How Much Does Hospice Cost? Medicare, Medicaid, and Private Pay Explained
By CRYSTAL BAI •
The short answer: Hospice is covered at 100% by Medicare Part A for eligible patients — there is no out-of-pocket cost for Medicare beneficiaries who choose hospice. Medicaid also covers hospice in all 50 states. Most private insurance plans cover hospice as well. The only costs patients may face are small copays for medications (up to $5 per drug) and room and board in a residential facility.
The Medicare Hospice Benefit: What It Covers
Medicare Part A pays for hospice care in full for eligible beneficiaries. To qualify, a patient must:
- Be enrolled in Medicare Part A
- Have a terminal diagnosis with a prognosis of six months or less if the illness follows its natural course (certified by two physicians)
- Choose comfort-focused care (forgo Medicare coverage for curative treatment of the terminal illness)
- Receive care from a Medicare-certified hospice provider
Medicare hospice covers: physician and nursing visits, home health aide services, social work services, chaplain visits, medications for symptom control, medical equipment (hospital bed, wheelchair, oxygen), and bereavement support for the family after the death.
What Medicare Hospice Does NOT Cover
- Room and board in a nursing facility or assisted living (Medicare covers the hospice services, not the room)
- Treatment aimed at curing the terminal illness
- Emergency room visits or hospitalizations for the terminal diagnosis (though hospice will pay for inpatient crisis care when needed)
Medication Copays
Medicare hospice patients may be charged a small copay — no more than $5 — for each prescription related to pain control and symptom management. There is no copay for other hospice services. Many hospice organizations waive even this small copay.
Medicaid Hospice Benefit
All 50 states provide hospice coverage through Medicaid, typically mirroring the Medicare benefit. Some states have additional coverage for room and board in residential hospice facilities.
Private Insurance
Most private insurance plans, including employer-sponsored plans and ACA marketplace plans, cover hospice care, though coverage details vary. Check your specific plan for eligibility requirements, duration limits, and network restrictions.
Costs Without Insurance
For patients without Medicare, Medicaid, or private insurance, hospice care costs vary widely: $150–$600 per day for routine home care (provided by the hospice team to a patient at home), and $700–$1,500 per day for inpatient hospice care in a facility. Many hospice organizations offer sliding scale fees or charity care for uninsured patients.
Frequently Asked Questions
Is hospice free with Medicare?
Yes. Medicare Part A covers hospice at 100% for eligible beneficiaries — there is no copay or deductible for hospice services. Patients may pay up to $5 per prescription for symptom-control medications; many hospice organizations waive even this.
Does Medicare cover hospice at home?
Yes. The Medicare hospice benefit covers home-based hospice care including nursing visits, home health aide services, medications, medical equipment (hospital bed, oxygen), and social work and chaplain support — all at home.
Who qualifies for Medicare hospice?
To qualify, you must be enrolled in Medicare Part A, have a terminal diagnosis with a prognosis of six months or less (certified by two physicians), and choose comfort-focused rather than curative care for the terminal illness.
What does hospice NOT cover?
Medicare hospice does not cover room and board in a nursing facility, treatment aimed at curing the terminal illness, or ER/hospital visits for the terminal diagnosis (though inpatient crisis care is covered when needed for symptom management).
Renidy connects grieving families with compassionate end-of-life professionals. Find support near you.