Medicare Part A pays for hospice care for a parent whose doctors expect them to live six months or less if the illness runs its usual course. The benefit covers the hospice team, medical equipment and supplies, and drugs for pain and symptoms related to the terminal illness, and families usually pay little or nothing for that care. The big gap is room and board: Medicare does not pay rent or daily living costs at home, in assisted living or in a nursing home.
Who qualifies for the Medicare hospice benefit
According to Medicare.gov, your parent must have Medicare Part A and meet all of these conditions:
- Their hospice doctor and their regular doctor (if they have one) certify that they are terminally ill, with a life expectancy of six months or less
- They accept comfort care (palliative care) instead of care to cure the illness and related conditions
- They sign a statement choosing hospice instead of other Medicare-covered treatments for the terminal illness
That signed form is called the Hospice Election Statement. It names the hospice, the start date and the attending doctor your parent chose. The hospice must be Medicare-approved for Medicare to pay.
How long hospice can last
Hospice is not cut off at six months. Medicare covers two 90-day benefit periods, then an unlimited number of 60-day benefit periods. After the first six months, a hospice doctor or the hospice medical director has to recertify that your parent is still terminally ill, after a face-to-face visit with a hospice doctor or nurse practitioner.
Your parent can also stop hospice at any time, for example to try a new treatment. The hospice will ask them to sign a form with an end date. Medicare's hospice booklet advises signing it only when your parent actually wants hospice care to stop.
What Medicare hospice covers
Medicare's hospice booklet (March 2026) lists the services covered when they are needed for the terminal illness and related conditions:
- Doctor and nursing care
- Medical equipment and supplies
- Prescription drugs for pain relief and symptom control
- Hospice aide and homemaker services
- Physical, occupational and speech-language therapy
- Social work services
- Dietary counseling, and grief counseling for your parent and the family
- Short-term inpatient care for pain and symptom management
- Short-term respite care
- Any other Medicare-covered service needed to manage the terminal illness, if the hospice team recommends it
The hospice team
The team can include doctors, nurses or nurse practitioners, counselors, social workers, pharmacists, therapists, hospice aides, homemakers and volunteers. A hospice nurse and doctor are on call 24 hours a day, seven days a week. The team writes a plan of care with your parent, their attending doctor and the main family caregiver.
Hospice staff visit; they do not move in. The National Institute on Aging notes that at home, family and friends usually provide most of the day-to-day care.
The four levels of care
CMS pays hospices at four levels of care. Knowing their names helps you ask for the right one:
- Routine home care. The usual level. Your parent is at home, or in a nursing home or assisted living community, and not in a crisis.
- Continuous home care. Mostly nursing care given around the clock during a brief crisis, so your parent can stay at home instead of going to a hospital.
- Inpatient respite care. Up to five days in a row in an approved inpatient facility, so the family caregiver can rest.
- General inpatient care. A short inpatient stay to control pain or symptoms that cannot be managed at home.
If you are the main caregiver and you are running on empty, ask the hospice about respite. It exists for exactly that.
What Medicare hospice does not cover
Once hospice starts, Medicare.gov says Original Medicare will not pay for:
- Treatment meant to cure the terminal illness or related conditions
- Prescription drugs meant to cure the illness, as opposed to drugs for comfort
- Care from any provider the hospice team did not arrange (your parent can keep their own doctor as attending doctor if they chose that doctor)
- Room and board at home, in a nursing home or in a hospice inpatient facility, except for short inpatient or respite stays the hospice arranges
- Hospital outpatient care, emergency room care, inpatient hospital care or ambulance rides, unless the hospice arranged them or they are unrelated to the terminal illness
That last point matters at 2 a.m. Call the hospice before calling 911 or heading to the ER. If your parent goes to the hospital without the hospice arranging it, Medicare.gov warns you may owe the full cost.
Room and board in assisted living or a nursing home
Hospice can be provided wherever your parent lives, including assisted living and nursing homes. But Medicare will not pay the monthly bill there. If your parent lives in a facility and chooses hospice, the family keeps paying room and board the same way as before, whether that is private money, long-term care insurance or Medicaid. Ask the facility in writing how hospice changes its charges, if at all.
Care for other health problems
Hospice covers the terminal illness. For unrelated problems, such as a broken wrist, Original Medicare still pays, with the usual deductibles and coinsurance. You can ask the hospice for a written list of items, services and drugs it has decided are unrelated to the terminal illness, with its reasons. Medicare.gov says it must provide that list within three to five days, depending on when you asked.
What the family pays
Under Original Medicare, the costs are small and predictable:
- $0 for hospice care from a Medicare-approved hospice, with no deductible
- Up to $5 per prescription for outpatient drugs for pain and symptoms
- 5% of the Medicare-approved amount for inpatient respite care, capped at the Part A inpatient hospital deductible
- Room and board, if your parent lives in a facility
- The usual Part A and Part B premiums
If your parent has Medicare Advantage
Original Medicare, not the Advantage plan, pays for hospice care related to the terminal illness, even if your parent stays in the plan. Medicare's booklet says the plan keeps covering unrelated care and any extra benefits as long as your parent keeps paying its premiums.
Choosing a hospice
You get to choose. Your parent's doctor, the hospital discharge planner or a nursing home may suggest one, but the choice belongs to your parent and family. Many areas have several Medicare-certified hospices, and they are not all alike.
Using Care Compare star ratings
CMS publishes a family caregiver survey star rating for hospices on its Care Compare site. It comes from the CAHPS Hospice Survey, which is sent to family caregivers of patients who died while in that hospice's care. The survey asks about:
- Communication with the family
- Getting timely help
- Treating the patient with respect
- Emotional and spiritual support
- Help for pain and symptoms
- Overall rating of the hospice and willingness to recommend it
CMS updates the star ratings twice a year. A hospice with too few survey responses shows no star rating, which tells you nothing either way. Look at the individual scores as well as the stars. If "getting timely help" is low, that is worth asking about directly.
You can find a hospice near your parent on Pairlo, where each Medicare-certified hospice shows its CMS family survey star rating.
Questions to ask a hospice
- How quickly can you start care after we call?
- How fast does a nurse come out at night or on weekends?
- How often will the nurse and aide visit?
- Do you provide continuous home care during a crisis, and how often do you do it?
- Where do patients go for respite or general inpatient care?
- Which drugs and supplies do you cover, and which will you not cover?
- Do you have experience with my parent's illness, such as dementia or heart failure?
- What bereavement support do you offer the family afterward?
Switching hospices
If the first hospice is not working, your parent can change hospice providers once in each benefit period. Talk with the new hospice before you make the change, so everyone agrees on a start date and there is no gap in care.
Practical next steps
- Ask the doctor directly whether your parent qualifies for hospice now. Families often wait longer than they need to.
- Compare at least two hospices. Check their star ratings and call each with the questions above.
- Get the paperwork in order. Make sure someone has health care power of attorney and that advance directives are signed and easy to find. Our documents checklist lists what to gather.
- Ask for the list of non-covered items so the family knows what it will pay for.
- Plan the home setup. The hospice orders covered equipment, but if you need anything beyond that, you can find a medical equipment supplier.
- Get local help if you live far away. An aging life care manager can coordinate with the hospice and keep siblings informed. Find a care manager near your parent.
