Hospice
A Medicare-covered benefit providing comfort-focused care for terminally ill patients with a life expectancy of 6 months or less, including nursing, medications, counseling, and respite care.
Medicare's hospice benefit (Part A) provides comprehensive end-of-life comfort care when a physician certifies the patient has a life expectancy of 6 months or less if the illness runs its normal course, and the patient elects to forgo curative treatment for the terminal diagnosis. The benefit includes nursing visits, medications related to the terminal illness, medical equipment, aide services, social work, chaplaincy, and bereavement support for the family.
Hospice is typically provided at home (about 66% of hospice care in the US occurs in the patient's home or nursing facility room) but can be delivered in an inpatient hospice facility during acute symptom crises. Medicare pays the hospice agency a per-diem rate ($217/day for routine home care in 2024); the patient pays no premiums, deductibles, or coinsurance for hospice services except a small $5 copay for outpatient prescription drugs.
The hospice benefit is provided in 90-day periods: two initial 90-day periods, followed by unlimited 60-day periods if the patient remains terminally ill. A patient who stabilizes or improves can revoke hospice and return to curative Medicare coverage at any time. The median length of hospice enrollment in 2022 was 18 days, but studies consistently show better quality of life and often longer survival for patients enrolled earlier.
Real-World Example
A 78-year-old with stage IV COPD enrolled in hospice 11 weeks before death; Medicare paid all nursing visits, oxygen equipment, medications (including around-the-clock morphine for comfort), and two nights of inpatient respite care so his family could rest — a total Medicare cost of approximately $7,200 at zero expense to the family.