If a doctor has said the word "hospice" about someone you love, you are likely holding two questions at once: is it covered, and what will it cost us. Here is the reassuring part, and it is true: the Medicare hospice benefit covers comfort care for a dying person at almost no out-of-pocket cost. There is one hard exception worth knowing before you decide: Medicare will not pay the room and board, the rent or the facility room fee, for a hospice patient at home, in assisted living, or in a nursing home.

Asking about money right now is not a betrayal of the person who is dying. It is part of caring for them, and for the rest of the family. This guide walks through what the benefit pays, the room-and-board gap and the one thing that fills it, who qualifies, and how to know when to call.

In This Guide

Everything below is grounded in Medicare's own rules for the hospice benefit.

Is Hospice Covered, and What Will It Cost?

Yes. If your loved one has Medicare Part A and a doctor has certified that they are terminally ill, the Medicare hospice benefit covers their care, and it covers it generously. Once hospice is elected, Medicare pays for the services and supplies related to the terminal illness, and the family's share of the cost is close to nothing.

The two small costs are easy to name. You may pay up to $5 for each outpatient prescription drug used to manage pain or other symptoms, and if your loved one needs a short inpatient respite stay so you can rest, you pay 5% of the Medicare-approved amount for that stay, and that copayment cannot be more than the inpatient hospital deductible. That is the whole of it for covered care.

The exception is room and board, and it is the one that surprises families later. If your loved one is at home, the "rent" is your own home, so there is nothing extra. But if they live in a nursing home or an assisted living facility, Medicare's hospice benefit does not pay that facility's room-and-board charge. We cover exactly how that works, and the one situation where another program pays it, below.

What the Medicare Hospice Benefit Covers

Hospice is comfort care. When a family elects it, the goal shifts from trying to cure the illness to keeping the person comfortable, present, and cared for, wherever they call home. A hospice team, which typically includes a doctor, nurses, aides, a social worker, a chaplain, and trained volunteers, manages the symptoms of the terminal illness and supports the family caring for them.

Medicare pays for that care at one of four levels, and the level can change as needs change:

Level of care What it is
Routine home care The most common level. The hospice team comes to wherever the patient lives, home, assisted living, or a nursing home.
Continuous home care Short periods of mostly nursing care at home during a symptom crisis, to avoid a hospital trip.
Inpatient respite care A short stay (up to 5 consecutive days at a time) in a Medicare-approved nursing home, hospice inpatient facility, or hospital so the family caregiver can rest.
General inpatient care Short-term care in a hospice or hospital setting for symptoms that cannot be managed at home.

Respite deserves a note, because it is built into the hospice benefit rather than something you have to argue for. Two things decide whether Medicare pays for it. The hospice team has to determine that your loved one needs the respite stay and arrange it, so contact the team before any of it happens or you may be left owing the entire cost. And a stay may be provided only on an occasional basis and may not be reimbursed for more than 5 consecutive days at a time. That 5-day rule limits the length of each stay, not the number of stays you can take. If a stay runs longer, the sixth day and any day after it is paid at the routine home care rate, and the patient becomes liable for the room and board for those days. One more limit matters if your loved one already lives in a facility: respite care cannot be provided at all to a hospice patient who resides in a facility such as a long-term care nursing home, because the facility is already furnishing the daily care a respite stay is meant to relieve. If you have been the one holding everything together, that short break is not a luxury the program frowns on. Our guide to the four levels of Medicare hospice care explains when each level applies and how a team moves between them.

The benefit also covers the medicines, medical equipment, and supplies needed to keep your loved one comfortable, along with the visits from the team. Inpatient care is meant to be short-term and symptom-driven, not a permanent placement: across all of a hospice's Medicare patients, total inpatient days (general inpatient plus respite) may not exceed 20 percent of the total days those patients spent on hospice. That 20 percent limit is a payment rule applied to the hospice's own aggregate at the end of the year, not a ceiling on any one patient, so no individual is rationed to a share of inpatient days and your loved one should still get general inpatient or respite care when it is clinically indicated.

What It Costs, and the Room-and-Board Surprise

Under the Medicare hospice benefit, the cost for the care itself is small: up to $5 per outpatient comfort drug, and 5% of the Medicare-approved amount for a short respite stay, capped at the inpatient hospital deductible. Those two are the only cost-sharing amounts Medicare names for the hospice services themselves.

Then there is the room and board, and this is the part to understand before you choose a setting.

There is one situation where that gap is filled, and it is worth knowing before you choose a setting. If your loved one is dual-eligible, meaning they have both Medicare and Medicaid, and they live in a Medicaid-participating nursing facility, Medicaid generally pays the room and board. Specifically, where the person would otherwise be eligible for that facility's services, federal law requires the state to pay the hospice an added room-and-board amount equal to at least 95% of the rate it would have paid the facility for that person's facility services, and the hospice passes that payment through to the nursing home. For a dual-eligible parent in a nursing home, that means Medicaid, not your family, generally covers the room and board that Medicare will not.

If your loved one is not dual-eligible and lives in a facility, it is worth talking with the facility and a benefits counselor before you elect hospice, so the room-and-board cost is not a shock. Medicaid eligibility can sometimes be established, and the answer is worth the phone call. Our guide to hospice and nursing home room and board walks through who pays what, setting by setting.

How You Qualify for the Medicare Hospice Benefit

Two things have to be true to elect the Medicare hospice benefit. First, a doctor, the hospice medical director and usually the patient's own physician, certifies that the person is terminally ill, with a life expectancy of 6 months or less if the illness runs its normal course. Second, the patient (or their representative) chooses comfort care and gives up Medicare coverage for treatment aimed at curing the terminal illness. Care for unrelated conditions still gets covered as usual.

That "6 months or less" number is a prediction, not a deadline, and people often live longer. Hospice is organized into benefit periods so it can continue: two 90-day periods, followed by an unlimited number of 60-day periods, each requiring the doctor to recertify that the person is still terminally ill (with a face-to-face visit before the third period and each one after). Outliving the prediction is not itself a reason to end coverage, as long as the doctor keeps certifying the terminal illness. Our guide to who qualifies for Medicare hospice care goes through the certification and recertification rules step by step.

It also is not a one-way door, though leaving is a formal step rather than a phone call. The patient or their representative may revoke the hospice election at any time during an election period, but it has to be in writing: a signed statement filed with the hospice revoking the election for the rest of that period, together with the date the revocation takes effect. A verbal revocation is not accepted, and the effective date cannot be earlier than the day the revocation is made, so it can never be backdated to make Medicare pay bills already incurred. Revoking forfeits hospice coverage for the days left in that election period. Once it takes effect, the person immediately resumes the Medicare coverage the election had waived, meaning Medicare payment for services related to the terminal illness and related conditions. There is no waiting period to elect hospice again, and a later benefit period can begin immediately if they still meet the eligibility rules. A hospice cannot revoke the election on the patient's behalf and should not ask them to, though a hospice may discharge a patient on defined grounds, such as a transfer to another hospice, moving out of the service area, the illness improving so the person is no longer terminally ill, or discharge for cause, which is a separate process with its own protections.

When to Call Hospice

Families almost never regret calling hospice. What they often regret is waiting. Because the benefit is built around a 6-month prognosis, calling early means more days of the support, symptom relief, and steadiness that hospice provides, for the patient and for you. Waiting until the final days means a family gets only a fraction of what the benefit could have given them.

You do not have to be certain. If a doctor has said your loved one may have months rather than years, if hospital trips are becoming frequent and harder on them than they help, or if the focus is shifting from fighting the illness to being comfortable, that is the moment to ask about hospice. You can call a hospice directly for an evaluation, and electing it is a choice you can revisit.

Hospice vs Palliative Care

These two get confused often, and the difference matters. Palliative care is comfort-focused care that a person can receive at any stage of a serious illness, alongside treatment meant to cure or control it. Hospice is the end-of-life form of palliative care: it is for someone a doctor believes has six months or less to live, and electing it means attempts to cure the terminal illness stop in favor of comfort. Stopping treatment aimed at curing an illness does not mean discontinuing all treatment, though: other medical care may continue as long as it is helpful, so someone who enters hospice with high blood pressure still gets medicine for it. Nor does the choice have to be permanent, since a person can leave hospice for a while and return later if a provider still believes they have less than six months to live. If your loved one is seriously ill but still pursuing treatment, palliative care may be the better fit for now. Our guide to Medicare palliative care coverage and our hospice vs palliative care comparison walk through the distinction in more detail.

Frequently Asked Questions

Does Medicare cover hospice care?

Yes. If a beneficiary has Medicare Part A and a doctor certifies a terminal illness with a life expectancy of 6 months or less, the Medicare hospice benefit covers comfort-focused care for the terminal illness, at almost no out-of-pocket cost.

How much does hospice cost with Medicare?

Very little for the care itself: up to $5 for each outpatient prescription drug for pain or symptom relief, and 5% of the Medicare-approved amount for a short inpatient respite stay, which cannot be more than the inpatient hospital deductible. Those are the only cost-sharing amounts Medicare names for the hospice services themselves. The cost Medicare does not cover is room and board.

Does Medicare hospice cover room and board?

No, not as a general rule. Medicare's hospice benefit does not pay room and board, whether the patient is at home, in assisted living, in a nursing home, or in a hospice inpatient facility. There is one exception inside that rule: if the hospice team determines the patient needs short-term inpatient or respite care and the team arranges it, Medicare does cover that stay in the facility. Separately, if the patient is dual-eligible, lives in a Medicaid-participating nursing facility, and would otherwise be eligible for that facility's services, federal law requires the state to pay the hospice a room-and-board amount of at least 95% of the rate it would have paid the facility, which the hospice passes to the facility.

How long does Medicare pay for hospice?

As long as the person remains terminally ill. Coverage runs in benefit periods, two 90-day periods then an unlimited number of 60-day periods, each needing the doctor to recertify the terminal illness, with a face-to-face encounter by a hospice physician or nurse practitioner before the third period and before each one after. Living longer than six months does not end coverage on its own.

Can you leave hospice and go back to regular Medicare?

Yes, but it is a written step rather than just a decision. The patient or their representative may revoke the hospice election at any time during an election period by filing a signed statement with the hospice that gives the effective date, and that date cannot be earlier than the day the revocation is made. A verbal revocation is not accepted, and revoking forfeits hospice coverage for the rest of that election period. Medicare coverage for services related to the terminal illness and related conditions resumes immediately, and there is no waiting period to elect hospice again later.

Learn More

MedicareWho Qualifies for Medicare Hospice CareWho qualifies for Medicare hospice? Part A covers it once two doctors certify a terminal illness of six months or less and you choose comfort care. MedicareThe Four Levels of Medicare Hospice CareMedicare hospice covers four levels of care: routine home, continuous home, general inpatient, and respite. What each one means, when it's used, and the cost. MedicareDoes Medicare Hospice Pay for Nursing Home Room and Board?Medicare hospice covers care for the terminal illness, but not nursing home room and board. Here's who pays the facility bill, and the one inpatient exception. MedicarePalliative Care vs. Hospice: The Real DifferencePalliative care and hospice aren't the same. Here's the real difference in plain terms, the Medicare cost gap, and how to know which your parent needs. MedicareMedicare Palliative Care CoverageYes, Medicare covers palliative care, but there's no single palliative-care benefit. Here's exactly how Part A, B, and D pay for it and what you'll owe. MedicaidGeorgia Medicare Hospice BenefitHow the Georgia Medicare Hospice Benefit works: who qualifies, the four levels of care, how long it lasts, what it costs, and how families start.

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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.