Does Medicaid (Oregon Health Plan) Cover Hospice?

Yes. The Oregon Health Plan, which is Oregon's Medicaid program, covers hospice care. For members who qualify, hospice services are covered much like they are under Medicare: care team visits, medications related to the terminal illness, medical equipment, and supplies, without bills landing on the family.

If your loved one is on the Oregon Health Plan and a doctor has mentioned hospice, here's what you need to know.

What Is the Oregon Health Plan?

The Oregon Health Plan (OHP) is the state's Medicaid program, health coverage for Oregonians with limited income. Many of the families we serve in Umatilla and Morrow counties rely on it, and some have both OHP and Medicare.

Hospice is a covered benefit under OHP. That surprises some families who assume hospice is only a Medicare program. It isn't.

Who Qualifies for Hospice Under Medicaid?

The medical criteria mirror Medicare's:

1. A physician certifies a life expectancy of six months or less if the illness runs its normal course.
2. The patient (or their representative) chooses comfort-focused care for the terminal illness rather than treatment meant to cure it.

That election isn't permanent. Patients can leave hospice at any time and return to curative treatment, and come back to hospice later if they still qualify. Our article on revoking the hospice benefit explains how.

What Does Medicaid Hospice Cover?

Coverage looks very similar to what the Medicare Hospice Benefit covers:

• Visits from nurses, hospice aides, social workers, and chaplains
• Medications related to the hospice diagnosis and comfort
• Medical equipment such as a hospital bed, oxygen, or a wheelchair
• Medical supplies connected to the diagnosis
• All four levels of hospice care, including respite care for caregivers
• Grief support for the family, at Engrace, for 13 months after a loss

Care comes to wherever the patient lives: a private home, an adult foster home, assisted living, or a nursing facility.

What If My Loved One Has Both Medicare and Medicaid?

This is common, and it's good news. For people who are dually eligible, Medicare typically acts as the primary payer for hospice services. Medicaid can help with needs Medicare doesn't touch.

The important part for families: you don't have to referee between two government programs. The hospice bills the right payer. If you're unsure which coverage your loved one has, bring the cards to the first visit and let the hospice team sort it out.

What Will the Family Actually Pay?

For covered hospice services under OHP, families should not expect bills from the hospice. The program pays the hospice directly.

Two honest caveats apply, the same ones that apply to Medicare:

• Room and board in a facility is separate from hospice coverage for routine home care. Hospice covers the hospice services delivered there, not the rent. (Medicaid has its own rules for facility residents; ask your hospice social worker about your situation.) Our article on room and board and hospice explains the distinction.
• Care unrelated to the terminal illness continues under the patient's regular coverage, not the hospice benefit.

For a broader look at paying for hospice, see our hospice costs page.

What If My Loved One Isn't on OHP Yet?

If income is limited and your loved one has no coverage, applying for the Oregon Health Plan may be worth doing even late in an illness. Eligibility is determined by the state, mostly based on income.

You don't have to figure that out alone. Hospice social workers help families with exactly this: understanding what coverage exists, what's possible, and who to call. It's part of the care, not an extra service.

How Engrace Hospice Can Help

Engrace Hospice is locally owned and based in Pendleton, serving families throughout Umatilla County, Morrow County, and Eastern Oregon. We care for patients with Medicare, the Oregon Health Plan, both, or private insurance, and our team verifies coverage and explains it in plain language before care ever starts. You can read more on our Medicare Hospice Benefits page, which also covers Medicaid basics.

If you're not sure how your loved one's coverage works, call us at (541) 263-7494. We'll check, explain it honestly, and help you with next steps, whether or not you choose Engrace.

Frequently Asked Questions

Does the Oregon Health Plan pay for hospice?

Yes. The Oregon Health Plan, Oregon's Medicaid program, covers hospice care for members who qualify. Eligibility works much like Medicare: a physician certifies a life expectancy of six months or less if the illness runs its normal course, and the patient chooses comfort-focused care.

Can someone have both Medicare and Medicaid for hospice?

Yes. Many Oregonians are dually eligible. In that case, Medicare typically serves as the primary payer for hospice services, while Medicaid can help with other needs. The hospice handles billing between the programs, so families aren't caught in the middle.

Will my family get a bill for hospice under the Oregon Health Plan?

Covered hospice services, including care team visits, medications related to the diagnosis, equipment, and supplies, are paid by the program, not the family. Ask your hospice to walk through your specific coverage before care begins so nothing is a surprise.

How do I find out if my loved one qualifies for the Oregon Health Plan?

Eligibility is based largely on income and is determined by the state. A hospice social worker can help you understand the application process and connect you with the right state resources. That help is part of hospice care.