FAQ

If you qualify for hospice care, you and your family will work with the hospice team to set up a plan of care that meets your needs. For more specific information on a hospice plan of care, call your national or state hospice organization. You and your family members are the most important part of a team that may also include:

• Doctors
• Nurses or nurse practitioners
• Counselors
• Social workers
• Physical and occupational therapists
• Speech-language pathologists
• Hospice aides
• Homemakers
• Volunteers

In addition, a hospice nurse and doctor are on-call 24 hours a day, 7 days a week to give you and your family support and care when you need it.

A hospice doctor is part of your medical team. You can also choose to include your regular doctor or a nurse practitioner on your medical team, as the attending medical professional who supervises your care.

The hospice benefit allows you and your family to stay together in the comfort of your home unless you need care in an inpatient facility. If the hospice team determines that you need inpatient hospice care, the hospice team will make the arrangements for your stay.

If your usual caregiver (like a family member) needs a rest, you can get inpatient respite care in a Medicare-approved facility (like a hospice inpatient facility, hospital, or nursing home). Your hospice provider will arrange this for you. You can stay up to 5 days each time you get respite care. You can get respite care more than once, but it can only be provided on an occasional basis.

When you choose hospice care, you’ve decided that you no longer want care to cure your terminal illness and related conditions, and/or your doctor has determined that efforts to cure your illness aren’t working. Medicare won’t cover any of these once you choose hospice care:

• Treatment intended to cure your terminal illness and/or related conditions. Talk with your doctor if you’re thinking about getting treatment to cure your illness. You always have the right to stop hospice care at any time.
• Prescription drugs (except for symptom control or pain relief).
• Care from any provider that wasn’t set up by the hospice medical team. You must get hospice care from the hospice provider you chose. All care that you get for your terminal illness and related conditions must be given by or arranged by the hospice team. You can’t get the same type of hospice care from a different provider, unless you change your hospice provider. However, you can still see your regular doctor if you’ve chosen him or her to be the attending medical professional who helps supervise your hospice care.
• Room and board. Medicare doesn’t cover room and board. However, if the hospice team determines that you need short-term inpatient or respite care services that they arrange, Medicare will cover your stay in the facility. You may have to pay a small copayment for the respite stay.
• Care in an emergency room, inpatient facility care, or ambulance transportation, unless it’s either arranged by your hospice team or is unrelated to your terminal illness and related conditions.

Hospice care is intended for people with a life expectancy of 6 months or less (if the disease runs its normal course). If you live longer than 6 months, you can still get hospice care, as long as the hospice medical director or other hospice doctor recertifies that you’re terminally ill (with a life expectancy of 6 months or less).

Important: Hospice care is given in benefit periods. You can get hospice care for two 90-day periods followed by an unlimited number of 60-day periods. At the start of each period, the hospice medical director or other hospice doctor must recertify that you’re terminally ill (with a life expectancy of 6 months or less), so you can continue to get hospice care. A benefit period starts the day you begin to get hospice care and it ends when your 90-day or 60-day period ends.