Here's the short version. Medicare covers both hospice care and home health care, and you pay little or nothing for either. Hospice is comfort care at the end of life, covered under Part A. Home health is part-time skilled care — like nursing or therapy — in your home while you recover or manage a condition. What Medicare does not cover at home: 24-hour care, meals, housekeeping, or paying a family member to be a caregiver.
Hospice: Who Qualifies
Hospice is end-of-life care for people with illnesses that can't be cured. To use the Medicare hospice benefit, you must have Part A and meet all of these conditions:
- Your hospice doctor and your regular doctor (if you have one) certify that you're terminally ill, with a life expectancy of 6 months or less.
- You accept comfort care (palliative care) instead of care meant to cure your illness.
- You sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness.
Living past 6 months doesn't end the benefit. You can keep getting hospice care as long as the hospice doctor recertifies, after a face-to-face visit, that you're still terminally ill. Coverage runs in benefit periods: two 90-day periods, then an unlimited number of 60-day periods. You may change your hospice provider once during each benefit period.
What Hospice Covers — and What You Pay
Once you choose hospice, the benefit should cover everything you need for your terminal illness, arranged by your hospice care team. You can get it at home, in an assisted living facility, or in a nursing home. Your costs are small:
- $0 for hospice care from a Medicare-approved hospice provider.
- Up to $5 per prescription for outpatient drugs for pain and symptom control.
- Up to 5% of the Medicare-approved amount for inpatient respite care (below).
Original Medicare still pays for health problems that aren't related to your terminal illness, with the usual deductibles and coinsurance. But hospice does not cover treatment meant to cure the terminal illness, care from a hospice provider your team didn't arrange, or room and board if you live at home or in a nursing home.
Respite Care: A Break for Family Caregivers
Hospice includes help for the caregiver too. If your hospice team arranges short-term inpatient respite care — so the family caregiver can rest — Medicare covers the stay. You may pay 5% of the Medicare-approved amount, and that copayment can't be more than the Part A inpatient deductible.
Home Health: Who Qualifies
Home health is a different benefit for a different situation: skilled care in your home for an illness or injury, to help you get better, keep your current level of function, or slow decline. To qualify, you must need part-time or intermittent skilled care, and you must be homebound — leaving home isn't recommended for your condition, or it takes major effort or help (like a walker, wheelchair, or another person). You can still leave for medical care, short trips like religious services, or adult day care.
A health care provider must assess you face-to-face and order the care, and a Medicare-certified home health agency must provide it.
What Home Health Covers — and What You Pay
You pay nothing for covered home health services. After the Part B deductible, you pay 20% of the Medicare-approved amount for medical equipment. Covered services include:
- Part-time or intermittent skilled nursing care — wound care, injections, IV or nutrition therapy, and monitoring serious illness.
- Physical therapy, occupational therapy, and speech-language pathology services.
- Medical social services, medical supplies, and durable medical equipment.
- A part-time home health aide (help with walking, bathing, grooming) — but only while you're also getting skilled nursing or therapy.
Visits are unlimited if you keep qualifying. "Part-time or intermittent" usually means up to 8 hours a day of combined nursing and aide care, up to 28 hours a week — or up to 35 hours a week for a short time if your provider decides it's necessary.
Will Medicare Pay a Family Caregiver?
This is the question families ask most, and the honest answer is no — Medicare doesn't have a benefit that pays family members to give care. Home health care must come from a Medicare-certified home health agency, and Medicare doesn't pay for:
- 24-hour-a-day care at home.
- Home meal delivery.
- Homemaker services, like shopping and cleaning, unrelated to your care plan.
- Custodial or personal care — help with bathing, dressing, or using the bathroom — when that's the only care you need.
If you need ongoing personal care, Medicaid — not Medicare — is the main program that pays, and some state programs have options for paying caregivers. Start with our guides on what Medicare covers for long-term care and Medicaid eligibility, and ask your state Medicaid agency what home-care programs it offers. Caregivers can also find respite and support programs through the resources on our Caregivers page.
Common Questions
Can you stop hospice care if you change your mind?
Choosing hospice is not one-way. Talk with your doctor if you're thinking about getting treatment to cure your illness — you can stop hospice care and return to standard Medicare coverage. You can also change hospice providers once during each benefit period.
Does hospice mean moving to a facility?
No. Most hospice care happens where you live — your home, an assisted living facility, or a nursing home. Inpatient hospice care is available if your care team decides you need it, and they must arrange it.
What if I'm in a Medicare Advantage plan?
Hospice is covered under Part A even if you're in a Medicare Advantage plan. For home health, check with your plan — plans must cover what Original Medicare covers, but the agencies you can use and the approval steps may differ. See Medicare Advantage and how prior authorization works.
Who pays for a nursing home if home care isn't enough?
Mostly not Medicare. Medicare covers up to 100 days of skilled nursing facility care after a qualifying hospital stay, but not long-term custodial care. Medicaid is the main payer for that — see Does Medicare Cover Nursing Home or Long-Term Care? and Medicaid Spend-Down and Look-Back Rules.