Hospice care aims to control pain and symptoms for people in their final months of life, focusing on comfort rather than curing a fatal disease. To qualify for hospice care, a patient typically needs a diagnosis of a medical condition likely to cause death within six months or less.

Hospice care can be provided at home, in a senior care community or in a medical facility. It doesn’t always need to continue uninterrupted; individuals may switch in and out of hospice as their health improves or deteriorates. For example, if a patient goes into remission, they can choose to stop receiving care temporarily, and resume it if symptoms reoccur or the condition worsens.

Hospice care offers a compassionate approach to end-of-life care, ensuring patients receive the support and comfort they require during their final months. In short, it allows patients to maintain their dignity and quality of life, surrounded by their loved ones in a setting that best suits their needs.

This guide will explore the benefits of hospice care, the services it provides and how patients and families can access this service.

Key Takeaways:

  • What Types of Hospice Care Services Are Available? Hospice care in the United States encompasses four levels tailored to meet patients’ needs through various services and settings, allowing flexibility in care transitions based on symptom management. 
  • What Are the Steps to Start Receiving Hospice Care? Choosing hospice care requires agreement with the patient and doctor, careful selection and enrollment in an agency and collaborative care planning, with flexibility to switch agencies if needed. 
  • How Much Does Hospice Care Cost? In many cases, Medicare pays for almost all hospice care costs. Medicaid, private insurance and veterans’ benefits may provide alternative coverage options.
  • How Do I Find the Right Hospice Care Agency? When selecting a hospice, evaluate insurance compatibility, certifications, agency ownership, and nurse proximity, alongside recommendations from health professionals and personal contacts.

What Can I Expect From Hospice Care?

Hospice services offer physical, emotional, spiritual and practical comfort and support to patients and families during the final stages of a terminal illness. The specific services that hospice provides vary depending on individual needs and preferences, but usually include the following:

  • Medical Care: Professionals monitor the patient’s condition, administer medication, manage pain and provide other essential medical services.
  • Social Services: Hospice teams can offer referrals and coordination with community resources to ensure patients and their families have access to the support they need.
  • Spiritual Services: Hospice provides spiritual care in accordance with the patient’s religious or spiritual beliefs.
  • Assistance with Daily Tasks: Hospice staff can help with household chores, meal preparation and basic personal needs, such as mobility, bathing and dressing.
  • Rehabilitation: Physical, occupational and speech therapy are available to help patients maintain or regain functionality and independence.
  • Respite Care: Hospice offers relief for primary caregivers, allowing them to take temporary breaks.
  • Bereavement Support: Hospice provides counseling and resources to help families adjust to life after the loss of their loved one.

Residential Hospice Care

If a patient requires extensive medical care and monitoring, hospice care may take place in a dedicated facility, hospital or nursing home, generally in specific rooms or wards decorated with cozy touches, such as plants and couches, to give them a more homelike feeling.

In hospice facilities, the usual rules for visiting hours and mealtime schedules do not apply. Visitors can generally come and go as they wish, and meals often include family favorites. This approach ensures that patients feel as comfortable and cared for as possible.

At-Home Hospice Care

Hospice care providers can also deliver services in the patient’s home. If your loved one’s symptoms remain controlled, visiting nurses, social workers, aides and counselors will deliver care as needed. However, patients with unstable conditions and those experiencing severe distress may require continuous nursing care. In these cases, hospice nurses will provide around-the-clock care at home.

Hospice Caregivers

Hospice care calls for a team effort, combining the talents and training of social workers, counselors, clergy and medical professionals. The hospice agency will typically assign a case manager to ensure that team members cater to your loved one’s needs and to coordinate their schedules. This becomes especially important if the care takes place at home.

If possible, family members can take the responsibility for much of the hands-on care, such as administering medicines and changing dressings. Otherwise, hospice workers may help secure other caregivers to take over.

What Types of Hospice Care Services Are Available?

There are four levels of care provided by hospices in the United States. Hospice patients can move from one level to another and back, depending on the services required to fulfill their needs.

Type of Care



Services Provided

Routine Home Care

Patient’s home or long-term care facility

For patients with manageable symptoms

Social worker visits, chaplain visits, home health aide services, counselors, medications, equipment, in-home care visits and 24/7 on-call hospice nurse care

General Inpatient Care

Hospice home or acute care hospital

For patients with unstable conditions

Intensive care to control symptoms, as well as moment-to-moment assessments by hospice team and physicians until the patient achieves a tolerable comfort level

Respite Care

Facility or hospice home

For patients with controlled symptoms

Allows caregivers to take a temporary break by placing the patient in a facility with 24-hour care for up to five days, according to Medicare regulations

Continuous Home Care

Patient’s home

For patients with out-of-control symptoms who choose to remain at home

Around-the-clock care provided by a hospice nurse to control symptoms

What Are the Benefits of Hospice Care?

  • Collaborative Care: The hospice team works with existing health care providers to coordinate treatment, allowing your loved one to remain with familiar doctors and professionals.
  • Comprehensive Support System: Hospice monitors changes in your loved one’s condition and implements appropriate interventions.
  • In-Home Visits: Sometimes, the hospice team can come to your loved one’s home or long-term care community, eliminating the need for traveling or scheduling appointments.
  • Medication Coverage: Hospice provides coverage for drugs related to your loved one’s terminal illness and may review these medications to ensure they remain beneficial at this stage.
  • Medical Equipment: If your loved one’s terminal illness requires medical equipment, such as a wheelchair or walker, hospice care may provide it.
  • Multiple Levels of Care: Hospice helps manage your loved one’s symptoms throughout the various stages of their disease.
  • Holistic Approach: The hospice team, typically consisting of a nurse, nursing assistant, social worker and spiritual care specialist, addresses your loved one’s physical, mental, emotional and spiritual needs.
  • Bereavement Support: Optionally, hospice can provide bereavement follow-up for you and your family, including one-on-one meetings, support groups and periodic check-ins.

What Are the Steps to Start Receiving Hospice Care?

  1. Discuss the option of hospice care with your loved one and their doctor, ensuring that everyone agrees it is the right choice.
  2. Choose a hospice agency that suits your loved one’s needs, considering recommendations from:
  1. Formally enroll the patient in the selected hospice agency. Usually, the agency will handle all necessary paperwork. If the patient cannot give consent, the person holding power of attorney or authority over their health care decisions must complete the enrollment.
  2. Collaborate with the hospice agency as they set up a care plan, which involves discussions with the patient and any family members or others who will provide full-time care.
  3. Expect a period of increased activity when the hospice agency first becomes involved, with various staff members visiting to assess the patient’s needs.
  4. Once the initial assessment concludes, the agency will establish a regular routine with one or more aides visiting on a schedule that adapts to your loved one’s changing needs.
  5. Communicate openly about any preferences or concerns regarding the care the patient receives, including requesting specific aides or expressing dissatisfaction about certain staff members.
  6. Consider switching to another agency if you or your loved one remain dissatisfied with the hospice care provided, ensuring the best possible experience during this challenging time.

What Is the Difference Between Hospice Care and Palliative Care?

Palliative care helps patients with life-threatening illnesses, regardless of life expectancy, addressing their physical, psychosocial and spiritual needs. It does not preclude intensive treatment of a disease. In contrast, hospice care focuses on minimizing pain and suffering for those in the last stages of a terminal illness, as determined by a doctor.

While Medicare, Medicaid, most private insurance plans, HMOs and other managed-care organizations provide hospice coverage, Medicare and Medicaid may not pay for all palliative care expenses. Patients should inquire about coverage and out-of-pocket costs with their provider.

To learn more, see our in-depth comparison between hospice and palliative care.

How Much Does Hospice Care Cost?

Hospice care usually costs less than most other types of end-of-life care for several reasons:

  • It involves less technical equipment and fewer medical procedures.
  • The patient receives care most often at home instead of in a hospital.
  • Patients only pay for the services they require.
  • Family members, friends or volunteers can provide some services at no charge.

Medicare, Medicaid, Medi-Cal and some forms of private insurance cover nearly all costs of hospice care. In addition, many hospice services offer care free of charge or based on a sliding scale to those with low incomes. Paid out of pocket, typical expenses range from about $150 per day for care at home to $650 daily for constant care in a facility.

How Do I Pay for Hospice Care?

Hospice bills can easily exceed several thousand dollars for those who require care for more than a few months. Medicare generally pays most expenses, but patients may need to cover some costs with personal assets and supplemental insurance. Specialized organizations, such as the Veterans Health Administration, also provide financial assistance to individuals who qualify.

Below, we’ll briefly explore some resources that can help pay for hospice care. For more information, read our comprehensive guide about hospice costs and payment options.

Medicare covers hospice care in 90-day or 60-day benefit periods. Patients receive two 90-day periods and unlimited 60-day periods. For continued care, hospice doctors or medical directors must certify the terminal illness again at the beginning of each period.

Medicare pays for most hospice services, including:

  • Nursing services
  • Durable medical equipment, such as wheelchairs and walkers
  • Medical supplies
  • Prescription drugs
  • Short-term hospital care, including respite care
  • Home health aide and housekeeping services
  • Physical, occupational and speech therapies
  • Social worker services
  • Nutritional counseling
  • Grief counseling for patient and families

Learn more in our detailed guide to Medicare benefits.

Managed care plans typically cover the same services as Medicare. These plans allow you to choose from Medicare-certified hospice agencies approved by your specific insurance company.

Each state administers its own Medicaid program, determining the type, amount, duration and scope of services. Federal law requires coverage of certain mandatory benefits, but states can also choose to provide other optional benefits. Medicaid classifies hospice care as an optional state plan service.

Visit our beginner’s guide to Medicaid for more information.

Long-term care insurance generally covers hospice care costs, but the extent of coverage can vary depending on the specific plan. Patients should consult with their insurance provider and carefully review policy details to understand any limitations.

VA benefits include coverage for hospice, provided the veteran meets eligibility criteria and demonstrates the need for this type of care. As with other payment options, a doctor typically must certify that the patient requires hospice care.

How Do I Find the Right Hospice Care Agency?

Choosing the right hospice agency for yourself or a loved one can seem overwhelming during an already challenging time. Keep these considerations in mind when searching for hospice care:

  • Memberships in state hospice organizations are available to any hospice and may not be a distinguishing factor.
  • Check if the hospice will accept your insurance.
  • Ensure that the hospice is Medicare-certified, as Medicare provides the baseline requirements for quality care. To qualify for Medicare certification, hospices must offer a variety of core services, including bereavement counseling, skilled nursing, nutritional counseling and physician services.
  • Verify if the hospice is Joint Commission-certified, which indicates that it has met a higher standard of care.
  • Find out who owns the hospice agency and their background. Consider whether the hospice service is nonprofit, for-profit or government-operated, as this may influence the services your loved one receives.
  • Before choosing a hospice, find out where the on-call nurse lives. If the nurse lives far from the patient requiring hospice care, the response time will be longer.

Start Your Search and Narrow Down Options

You can start your search for hospice care in the directory at the top of this page, or by clicking on one of the locations below.

Other helpful resources include:

  • Your or your loved one’s physicians and nurses
  • Friends who have had experience with hospice care
  • Clergy, social workers and counselors
  • Your state hospice association

After making a list of providers in your area, interview each one to determine if a particular hospice meets your needs. Below, you’ll find some questions to get you started:

  • How long has the hospice been in operation?
  • What services does the hospice program provide?
  • How often will a nurse or other hospice staff visit?
  • Who owns the hospice?
  • Does the hospice have any accreditations?
  • What quality standards does the hospice meet?
  • How are home caregivers trained?

Because of the association with end-of-life, talking about hospice sometimes causes families to become anxious. While this is natural, it’s important to have these discussions with your family and medical providers.

Hospice can provide a positive experience during a time when every day matters, and outside help can significantly improve your loved one’s quality of life. For tailored assistance from an expert, reach out to one of our Family Advisors today.