6 monthsLife expectancy to qualify
$0Cost of hospice care itself
$5Max copay per drug prescription
5%Coinsurance for inpatient respite care
Who qualifies
You can receive Medicare hospice benefits if you meet all of these:
- You have Medicare Part A.
- Your doctor and the hospice medical director certify that you are terminally ill, with a life expectancy of six months or less if the illness runs its normal course.
- You accept comfort care (palliative care) instead of care meant to cure the terminal illness.
- You choose a Medicare-approved hospice program and sign a statement choosing hospice.
What hospice covers
- Doctor and nursing services, and a care team including social workers and counselors
- Medical equipment and supplies for your comfort
- Drugs for symptom control and pain relief
- Short-term inpatient care for symptoms that cannot be managed at home
- Short-term respite care to give caregivers a break
- Grief counseling for you and your family
What it costs
| Service | Your cost |
|---|---|
| Hospice care from the approved program | $0 |
| Prescriptions for pain and symptom relief | A copay of up to $5 per prescription |
| Inpatient respite care | 5% of the Medicare-approved amount |
| Room and board at home, or in a nursing home | Not covered, unless you are in a hospital or hospice inpatient unit |
How long it lasts
Hospice is provided in benefit periods: two 90-day periods followed by an unlimited number of 60-day periods, as long as the doctor recertifies that you remain terminally ill. You can stop (revoke) hospice at any time and return to regular Medicare coverage, and you can choose it again later.
Other care while on hospice
Original Medicare still covers care unrelated to your terminal illness. If you are in a Medicare Advantage plan, Original Medicare pays for your hospice care, and your plan covers other care.
Hospice is different from skilled nursing and home health. See nursing home coverage and home health.