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What Does Medicare's Hospice Benefit Actually Cover?

More than most families expect — the team, the medicines, the equipment. The main gap is room and board.

Medicare's hospice benefit (under Part A) covers the hospice care team, medications for symptom and pain relief, medical equipment and supplies, short-term inpatient care for symptom control, and respite care to give family caregivers a break — with little or no out-of-pocket cost. What it generally does not cover is room and board when hospice happens in a facility.

What's covered

Nursing visits, aide help, a social worker and chaplain, comfort medications, oxygen and equipment, short inpatient stays for hard-to-control symptoms, and respite care — all covered. Care is usually provided wherever the person lives, most often at home.

What's not covered

Room and board in an assisted living or nursing facility is the main gap; that daily cost falls to the family or another payer like Medicaid. Curative treatment for the terminal illness also stops under hospice — the focus shifts to comfort — though you can leave hospice and resume treatment anytime.

What it costs the family

Very little for the hospice services themselves: Medicare covers them, with at most small copays (a few dollars for prescriptions, 5% for respite). The financial planning is mostly about room and board, not the care.

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Common questions

Does hospice mean giving up?

No. Hospice is comfort-focused care, and you can leave it and return to curative treatment at any time if circumstances change.

Who's eligible for Medicare hospice?

Someone with a terminal illness whose doctor certifies a life expectancy of six months or less if the illness runs its usual course.