How Do You Qualify for Hospice Care at Home?

Author: Andrea Miller

Reviewed by: Brindusa Vanta

You qualify for hospice care at home if you have a terminal illness with a life expectancy of six months or less. Medicare requires you to sign a statement selecting comfort care measures instead of treatment for the underlying illness. In addition, your primary care physician and the hospice physician must certify the terminal diagnosis. You also need to sign a statement confirming you choose hospice care instead of other treatments covered by Medicare for your terminal diseases and related illnesses. 

What Does Medicare Cover for Hospice Care?

Medicare covers the entire cost of hospice care, except for a $5 co-payment for each prescription medication to manage symptoms such as pain.

Services include:

  • Medical and nursing care 
  • Grief and spiritual counseling
  • Occupational and physical therapy
  • Help with housekeeping tasks
  • Medical supplies, social services and nutrition counseling

Medicare also pays for up to five days of respite care at an inpatient facility. This benefit provides a break for family caregivers. 

When Should You Start Hospice Care?

You should start hospice care when you feel ready to stop treatment for a terminal illness and receive comfort care for the remainder of your life. Consider talking to your doctor and your loved ones about hospice if you:

  • Think treatment affects your quality of life
  • Struggle with frequent hospitalizations
  • Need more support for the physical and emotional symptoms of your illness

Many people wait to start hospice after a terminal diagnosis because they have trouble having the conversation or they don’t know if they qualify for this type of coverage. Enrolling earlier provides benefits such as better symptom management and strong family connections.