Does Medicare Pay for Hospice?

For patients who qualify, Medicare Part A includes a hospice benefit.
Generally, a patient must:

• Be eligible for Medicare Part A
• Be certified as having a terminal illness with a life expectancy of six months or less if the illness follows its normal course
• Choose hospice care instead of treatment intended to cure the terminal illness
• Receive care from a Medicare-certified hospice provider

Once a patient elects hospice, Medicare generally pays the hospice provider for the services related to the
terminal illness and related conditions.
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For covered hospice services, Medicare states that patients generally pay $0 for the hospice care itself.
There can be a few limited out-of-pocket costs, including a copayment of up to $5 for certain outpatient
prescriptions used for pain and symptom management and 5% of the Medicare-approved amount for
inpatient respite care.
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For most families, however, the hospice benefit covers a wide range of services that would otherwise
represent significant expenses.

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What Does the Medicare Hospice Benefit Cover?

Hospice is much more than an occasional nursing visit.
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Depending on the patient's individualized plan of care, hospice services may include:

• Nursing care
• Physician services
• Medications related to pain and symptom control
• Medical equipment
• Medical supplies
• Hospice aide services
• Medical social services
• Spiritual support
• Physical, occupational, or speech therapy when appropriate
• Dietary counseling
• Grief and bereavement support
• Short-term inpatient care for symptom management
• Short-term respite care for caregivers

One of the things families are often surprised to learn is how comprehensive hospice care can be.
The goal is to support not only the patient, but the entire family.

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What About Medicaid?

For patients who qualify for Medicaid, hospice benefits may also be available.
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Coverage varies by state and by the individual's eligibility, but Medicaid programs can help cover hospice
services and may also assist with certain Medicare cost-sharing expenses for people who are eligible for
both Medicare and Medicaid.
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If you're unsure what coverage your loved one has, the hospice team can help you understand your options
before care begins.

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Does Private Insurance Cover Hospice?

Many private insurance plans also include hospice benefits.
Coverage varies depending on the individual policy, so it's important to verify benefits with the insurance
company.

A hospice provider can typically help with that process by reviewing coverage, explaining what services are
included, and identifying any potential out-of-pocket costs.
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Families should never be afraid to ask:
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“What will this cost us?”
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That is an important question, and you deserve a clear answer.

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What Isn't Typically Covered?

There are some expenses families should understand may fall outside the hospice benefit.
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For example, Medicare generally does not pay for room and board simply because someone is receiving
hospice.
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If a patient lives at home, there is no room-and-board charge associated with hospice.
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However, if a patient lives in a nursing home, assisted living community, or another residential setting, the
cost of that room and board is generally separate from hospice care unless another benefit or program
covers it.
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There are also situations in which treatment, medications, or services that are unrelated to the terminal
illness may be handled differently.
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That's why having open communication with the hospice team is so important.

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Hospice Care Shouldn't Begin With Financial Fear

After more than three decades in healthcare, I've seen families delay hospice because they assume they
can't afford it.
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That breaks my heart.
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Too often, families spend precious time worrying about the cost of care when the hospice benefit may
already provide the support they need.
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Hospice should never feel like something reserved only for people with certain financial resources.
It exists so patients can receive comfort, dignity, symptom management, and support during one of life's
most meaningful seasons.

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Ask the Questions Before You Need the Answers

You don't have to wait until a crisis to find out what hospice will cost.

If someone you love has a serious illness, you can call a hospice provider simply to ask questions.
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You can learn:

• Whether your loved one may qualify
• What services would be covered
• Which insurance benefit would pay for care
• Whether there are any potential out-of-pocket costs
• What support is available for caregivers and family members
• Getting information doesn't obligate you to choose hospice.

It simply gives you the ability to make an informed decision.
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At BeyondFaith Hospice, we believe families deserve honesty, compassion, and clarity—especially when
navigating decisions this important.

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If you're wondering whether hospice may be appropriate for someone you love, please reach out.
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Let us help you understand your options so you can spend less time worrying about bills and more time
focusing on what matters most:
your loved one.

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With gratitude,

Becky Richardson, RN, BSN

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‍Becky Richardson, RN, BSN
Owner & CEO
BeyondFaith Hospice

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For more than three decades, Becky Richardson RN, BSN has dedicated her life to caring employees, patients and families through some of life's most challenging and meaningful moments. As Co-Founder and CEO of BeyondFaith Hospice and Above & Beyond Home Health & Rehab, Becky believes healthcare should be compassionate, personal, and centered on the unique needs of every patient. Each month, through The Heart Behind the Care, Becky will share practical healthcare insights, caregiver resources, leadership lessons, and reflections from her years serving families across Texas.

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