Does Medicare cover it?
Does Medicare cover hospice care?
Yes, under Part A, from a Medicare-approved hospice. Enter the number of prescriptions a month: the estimator gives the drug copays, the only regular cost of covered hospice care.
What this service costs you
You pay
$20
Hospice: up to $5 per prescription for symptom control; everything else costs nothing.
How this is calculatedMedicare Part A covers hospice, the end-of-life care for an illness that cannot be cured, when your hospice doctor and your regular doctor, if you have one, certify that you are terminally ill with a life expectancy of 6 months or less, you accept comfort care instead of care to cure the illness, and you sign a statement choosing hospice. From a Medicare-approved hospice provider, covered hospice care costs you nothing. The exceptions are small but real: a copayment of up to $5 for each outpatient prescription for pain and symptom management, so $20 for four prescriptions, and up to 5% of the Medicare-approved amount for inpatient respite care, the short stay that gives a caregiver a rest. Room and board are not covered when you receive hospice care at home, in a nursing home or in an inpatient hospice facility, unless the hospice team arranges short-term inpatient or respite care. Coverage runs for two 90-day benefit periods, then an unlimited number of 60-day periods, as long as a hospice doctor recertifies that you are terminally ill.
Hospice drug copays
At most
$60
| Per prescription | $5 |
| Per month | $20 |
| Hospice team, visits, equipment | $0 |
Costs computed by Radif Partners · Editorial policy · How the costs are calculated
Who qualifies
You must have Part A and meet three conditions: a hospice doctor and your regular doctor, if you have one, certify that you are terminally ill with a life expectancy of 6 months or less; you accept comfort care, also called palliative care, instead of care to cure your illness; and you sign a Hospice Election Statement choosing hospice instead of other Medicare-covered treatments for the terminal illness and related conditions. The statement names the hospice, the start date and your attending doctor, and it must be completed before any hospice service.
Benefit periods
Hospice is covered for two 90-day benefit periods, followed by an unlimited number of 60-day periods. After the first 6 months, care continues as long as the hospice medical director or hospice doctor recertifies, after a face-to-face meeting with the hospice doctor or nurse practitioner, that you are still terminally ill. You may change hospice provider once in each benefit period, and you may stop hospice care.
What you pay
- Covered hospice care from a Medicare-approved provider: $0.
- Outpatient drugs for pain and symptoms: up to $5 per prescription. In the rare case the hospice benefit does not cover a drug, the hospice should contact your drug plan to see if Part D covers it.
- Inpatient respite care: up to 5% of the Medicare-approved amount, and never more than the inpatient deductible, $1,736 in 2026.
- Room and board where you live, if that is a nursing home or other facility: not covered.
| Prescriptions a month | Most you pay a month | Over 3 months |
|---|---|---|
| 1 | $5 | $15 |
| 4 | $20 | $60 |
| 8 | $40 | $120 |
| 15 | $75 | $225 |
Medigap
The standardized Medigap chart includes the Part A hospice coinsurance or copayment: Plans A, B, C, D, F, G, M and N pay it in full, Plan K pays 50% and Plan L 75%. With those plans, the drug copays and respite coinsurance above can drop to zero or be halved.
Where care takes place
Hospice care is usually given at home or in the facility where you live, such as an assisted living facility or a nursing home. Under certain conditions it can be given in an inpatient hospice facility. If the hospice team decides you need hospital inpatient care, it must arrange the stay; otherwise you might pay the entire cost of the hospital care. The hospice provider must tell you if any drug or service is not covered and why, and whether you will be required to pay for it. Coverage rules come from the medicare.gov hospice page.
Questions for the hospice team
Ask for the addendum to your election statement that lists the items, services and drugs the hospice will not cover because it considers them unrelated to your terminal illness; if your coverage changes, the hospice gives you an updated one. Ask which of your current prescriptions it will provide, and at what copay. If you live in a nursing home, ask who will bill the room and board. And before any trip to an emergency room or any ambulance ride, call the hospice team first, so that the care is arranged by it.