longer effective or no longer wanted. [5] Read more about hospice vs. palliative care.

Core Principles of Hospice

  • Comfort comes first: The focus is on comfort, not on curing the illness. [2]
  • The patient and family are cared for together. Hospice supports the patient's loved ones as well as the patient. [6] Family caregivers can get support too. [2]
  • Care comes to you. In most cases, hospice care is given in the patient's home. It can also be given in hospice facilities, hospitals, nursing homes, assisted living, and other long-term care settings. [6]
  • A team cares for the whole person. A specially trained team cares for the patient's physical, emotional, social, and spiritual needs. [2]

Who Provides Hospice Care?

Hospice care comes from a team that works together on one plan of care. The patient and family are part of the team. [2] The team usually includes:

  • a hospice doctor or medical director
  • nurses
  • hospice aides
  • social workers
  • grief counselors
  • chaplain/spiritual care providers
  • trained volunteers. [6]

Together, the team manages pain and other symptoms, helps the patient and family with the emotional and spiritual side of dying, provides medicines and medical equipment, and teaches family members how to care for their loved one. [6] Federal rules require hospices to offer grief support to the family for up to one year after the patient dies. [7]

What Does Hospice Care Cover?

Under Medicare, hospice covers everything needed for the terminal illness and related conditions. [2] Depending on the patient's needs, this can include:

  • Hospice doctor services and nursing care
  • Medicine for pain and symptom control
  • Equipment such as wheelchairs or walkers
  • Supplies such as bandages and catheters
  • Hospice aide
  • Social work and dietary counseling
  • Grief and loss counseling for the patient and family
  • Short-term inpatient care for pain and symptoms
  • Short-term respite care, which gives family caregivers a rest [2]

Four levels of care. Medicare pays for four levels of hospice care. [8] Most patients only need the first. [6]

  • Routine home care is the standard level of hospice care. The team visits the patient wherever they live. [6]
  • Continuous home care is used during a short crisis. Care is given for 8 to 24 hours a day, mostly by nurses, so the patient can stay home while severe symptoms are brought under control. [6]
  • General inpatient care is a short stay in a hospital, hospice inpatient facility, or nursing facility when pain or symptoms can't be managed anywhere else. [6]
  • Respite care is a short facility stay of up to 5 days at a time so the family caregiver can rest. [2]

Learn more about the four levels of hospice care.

What families pay. Medicare says you pay nothing for hospice care from a Medicare-approved hospice. [9] There's no deductible. Patients keep paying their usual Medicare premiums, plus two small costs: up to $5 per prescription for pain and symptom medicine, and 5% of the Medicare-approved amount for inpatient respite care. [2] Texas Medicaid also covers hospice for people who qualify, [3] and most other insurance plans cover hospice too. [5] Call your plan to confirm costs. See our guide on understanding hospice costs.

What Is Not Typically Covered?

Once hospice starts, the hospice benefit does not cover:

  • Treatment meant to cure the terminal illness. The patient can stop hospice at any time to get this treatment. [2]
  • Prescription drugs for other health problems. These may be covered by Medicare drug coverage (Part D), and a copayment may apply. Always verify for your individual circumstance. [2]
  • Room and board. The hospice benefit doesn't pay for room and board in a nursing home, assisted living, or other residence. It does cover the facility stay when the hospice team arranges short-term inpatient or respite care. [2]
  • Care the hospice team didn't arrange. This includes emergency room visits, hospital stays, and ambulance rides for the terminal illness. If the hospice didn't arrange the care, the patient might have to pay the full cost, so call the hospice team first. [2]
  • A caregiver in the home around the clock. Hospice staff make regular visits, but a family member usually serves as the main caregiver. During a short crisis, continuous home care can bring staff into the home for longer periods. [6]

Common Misconceptions

Myth: "Hospice means giving up."
Truth: Choosing hospice means choosing a different kind of care. The goal is better quality of life, helping the patient live as well as they can for the time they have. [1]

Myth: "You have to move to a hospice facility."
Truth: Most hospice care happens where the patient lives. In 2022, nearly 99 out of every 100 days of Medicare hospice care were routine home care, given in the patient's home, nursing home, or assisted living. [6]

Myth: "Hospice is only for older adults with cancer."
Truth: Hospice is not only for people with cancer. [2] Along with cancer, the most common reasons people also enter hospice include heart and circulatory diseases and brain and nervous system diseases such as dementia. [6]

Children can receive hospice too. Under federal law, children and young adults under 21 on Medicaid, including Texas Medicaid, can get hospice and keep getting treatment for their illness at the same time (this is called concurrent care). [10]

Myth: "Hospice is only for the last few days of life."
Truth: Patients can start hospice when their doctor expects that they have six months or less to live, and care can continue longer if a hospice doctor believes that the patient is still terminally ill. [2] Many people start too late: half of Medicare hospice patients receive care for 18 days or less. [6] In a study of patients with advanced cancer, those with longer hospice stays had better quality of life at the end of life. [11]

Myth: "Hospice is expensive."
Truth: For most families, hospice costs little or nothing. Beyond their usual Medicare premiums, patients usually pay no deductible for hospice care, and costs are limited to up to $5 per prescription and 5% of the approved amount for respite care. [2,9] The main cost to plan for is room and board if the patient lives in a nursing home or assisted living. [2]

Myth: "Once you start hospice, you can't stop."
Truth: Patients have the right to start or stop hospice at any time and can go back to hospice later if they're eligible. Patients can also switch hospice providers once during each benefit period. [2]

Myth: "It's better not to talk about end-of-life wishes."
Truth: Planning ahead helps patients and families. In a study of hospital patients aged 80 and older, those who planned their care in advance were much more likely to have their wishes known and followed. Their families also had less stress, anxiety, and depression after the patient died. [12] The National Institute on Aging encourages people with a serious illness to talk early with their family and doctors. [4]

Summary

  • Hospice is specialized medical care that focuses on comfort and quality of life rather than curing illness.
  • It cares for the whole person and supports the family, too.
  • A team of doctors, nurses, aides, social workers, spiritual care providers, and volunteers provides care, and help is available 24/7.
  • Most care happens where the patient lives.
  • Medicare covers nearly all hospice care, with only small costs. Room and board is the main cost that isn't covered.
  • Patients stay in control and can stop hospice at any time.
  • Starting hospice earlier gives patients and families more time to get the full benefit.

Before starting hospice, Medicare covers a one-time visit with a hospice doctor to talk about care options, even if you decide not to choose hospice. [2]

This article is for general information only and is not medical advice. Talk with your doctor about your own situation.

References

References accessed September 30, 2026. Coverage rules and clinical guidance can change over time; please confirm current details with your hospice team, doctor, or Medicare.

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