Hospice Eligibility

Eligibility for Hospice Care

Congress established the Medicare Hospice Benefit in 1982 to provide patients facing life-limiting illnesses a program of compassionate, coordinated care to manage the symptoms and consequences of their disease. Hospice helps terminally ill patients with the often-significant expenses incurred at the end of life, including prescription and over-the-counter drugs, medical equipment, supplies and counseling support for the family.

Click here to view our interactive hospice diagnosis chart, developed based on standards set by Medicare.

In order for the benefit to be covered by Medicare, there are a few requirements providers must meet in order to qualify for payment from Medicare.

To be eligible for Medicare hospice coverage, a patient must:

  • Be eligible for Medicare Part A
  • Consent to hospice care and agree that he or she wishes to receive “palliative, not curative care”
  • Be certified by his or her physician and the hospice medical director as having a “medical prognosis that his or her life expectancy is six months or less, if the illness runs its normal course”
  • Continue to have a six-months-or-less prognosis, although some patients may receive hospice services for longer than six months but they must continue to have a limited life expectancy throughout that time