No, Medicare hospice does not pay for nursing home room and board. The Medicare hospice benefit covers the care for your loved one's terminal illness, but the facility's room-and-board charge is a separate bill that stays with the family, or with Medicaid if your loved one qualifies. There's one exception worth knowing: a short inpatient or respite stay the hospice arranges.

In This Guide

Does Medicare Hospice Pay for Nursing Home Room and Board?

Short answer: no. The Medicare hospice benefit, paid under Part A, covers the care your loved one needs for their terminal illness, the nursing visits, the medications for pain and symptoms, the hospice aide, the medical equipment, the counseling. What it doesn't cover is room and board. Medicare's own coverage page says it plainly: Medicare doesn't cover room and board if you get hospice care at home, or if you live in a nursing home or a hospice inpatient facility.

This trips up a lot of families, and it's an honest confusion. You hear that hospice is covered at almost no cost, which is true for the hospice care itself. But if your loved one is living in a nursing home or an assisted living community, the monthly charge for the room, the meals, and the day-to-day help isn't hospice care. It's the facility's own bill, and hospice doesn't touch it.

So the two things run side by side. Medicare (or Medicare hospice specifically) pays the hospice team. The facility keeps billing for the room. Electing hospice doesn't merge those two bills into one.

Why the Room-and-Board Bill Doesn't Go Away

Here's the mechanics behind it. When someone who lives in a Medicare or Medicaid facility, a skilled nursing facility, a nursing facility, or an intermediate care facility, elects the hospice benefit, federal rules say that facility must keep furnishing 24-hour room and board. That responsibility stays with the facility, not the hospice.

Think of it this way. Before hospice, your loved one was already living there and someone was paying the facility for the room. Choosing hospice doesn't change that arrangement. The hospice team now comes in to manage comfort and symptoms, and the facility keeps doing what it was already doing, housing and caring for your loved one day to day, and billing for it the same way it did last month.

That's why the room-and-board charge doesn't disappear when hospice starts. The care your loved one gets actually expands, because the hospice team is added on top. But the rent, so to speak, is unchanged.

If Medicare Hospice Won't Pay Nursing Home Room and Board, Who Does?

This is the part families most need to plan for, so let's be concrete. Since Medicare hospice won't pay the facility's room-and-board charge, that bill lands on whoever was already responsible for it. In practice, that's one of two payers.

If your loved one is paying privately, the family keeps paying the facility's monthly rate out of pocket, or from your loved one's income and savings, exactly as before hospice. Hospice care gets added at little or no cost, but it doesn't offset the room-and-board bill.

If Medicaid is covering the nursing home stay, that generally continues. For someone who qualifies for Medicaid and is already living in a Medicaid-covered nursing facility, Medicaid is the program paying the facility's room and board, and electing Medicare's hospice benefit doesn't cut that off. If your loved one isn't on Medicaid but the nursing home cost is more than the family can carry, this is the moment to look into whether they'd qualify. Our guides on what Medicare does and doesn't cover for long-term care and how to pay for nursing home care walk through where that gap sits and how families fill it.

Assisted living works the same way on the room-and-board side: Medicare hospice covers the hospice care that comes to the resident, and the assisted living community's monthly fee stays a private bill.

The One Exception: Inpatient and Respite Stays

There's one situation where Medicare does pick up a facility stay, and it's worth knowing because it can genuinely help. Hospice care comes in four levels, and two of them are delivered in a facility for a short time: general inpatient care, for symptoms that can't be managed at home, and inpatient respite care, a short stay that gives a family caregiver a break.

For those two levels, Medicare covers the short-term inpatient stay, room-and-board-type costs included, rather than leaving it to you. That's the exception to everything above. It does carry its own cost-sharing, so it isn't quite free, but it's a real Medicare-covered benefit, not a private facility bill.

The key difference: this covers a short stay the hospice arranges as part of the hospice plan, not the ongoing months your loved one spends living in a nursing home or assisted living. For that long-term residence, we're back to the general rule, room and board is on the family or Medicaid.

Frequently Asked Questions

Does Medicare hospice pay the nursing home bill?

No. Medicare's hospice benefit pays for the hospice care, the nursing, medications for the terminal illness, the aide, equipment, and counseling. It does not pay the nursing home's room-and-board charge. That charge stays with whoever was already paying it: the family, or Medicaid if your loved one qualifies for the nursing home stay.

If my mom is in assisted living and starts hospice, does Medicare cover her rent?

No. Medicare hospice covers the hospice care that comes to her in the assisted living community, but the community's monthly room-and-board fee stays a private bill, the same as before hospice.

Does Medicaid pay room and board when someone is on hospice?

If your loved one already qualifies for Medicaid and Medicaid is covering their nursing facility stay, that coverage generally continues after they elect Medicare hospice. Medicaid rules and rates vary by state, so confirm the specifics with your state Medicaid agency.

Is there ever a time Medicare covers a facility stay for hospice?

Yes. When the hospice arranges a short-term general inpatient stay for symptoms that can't be controlled at home, or a short inpatient respite stay to give a family caregiver a break, Medicare covers that facility stay. It carries its own cost-sharing, but it's a covered hospice benefit rather than a private bill.

If hospice is free, why does the nursing home still charge me?

Because they're two separate things. Hospice care and room and board are billed separately. Medicare hospice covers the care for the terminal illness at little cost to you, but the room, meals, and daily help a nursing home or assisted living provides is the facility's own charge, and hospice doesn't cover it.

Learn More

MedicareWhat the Medicare Hospice Benefit Actually CoversThe Medicare hospice benefit covers end-of-life care at almost no cost, but not room and board. What it pays, what it doesn't, who qualifies, and when to call. MedicareWho Qualifies for Medicare Hospice?Who 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. MedicareDoes Medicare Cover Long-Term Care?Does Medicare pay for nursing home long-term care? No, not custodial care. It covers only short-term skilled nursing after a hospital stay. Here's the split.

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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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Brevy Care Team

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