Medicare 2026

How Medicare Covers Hospice Care: What to Expect, What You Pay, and How to Start

Hospice care focuses on comfort, dignity, and support when a serious illness is no longer expected to be cured. If you or someone you love is approaching that stage, understanding how Medicare's hospice benefit works can make a hard moment a little less overwhelming. This guide explains, in plain English, what Medicare covers, what it may cost, and how the benefit fits with the rest of your coverage.

Who qualifies for the Medicare hospice benefit

Hospice is covered under Medicare Part A (hospital insurance). To qualify, two doctors — your regular doctor (or nurse practitioner) and the hospice medical director — must certify that you have a terminal illness with a life expectancy of six months or less if the illness runs its normal course. People sometimes live longer than six months; if that happens, the hospice team can recertify you so your care continues.

Choosing hospice also means choosing comfort care instead of treatment aimed at curing the terminal illness. That's an important decision, and it's one you can revisit — you have the right to stop hospice and return to curative treatment at any time.

Importantly, Medicare still covers care for health problems that aren't related to your terminal illness. If you break a bone, develop an unrelated infection, or need routine care for a separate chronic condition, your usual Medicare benefits continue to apply for those services.

What hospice includes

Medicare's hospice benefit is designed to support the whole person — and the family. A hospice team typically includes doctors, nurses, aides, social workers, chaplains, counselors, and trained volunteers. Covered services generally include:

• Doctor and nursing care related to the terminal illness
• Medical equipment (like a hospital bed or wheelchair) and medical supplies
• Prescription drugs for symptom control and pain relief
• Hospice aide and homemaker services
• Physical, occupational, and speech-language therapy for symptom management
• Social work services and dietary counseling
• Spiritual and grief counseling for the patient and family
• Short-term inpatient care for pain and symptom management
• Short-term respite care so family caregivers can rest
• Bereavement support for the family after a loved one dies

Most hospice care is provided wherever you call home — which may be a private residence, an assisted living community, or a nursing facility.

What you pay

One of the most reassuring parts of this benefit: there is generally no cost to you for hospice care itself. The two possible out-of-pocket amounts are limited and specific:

• Up to $5 per prescription for outpatient drugs used for pain and symptom control.
• 5% of the Medicare-approved amount for inpatient respite care, which gives your usual caregivers a short break.

Medicare does not cover room and board if you live at home or reside in a nursing facility or assisted living community — your hospice benefit covers the hospice services, but not the cost of the residence itself. The exception is short-term inpatient or respite care arranged by the hospice team.

If you're in a Medicare Advantage plan

Many people choose a Medicare Advantage plan for their day-to-day coverage, while others stay with Original Medicare, often paired with a Medigap policy and a stand-alone Part D plan. Both paths have trade-offs — things like network rules, extra benefits, cost-sharing structures, and out-of-pocket limits differ — and the right choice is personal.

When it comes to hospice, however, the rule is the same for everyone: Original Medicare pays for your hospice-related care, even if you're enrolled in a Medicare Advantage plan. Your Advantage plan continues to cover services unrelated to your terminal illness, like a non-related doctor's visit, if you choose to keep using it.

How prescription coverage fits in

While you're in hospice, drugs for pain and symptom control related to your terminal illness are covered through the hospice benefit, with the small copay noted above. Drugs for unrelated conditions may still be covered under your Part D plan.

For reference on the broader Part D program in 2027: the annual out-of-pocket cap is $2,400 (down from $2,100 in 2026), the maximum deductible any Part D plan may charge is $700, and the national base beneficiary premium — used in calculating the late-enrollment penalty — is $41.33. Individual plan premiums are set plan by plan.

Enrollment windows and special rules

Medicare's Annual Enrollment Period runs October 15 – December 7, 2026, with choices taking effect January 1, 2027. Social Security also announced on October 14, 2026 a 3.6% cost-of-living adjustment for benefits payable beginning January 2027. The 2027 Part B standard premium and deductible, along with the IRMAA income brackets, have not yet been announced; CMS typically releases them in the fall.

If you have Medicaid or qualify for Extra Help, you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can also join an integrated D-SNP in any month.

How to start

Hospice begins with a conversation — with your doctor, your family, and a Medicare-certified hospice provider. You can also compare providers and read about the benefit at Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), available 24 hours a day, 7 days a week. Taking that first step can bring in a team whose only job is to help you live as comfortably and fully as possible.