What the Medicare Hospice Benefit Covers (and What It Doesn't)

The Medicare Hospice Benefit covers hospice care at 100% — the care team's visits, medications related to the hospice diagnosis, medical equipment, and supplies. For most families, that means no bills from the hospice at all. But the benefit has limits, and knowing them ahead of time prevents painful surprises.

Here is what's covered, what isn't, and how to tell the difference.

Who Qualifies for the Medicare Hospice Benefit?

To use the benefit, a physician must certify a life expectancy of six months or less if the illness runs its normal course. The patient also chooses comfort-focused care for the terminal illness instead of treatment meant to cure it.

That choice is not permanent. Patients can leave hospice at any time and return to curative treatment, then re-enroll later if they still qualify.

What Does the Medicare Hospice Benefit Cover?

Once hospice is elected, Medicare pays the hospice directly. Covered services include:

• Care team visits. Nurses, hospice aides, social workers, and chaplains visit on a schedule built around the patient's needs.
• Medications related to the hospice diagnosis. Drugs for pain, breathing, anxiety, nausea, and other symptoms tied to the terminal illness.
• Medical equipment. Items like a hospital bed, wheelchair, walker, oxygen, or bedside commode, delivered to wherever the patient lives.
• Medical supplies. Wound care supplies, incontinence products, gloves, and similar items connected to the diagnosis.
• All four levels of hospice care. Routine home care, continuous home care during a crisis, general inpatient care when symptoms can't be managed at home, and respite care.
• Respite care. Up to 5 days of inpatient care at a time so the family caregiver can rest.
• Grief support for the family. At Engrace, that support continues for 13 months after a loss.

There is no requirement to be homebound, and the benefit follows the patient — home, assisted living, or a nursing facility.

What Doesn't Medicare Hospice Cover?

A few important exclusions catch families off guard:

• Treatment meant to cure the terminal illness. Electing hospice means choosing comfort care for that diagnosis. If you want to resume curative treatment, you can revoke the benefit.
• Care for the terminal illness from providers outside the hospice's plan of care. The hospice team coordinates everything related to the diagnosis, so check with your hospice before scheduling outside care.
• Room and board. If your loved one lives in an assisted living or nursing facility, hospice covers the hospice services delivered there — not the facility's room and board charges for routine home care.
• Round-the-clock caregivers. Hospice supplements family caregiving with visits and 24/7 on-call nursing; it does not replace it with live-in staff.

What About Health Problems Unrelated to the Hospice Diagnosis?

Your other Medicare coverage keeps working. If a hospice patient with heart failure needs care for an unrelated condition — say, an eye problem — Medicare covers it the same way it did before hospice.

The dividing line is simple: hospice handles everything connected to the terminal illness, and regular coverage handles the rest. Your hospice team helps sort out which is which, so you're never guessing. You can read more about how this works locally in our guide to the Medicare Hospice Benefit in Oregon.

How Long Does Coverage Last?

The benefit is structured in periods: two 90-day periods, then unlimited 60-day periods. At each new period, a physician recertifies that the patient still meets hospice criteria. As long as the patient remains eligible, coverage continues — there is no six-month cutoff. Our article on hospice benefit periods walks through this in detail.

A Quick Comparison

Service	Covered by hospice?
Nurse, aide, social worker, chaplain visits	Yes
Medications related to the diagnosis	Yes
Hospital bed, oxygen, supplies	Yes
Respite care (up to 5 days at a time)	Yes
Facility room and board	No
24-hour live-in caregiver	No
Curative treatment for the terminal illness	No

How Engrace Hospice Can Help

Engrace Hospice is locally owned and based in Pendleton, serving families across Umatilla County, Morrow County, and Eastern Oregon. We handle the Medicare paperwork, explain exactly what's covered before care begins, and answer the phone with a real team member 24/7. More about the benefit itself is on our Medicare Hospice Benefits page, and our hospice costs page covers what families can expect to pay.

If you're trying to figure out whether hospice would cost your family anything, call us at (541) 263-7494. We'll go through your specific situation honestly — no obligation, no pressure.

Frequently Asked Questions

Does Medicare pay 100% of hospice costs?

Medicare covers hospice care at 100% for covered services. That includes care team visits, medications related to the hospice diagnosis, medical equipment, and supplies. Families do not receive bills from the hospice for these services.

Does Medicare hospice cover medications?

Yes, the Medicare Hospice Benefit covers medications related to the hospice diagnosis and to comfort. Medications for unrelated conditions are usually still handled through your regular Medicare drug coverage.

Does the Medicare Hospice Benefit pay for 24-hour caregivers in the home?

No. Hospice provides scheduled visits from nurses, aides, social workers, and chaplains, plus a 24/7 on-call team member for urgent needs. Day-to-day caregiving between visits is still provided by family or privately hired caregivers.

What happens to coverage for my other health problems on hospice?

Care unrelated to the terminal illness is still covered by Medicare the way it was before. Hospice covers everything related to the hospice diagnosis; your other coverage continues to work for everything else.