Hospice and end-of-life care

What hospice is

Hospice is care that shifts the goal from curing an illness to comfort, dignity, and quality of life. Under Medicare, the hospice benefit is available when a doctor certifies that someone has a terminal illness with a life expectancy of about six months or less, and the person chooses comfort care rather than treatment aimed at curing the illness. It’s a difficult moment for any family, and hospice exists to make it gentler.

What it covers

The benefit is broad and centered on support. It covers nursing care, medical equipment and supplies, medications to manage pain and symptoms, a hospice aide for personal care, physical and other therapies as needed, and social work and spiritual counseling. Importantly, it also includes counseling and bereavement support for the family, both during and after. Care is usually provided wherever the person lives — at home, with family, or in a facility — and short-term inpatient or respite care is available when needed.

What it costs

Cost is rarely a barrier to hospice. Medicare covers nearly all of it: there’s no charge for most hospice services, a small copay of up to $5 for each prescription for symptom relief, and a 5% share for inpatient respite care. What hospice doesn’t cover is room and board if your loved one lives in a facility, and treatment intended to cure the terminal illness, since the focus has moved to comfort.

Choosing and changing your mind

Electing hospice is always the person’s choice, and it isn’t a one-way door. They can stop hospice care at any time and return to standard Medicare coverage — for instance, to try a new treatment — and can elect hospice again later if they wish. Having that flexibility can make the decision feel less final and a little easier to approach.