Hospice & Medicare
- Hospice costs may be paid through the Medicare Hospice Benefit,
Medicaid Hospice Benefit, and most private insurers.
- More than 90 percent of hospices in the United States are certified by Medicare.
- If your loved one does not have coverage through Medicare, Medicaid or a private
insurance company, the hospice will work with you to ensure needed services can be provided.
Next Step
Get details about Medicare’s Hospice Benefit including what is and is not covered.
Learn More
The Medicare Hospice Benefit, initiated in 1983, is covered under Medicare Part A
(hospital insurance). Medicare beneficiaries who choose hospice care receive a full
scope of medical and support services for their life-limiting illness. Hospice care
also supports the family and loved ones of the person through a variety of services.
About 80 percent of people who use hospice care are over the age of 65, and are thus
entitled to the services offered by the Medicare Hospice Benefit. This benefit covers
virtually all aspects of hospice care with little out-of-pocket expense to the person
or family. Most private health plans also cover hospice, as do Medicaid programs
in every state except Connecticut, Indiana, and New Hampshire.
If your loved one’s health improves or his or her illness goes into remission, a doctor may
determine that hospice care is no longer needed. Also, your loved one always has the
right to stop getting hospice care, for any reason. If he or she stops hospice care,
your loved one will receive the type of Medicare coverage that he or she had before
electing hospice. Your loved one can go back to hospice care at any time, if eligible.
Medicare Hospice Benefit Eligibility
Your loved one is eligible for the Medicare Hospice Benefit when he or she meets all
of the following conditions:
- Your loved one is eligible for Medicare Part A (hospital insurance)
- Your loved one’s doctor and the hospice medical director certify that
he or she has a life-limiting illness and is expected to survive for
six months or less, assuming the normal course of the illness.
- Your loved one or a legal designee signs a statement choosing
hospice care instead of routine Medicare benefits for the illness.
Note that Medicare will continue to pay only for previously covered
conditions unrelated to the life-limiting illness.
- Care is provided by a Medicare-approved hospice program
Next Step:
Learn about the details of Medicare’s hospice coverage.
Content shown was developed through a collaboration between AGIS and the National Hospice and Palliative Care Organization.
