Understanding Hospice
What Does Hospice Cost?
Medicare, Medicaid & Insurance Explained
Worrying about how to pay for hospice shouldn't keep a family from asking for help.
When families begin considering hospice, one of the first practical questions is often: "How are we going to pay for this?"
The answer may be much more reassuring than you expect.
For eligible patients, hospice care is often covered through Medicare, Medicaid or private insurance. What is covered — and whether there are any out-of-pocket costs — depends on the patient's coverage, care needs and living situation.
Stonewood Hospice can help your family understand the benefits available before you make a decision.
Does Medicare Pay for Hospice?
Yes. For eligible Medicare beneficiaries, Medicare Part A includes a hospice benefit.
If the patient meets Medicare hospice eligibility requirements and receives care from a Medicare-approved hospice provider, Medicare generally pays for covered hospice services related to the terminal illness and related conditions. For covered hospice services, the patient generally pays $0, although limited cost-sharing and other expenses can apply in certain circumstances.
See What's Covered ↓Medicare Hospice Benefit
What Does Medicare Cover for Hospice?
Medicare Part A covers hospice care for eligible beneficiaries who elect the hospice benefit. When related to the patient's terminal illness and included in the hospice plan of care, Medicare hospice coverage may include:
Nursing Care
Hospice nurses assess symptoms, provide clinical care, educate families and help manage changes in the patient's condition.
Physician & Hospice Medical Services
Physician and other appropriate hospice medical services related to the hospice plan of care.
Medications for Pain & Symptom Management
Medications related to relieving pain and managing symptoms of the terminal illness and related conditions.
Medical Equipment
Equipment needed for hospice care may include items such as a hospital bed, wheelchair, oxygen or other medically necessary equipment when included in the hospice plan of care.
Medical Supplies
Supplies needed for hospice care and management of the terminal illness and related conditions.
Hospice Aide & Homemaker Services
Appropriate hospice aide and homemaker support as included in the individualized plan of care.
Social Work Services
Support with emotional, practical and family needs.
Spiritual Support
Spiritual counseling and support according to the patient's and family's preferences.
Counseling & Bereavement Support
Emotional support for patients and families, including grief and bereavement services.
Therapy Services When Appropriate
Physical therapy, occupational therapy and speech-language pathology when necessary for hospice goals and included in the plan of care.
Short-Term Inpatient Hospice Care
General Inpatient Care when qualifying symptoms cannot be effectively managed in another setting.
Inpatient Respite Care
Short-term inpatient care when appropriate to provide temporary relief for the patient's caregiver.
What You May Pay
Is Hospice Completely Free With Medicare?
For covered hospice services from a Medicare-approved hospice provider, Medicare states that the patient generally pays $0 for the hospice care itself. However, there are a few important exceptions families should understand.
Prescription Copayment
A patient may have a copayment of up to $5 per prescription for certain outpatient medications used for pain relief and symptom management.
Inpatient Respite Care
A patient may pay 5% of the Medicare-approved amount for inpatient respite care.
Room & Board
Medicare's hospice benefit generally does not pay room and board simply because a patient is receiving hospice while living in a nursing facility, assisted living setting, hospice residence or other residential setting. Short-term inpatient hospice or respite stays arranged by the hospice under the applicable hospice benefit are different and may be covered according to Medicare rules.
Hospice Care and Room & Board Are Not the Same Thing
Hospice is a medical benefit. Where someone lives is a separate issue.
A person can receive Medicare-covered hospice services while living in a nursing facility, assisted living community or other residential setting, but that does not automatically mean Medicare's hospice benefit pays the cost of living in that facility.
If a family is considering Stonewood's residential care options, we encourage you to speak directly with our team so we can explain which services are covered and which residential expenses may be separate.
What Medicare Does Not Cover Under the Hospice Benefit
Are There Things Medicare Hospice Doesn't Pay For?
Yes. Electing the Medicare Hospice Benefit changes how Medicare pays for treatment related to the patient's terminal illness and related conditions. Examples of things the hospice benefit generally does not cover include:
Treatment Intended to Cure the Terminal Illness
Hospice focuses on comfort and symptom management rather than treatment intended to cure the terminal illness.
Medications Intended to Cure the Terminal Illness
The hospice benefit generally covers medications for comfort and symptom management related to the terminal illness, rather than medication intended to cure it.
Hospice Care Obtained Independently From Another Provider
Care related to the terminal illness generally needs to be provided or arranged by the patient's chosen hospice.
Unarranged Hospital or Emergency Care Related to the Terminal Illness
If hospital, emergency or ambulance care is needed for the terminal illness, families should contact the hospice team so the hospice can coordinate the appropriate care.
If you're receiving hospice and believe you need emergency or hospital care related to the terminal illness, contact your hospice team first whenever possible.
Other Health Conditions
What About Medical Care That Has Nothing to Do With Hospice?
Choosing hospice does not mean Medicare stops covering every other health condition.
Original Medicare may continue to cover eligible medical services for health problems that are unrelated to the terminal illness and related conditions. The normal Medicare deductible, copayment or coinsurance rules for those unrelated services may still apply.
For example, if someone is receiving hospice for advanced heart disease but needs medical treatment for an unrelated condition, that care may continue to be covered outside the hospice benefit when applicable.
Coverage for unusual situations can be complex. We encourage families to verify specific circumstances with Stonewood, Medicare or their health plan.
Medicare Advantage
What If I Have a Medicare Advantage Plan?
A person who was enrolled in a Medicare Advantage plan before starting hospice may generally remain enrolled in that plan.
Under current Medicare rules, once the hospice benefit begins, Original Medicare generally pays for hospice services related to the terminal illness and related conditions, even if the patient remains enrolled in Medicare Advantage.
The Medicare Advantage plan may continue to provide plan benefits and may cover eligible care for health problems unrelated to the terminal illness, depending on the plan and circumstances.
Coverage can be confusing. Stonewood can help verify benefits and explain how your specific plan may interact with the hospice benefit.
Let Us Help Verify Your Coverage →
Texas Medicaid
Does Texas Medicaid Cover Hospice?
Texas has a Medicaid Hospice Program for eligible Medicaid recipients.
Eligibility for Medicaid and the hospice benefit depends on the individual's Medicaid status and other program requirements.
Texas Medicaid hospice services may be available in different settings, including a person's home and certain qualifying facility settings.
When a Medicaid recipient elects hospice, hospice generally becomes responsible for covered services related to the terminal illness under the applicable Medicaid hospice rules, while Medicaid coverage for eligible services unrelated to the terminal illness may continue.
Private Insurance
Does Private Insurance Cover Hospice?
Hospice benefits under private or employer-sponsored insurance vary by plan. Coverage may depend on factors including the specific insurance policy, hospice eligibility requirements, network requirements, deductibles, copayments or coinsurance, covered medications and equipment, and the location where care is provided.
We Can Help With the Insurance Question
Stonewood can help verify hospice benefits and explain available coverage before services begin. Families should not assume that their coverage is the same as Medicare or another person's insurance plan.
Let Stonewood Check Your Benefits →A Question We Hear Often
Do I Have to Give Up Medicare to Choose Hospice?
No.
Choosing the Medicare Hospice Benefit does not mean giving up Medicare entirely. Instead, the patient elects hospice coverage for care related to the terminal illness and related conditions.
Medicare may still cover eligible care for medical problems unrelated to the terminal illness under the normal Medicare rules.
Patients also retain the right to stop hospice care if they choose and may return to hospice later if they remain eligible.
Understanding Your Benefits
What Should I Ask Before Starting Hospice?
Does my loved one have Medicare Part A?
Is the hospice provider Medicare-approved?
Which medications will hospice cover?
Which equipment and supplies will hospice provide?
Are there any prescription copayments?
What would respite care cost, if needed?
Are room and board charges separate?
How will unrelated medical conditions be covered?
If we have Medicaid, what hospice benefits apply?
If we have private insurance, is the hospice in network?
Who should we call before going to the emergency room or hospital?
Who can we contact if we receive a bill we don't understand?
No Surprises
Stonewood Can Help You Understand Coverage Before Care Begins
Insurance terminology can make an already difficult situation feel even more overwhelming. You don't need to become a Medicare expert before calling hospice.
Stonewood can help your family:
- Review available insurance information
- Verify hospice benefits
- Explain which hospice services are covered
- Discuss medications, supplies and equipment
- Explain potential costs that may fall outside the hospice benefit
- Answer questions about residential care and room and board
- Help coordinate coverage questions when circumstances change
Ask the questions. Know your options. Understand your coverage.
Hospice Costs at a Glance
Typical Cost
$0 for covered services
Notes
When eligibility requirements are met and care is provided by a Medicare-approved hospice.
Typical Cost
Up to $5 per prescription
Notes
For certain drugs used for pain and symptom management.
Typical Cost
Up to 5% of Medicare-approved amount
Notes
When inpatient respite care is needed.
Typical Cost
Generally not covered
Notes
Medicare's hospice benefit generally does not cover room and board in a facility. Qualifying short-term inpatient and respite care arranged by the hospice are treated differently.
Typical Cost
May continue through Medicare
Notes
With the usual deductibles or cost-sharing that apply to those services.
Typical Cost
Varies
Notes
Depends on eligibility, insurance plan and individual circumstances. Stonewood can help verify benefits.
Frequently Asked Questions About Paying for Hospice
Continue Learning About Hospice
← Back to Hospice Resources & Family GuidesWho Qualifies for Hospice? →
Learn about the medical criteria and eligibility requirements for hospice care.
When Is It Time for Hospice? →
Recognize the signs that a loved one may benefit from hospice support.
The Four Levels of Hospice Care →
Understand Routine Home Care, GIP, Continuous Home Care and Respite Care.
Hospice Care in Southeast Texas →
Learn what hospice is, what it covers, and how Stonewood serves your family.
Hospice Resources & Family Guides →
Browse all educational guides for families considering hospice care.
Free Download
Is It Time for Hospice? A Family Guide & Checklist
A practical guide to help families recognize when hospice may be appropriate.
Questions About Coverage?
Don't Let Cost Questions Keep You From Asking About Hospice.
Every family's situation is different. Whether your loved one has Medicare, Medicaid, private insurance or a combination of coverage, Stonewood can help you understand your options.
You do not need to have the insurance answers before you call us.
Tell us what's happening. We'll help you figure out the next step.
Available 24/7. No pressure. No obligation.
Sources
- • Medicare.gov — Hospice Care Coverage
- • Centers for Medicare & Medicaid Services — Medicare Hospice Benefit
- • Medicaid.gov — Hospice Benefits
Written by: Stonewood Hospice
Last reviewed: August 2026
Insurance benefits and hospice coverage vary by individual circumstances and may change. This information is provided for general educational purposes and is not a guarantee of coverage or payment. Stonewood Hospice can help verify available benefits for an individual patient. For questions about Medicare, Medicaid or private insurance benefits, patients may also contact their health plan or appropriate government program directly.