Who Pays for Hospice Care at Home? A Guide to Coverage Options
Hospice care at home offers patients with terminal illnesses the opportunity to receive comfort-focused care in the familiarity and privacy of their own residence. While this approach provides peace and dignity in the final stages of life, many families are concerned about how hospice care is paid for and what resources are available to them.
According to the National Hospice and Palliative Care Organization (NHPCO), nearly 80% of hospice patients in the U.S. receive care at home. Understanding your payment options is essential for making informed decisions and reducing financial stress during this critical time.
Medicare Coverage
Medicare is the primary payer for most hospice care in the United States. If the patient is enrolled in Medicare Part A and meets the eligibility criteria (such as a terminal illness prognosis of six months or less if the illness runs its typical course), Medicare covers:
Physician and nursing services
Pain and symptom management
Medications related to the terminal diagnosis
Medical equipment and supplies (e.g., hospital beds, wheelchairs)
Hospice aide visits
Social work, chaplain, and bereavement services
Care must be delivered by a Medicare-approved hospice provider.
Medicaid Coverage
For those with limited income and assets, Medicaid often mirrors Medicare’s hospice benefit. Coverage specifics may vary by state, but in general, Medicaid pays for home hospice care, including skilled nursing, therapies, and caregiver support. Dual-eligible individuals (those who qualify for both Medicare and Medicaid) may benefit from full coverage with minimal out-of-pocket costs.
Private Insurance
Most major private insurance plans and Medicare Advantage plans include hospice benefits, especially when medically necessary and ordered by a physician. However, plans differ, and it’s critical to:
Check your deductible and co-pay responsibilities
Confirm if your preferred hospice provider is in-network
Understand if services outside the terminal diagnosis are covered
Veterans Affairs (VA) Benefits
The Department of Veterans Affairs provides hospice care coverage for qualifying veterans through VA medical centers or community hospice partners. Benefits include:
In-home hospice care
Medication and medical supplies
Counseling and respite services
Additional support programs for veterans and families
Veterans can also explore Aid & Attendance and other pension enhancements to help offset related expenses.
Private Pay and Charitable Assistance
For individuals who are not eligible for public programs or lack insurance coverage, out-of-pocket payment is sometimes necessary. However, many nonprofit hospices offer sliding scale fees or support from charitable foundations and grants. Some organizations that may offer help include:
Local hospice foundations
Religious or community groups
Disease-specific organizations (e.g., American Cancer Society, ALS Association)
We’re Here to Help
Paying for hospice care at home can feel overwhelming, but you don’t have to face it alone. Our team is available to guide you through your options and connect you with coverage or support programs that fit your situation. The earlier you plan, the more choices you’ll have.
Let us walk this journey with you—with compassion, clarity, and respect for your needs.