Quick Answer: What Does Hospice Cost?
For most patients, hospice care costs $0. Medicare Part A and Medi-Cal cover hospice services in full when you elect the hospice benefit. There are no deductibles or coinsurance for hospice services themselves.
Small Medicare cost-sharing applies in two narrow cases: outpatient drugs related to your terminal illness (up to $5 per prescription) and inpatient respite care (5% of the Medicare-approved rate, capped at the annual inpatient hospital deductible). Both caps are set by federal regulation; you will never be billed more than these limits.
Medicare Part A Hospice Benefit
Eligibility
To qualify, you must be entitled to Medicare Part A. Two physicians — your attending physician and the hospice medical director — must certify that your illness is terminal, with a life expectancy of six months or less if the illness runs its normal course.
Covered
Medicare covers all hospice services delivered by your hospice team: nursing visits, physician oversight, hospice aide care, social worker, chaplain, bereavement support, medications related to your terminal illness, durable medical equipment, and all four levels of care described below.
Not covered
Medicare hospice does not cover treatments aimed at curing the terminal illness once you elect hospice, room and board in your private home, or care from providers outside your hospice team unless arranged in advance. Room and board in a nursing facility may be covered separately by Medi-Cal.
The Four Levels of Care
Medicare defines four levels of hospice care. Your level can change day-to-day depending on what you need. Eminent delivers all four.
Routine Home Care (RHC)
The most common level. Scheduled visits from your hospice team to wherever you live.
Paid at a tiered daily rate, with a lower rate after day 60 to encourage sustained engagement throughout the hospice stay.
Continuous Home Care (CHC)
Eight or more hours of mostly nursing care in a 24-hour period, during a short crisis of pain or symptoms — delivered in your home so you do not have to go to a hospital.
Paid at an hourly rate. Used for brief, intensive periods, not for sustained nursing.
General Inpatient Care (GIP)
Short-term inpatient care for symptoms that cannot be safely managed at home. Delivered in a hospital, skilled nursing facility, or hospice inpatient unit.
Paid at a daily facility rate.
Inpatient Respite Care (IRC)
Up to five consecutive days of inpatient care, used to give the family caregiver a planned break.
Paid at a daily rate. A 5% patient coinsurance applies, capped at the annual inpatient hospital deductible.
The federal cap on average Medicare payments to a hospice per patient over a year. This is a backstop on the program, not a per-patient limit on the care you can receive.
Source: CMS FY2026 Hospice Wage Index Final Rule (CMS-1835-F), effective October 1, 2025. Federal rates are updated annually each October.
Federal payment rates increased 2.6% in FY2026. Specific dollar amounts below reflect the FY2026 final rule.
Medi-Cal Hospice Coverage
Medi-Cal covers hospice services for California residents who qualify for Medi-Cal benefits. Coverage parallels Medicare's hospice benefit and is delivered by the same Medicare-certified hospices.
Important: for patients living in a skilled nursing facility, Medi-Cal pays a room-and-board amount of at least 95% of the facility's Medi-Cal nursing-facility rate. This is the meaningful difference between Medi-Cal and Medicare hospice — Medicare alone does not pay for room and board.
What's covered — Comparison
A side-by-side look at what each pays for. For most patients in Los Angeles County, Medicare or Medi-Cal will be the primary coverage.
| What's covered | Medicare Part A | Medi-Cal | Private Insurance |
|---|---|---|---|
| Hospice services | Fully covered | Fully covered | Most plans cover; varies |
| Room & board (nursing facility) | Not covered | ≥95% of Medi-Cal NF rate | Varies by plan |
| Eligibility | Medicare Part A + terminal certification | Medi-Cal qualified + terminal certification | Per plan; usually requires certification |
| Election process | Sign election statement | Sign election statement | Per plan |
| What family pays | $0 for services; up to $5/drug; 5% respite | Generally $0 | Per plan; verify first |
The Election Process — Step by Step
Electing hospice takes one signed form. Here is how it usually goes.
- 1 Your attending physician and the hospice medical director both certify that your illness is terminal, with a life expectancy of six months or less.
- 2 You sign the hospice election statement, choosing comfort care for your terminal illness.
- 3 You name your attending physician and choose your hospice provider.
- 4 Within 48 hours, the hospice team visits to set up your care plan and arrange medications or equipment.
- 5 You have two 90-day benefit periods, then unlimited 60-day periods. Each requires a recertification that your illness is still terminal.
- 6 You can revoke the hospice benefit at any time and return to standard insurance. You can also re-elect later. There is no penalty and no waiting period.
Revoking is your right. Many patients do not — but the option is always there.
Need Help Verifying Coverage?
Our admissions team verifies your Medicare, Medi-Cal, or private insurance coverage at no cost and with no obligation. We can also help you understand what your specific plan covers before you make any decisions.