Hospice is comfort care for a person with a terminal illness, given by a team that comes to where the person lives. Medicare covers it under Part A when a hospice doctor certifies a life expectancy of 6 months or less and the person chooses comfort care instead of treatment to cure the illness.
This guide covers what hospice includes, what it leaves out, who pays and how to compare hospices. It does not tell you when hospice is the right choice. That decision belongs to the patient, the family and their doctors. For the difference between hospice and palliative care, read hospice vs palliative care, which we do not repeat here.
What hospice care is and how it works
Medicare.gov describes hospice as end-of-life care for people with illnesses that cannot be cured. The aim is comfort and quality of life, not cure. Federal rules say each patient gets a written plan of care built by an interdisciplinary group together with the patient or representative, the family and the primary caregiver. The group reviews and revises the plan as often as the patient's condition requires, and at least every 15 calendar days.
The same rules require the group to include a physician, a registered nurse, a social worker, marriage and family therapist or mental health counselor, and a pastoral or other counselor. A registered nurse coordinates care and makes sure each patient's and family's needs are assessed on an ongoing basis.
Who qualifies for hospice and who it helps
Hospice is for the person who is ill and for the family around them. Medicare sets the entry rules:
- You have Part A.
- Your hospice doctor and your regular doctor, if you have one, certify that you are terminally ill with a life expectancy of 6 months or less.
- You accept comfort care (palliative care) instead of treatment to cure your illness.
- You sign a hospice election statement before services start. It names your hospice and your attending doctor.
If you are a Veteran, VA also provides hospice for a terminal condition, and VA's own page describes it as comfort care for people who are no longer seeking treatment beyond pain relief.
What the hospice team provides
Federal core service rules name four things a hospice must provide routinely through its own employees:
- Physician services. The medical director and hospice physicians are responsible for managing the terminal illness and related conditions.
- Nursing. Care by or under the supervision of a registered nurse.
- Medical social services. A qualified social worker, working from a psychosocial assessment.
- Counseling. Help for the patient and family to cope with the illness and dying. That includes bereavement counseling, available to the family for up to one year after the patient's death, dietary counseling when the plan of care calls for it, and spiritual counseling after an assessment of the patient's and family's needs.
Medicare.gov says the hospice benefit should cover everything you need for the terminal illness. Ask the hospice for the specific list of equipment, supplies and medicines it provides, in writing.
What hospice does not cover
Once you start hospice, Medicare.gov says these are not covered:
- Treatment intended to cure your terminal illness and related conditions
- Prescription drugs meant to cure the illness, as opposed to control symptoms or relieve pain
- Care from a hospice provider that your hospice team did not set up. Your regular doctor or nurse practitioner can still be your attending medical professional if you choose
- Hospital outpatient or inpatient care, emergency room visits and ambulance transport, unless your hospice team arranges them or they are unrelated to your terminal illness
Medicare.gov warns that you should contact your hospice team before you get any of these services, or you might have to pay the entire cost.
Medicare also does not pay room and board if you get hospice at home or live in a nursing home or hospice inpatient facility. Short-term inpatient or respite stays that the hospice team arranges are covered. If you live in a facility such as a nursing home or assisted living community, you may have to pay for room and board there.
You can ask your hospice for a list of items, services and drugs it has decided are unrelated to your terminal illness, with its reasons. Medicare.gov says the hospice must supply the list within 3 to 5 days of your request, depending on when you made it.
Inpatient and respite hospice care
Federal rules require a hospice to make inpatient care available for pain control, symptom management and respite. Inpatient respite must be provided by a Medicare-certified hospice, hospital or skilled nursing facility, or a Medicare or Medicaid certified nursing facility, and the facility must provide 24-hour nursing. Total inpatient days are capped at 20 percent of a hospice's total hospice days for its Medicare hospice patients over a 12-month period.
This matters to families because respite is how a caregiver gets a break. If you want a short stay, ask the hospice how it arranges it and what the copay is. For respite outside hospice, see respite care.
How hospice differs from other care
- Home health care is skilled care for recovery, not comfort care at the end of life. Hospice covers a different set of needs and follows different Medicare rules.
- Home care is non-medical help with daily tasks. A family may use home care alongside hospice, paid privately or through another program.
- Nursing homes are residences. Hospice can be given inside a nursing home, but Medicare hospice does not pay the nursing home's room and board.
- Palliative care is a wider category. The hospice vs palliative care guide covers it.
Who pays for hospice care
Medicare. Medicare.gov says you pay nothing for covered hospice care from a Medicare-approved provider. There are limited costs:
- A small copayment per prescription for outpatient drugs used for pain and symptom management (Medicare.gov gives the current maximum)
- For inpatient respite care, 5% of the Medicare-approved amount, capped at the inpatient deductible amount
- Deductibles and coinsurance for care unrelated to the terminal illness, which Original Medicare still covers
See what Medicare pays for for the wider picture, including the Part A deductible of $1,736 that applies to hospital stays.
Medicaid. The Medicare.gov and VA pages we read do not set out Medicaid hospice rules, and Medicaid benefits vary by state. Ask your state Medicaid agency or plan. Medicaid waivers may also help with care in the community. See Medicaid and the state programs.
VA. VA lists hospice among its long-term care services for Veterans, with the hospice described as for terminal conditions with less than 6 months to live. VA says you may still need to pay a copay for some covered services. Contact your VA social worker. See VA benefits.
Long-term care insurance and private pay. Some policies pay for care at the end of life, and some families pay for extras such as additional home care privately. Read the policy and ask the insurer in writing. See long-term care insurance and private pay.
What affects your out-of-pocket costs
Because Medicare covers the hospice benefit itself, the money questions for most families are not about the hospice bill. They are about:
- Room and board, if the person lives in a facility
- Services outside the plan of care, such as extra home care hours
- Drug copayments and respite stays
- Care unrelated to the terminal illness, which keeps its normal Medicare costs
- Whether the person has Medicare at all
We do not quote average prices, because a national average would not match your plan, your state or your living situation.
How CMS reports hospice quality
CMS publishes hospice quality measures on Care Compare. They come from several data sources, and they measure different things.
The CAHPS Hospice Survey is the experience measure. CMS says it collects information on the experiences of hospice patients from the perspective of their informal caregivers. It samples primary caregivers of deceased hospice patients, several months after the death. Topics include starting hospice care, help with symptoms, communication with the hospice team, the caregiver's own experience, an overall rating and willingness to recommend. CMS says public reporting uses eight quarters of survey data, refreshed quarterly. The revised survey, from the second quarter of 2025, produces nine measures.
Other measures include a comprehensive assessment at admission, visits from a nurse or social worker in the last days of life, and a Hospice Care Index scored from 0 to 10. Hospices with fewer than 20 discharges in the two pooled years get no index score.
Read these as a starting point. A hospice with no score may be small, new or unrepresentative. See our care ratings by state and methodology for how we use CMS data.
How to choose a hospice provider
- Confirm the hospice is Medicare-certified. Medicare.gov has a find-a-provider tool for ZIP codes.
- Look at its Care Compare results and note any missing measures.
- Ask whether it can serve the person where they live now, whether that is a home, an assisted living community or a nursing home.
- Ask who is on the team, how the nurse is reached at night and how fast someone arrives for a crisis.
- Ask for the list of items and services it considers unrelated to the terminal illness.
- Ask about inpatient and respite arrangements.
Questions to ask each hospice
- Which of my current medicines, equipment and treatments will you cover?
- What happens if symptoms get worse at 2 a.m.?
- How often will the nurse, aide and social worker visit, and can we change that?
- What help does the family get after a death?
- If we want to change hospices, what is your process?
Red flags when choosing a hospice
- Pressure to sign before the hospice has explained what it will and will not cover
- A hospice that cannot or will not give you the list of services it considers unrelated
- No clear answer on 24-hour contact or response time
- Not Medicare-certified, if you are relying on the Medicare benefit
- Vague answers about room and board
About the hospices listed below
Carevo is a directory and connection platform. It does not provide hospice care, decide who qualifies or vouch for any hospice. The lists below come from CMS data. Check each hospice yourself, and use get matched if you want help finding options near you.