What You Need to Know About Hospice Benefits and Eligibility
When families are considering hospice care for a loved one, one of the most common questions is: “Will Medicare cover this?”
The answer is yes. Hospice care is fully covered under Medicare in Missouri, and understanding how it works can help families access care without financial uncertainty.
Medicare Covers Hospice Care in Missouri
Hospice is a Medicare Part A benefit. If a person qualifies, Medicare covers nearly all hospice-related services, including:
- Visits from nurses, aides, social workers, and chaplains
Medications for pain and symptom control - Medical equipment (such as hospital beds, oxygen, and wheelchairs)
- Supplies related to the terminal condition (like wound care items)
- 24/7 on-call clinical support
- Short-term inpatient stays for symptom management
- Respite care to provide short-term relief for family caregivers
- Bereavement support for the patient’s family for up to 13 months after a loved one passes
There are no out-of-pocket costs for these hospice services under traditional Medicare.
What If You Have a Medicare Advantage Plan?
Many people in Missouri have Medicare Advantage plans (also called Medicare replacement plans). When a patient elects hospice, their Medicare Advantage plan is paused, and traditional Medicare takes over all hospice-related care.
This ensures every eligible patient receives the full hospice benefit, regardless of their plan. The Medicare Advantage plan may continue to cover care unrelated to the terminal illness.
If a patient revokes hospice, their original Medicare Advantage coverage resumes.
How to Qualify for Medicare Hospice Benefits
A patient qualifies for Medicare-covered hospice care if they:
Have Medicare Part A
Have a terminal illness with a life expectancy of six months or less (as certified by a physician)
Elect hospice care, formally choosing comfort care instead of curative treatment
Note: Electing hospice is a formal process. The patient (or their healthcare proxy) must sign a statement confirming they understand and agree to receive care focused on comfort rather than cure.
Hospice services are re-evaluated regularly, and care can continue beyond six months if the condition remains terminal.
Respite Care for Families
Medicare also includes respite care, which allows the patient to stay in a facility for up to five consecutive days while the caregiver takes a much-needed break. This benefit can be used occasionally and is an important support for family members providing day-to-day care.
Bereavement Support Is Included
One often-overlooked part of the hospice benefit is bereavement support. After a loved one passes, families receive up to 13 months of grief support and counseling from the hospice team at no cost. This may include phone calls, grief literature, one-on-one counseling, or support groups, depending on what the family needs.
Frequently Asked Questions
Yes. Patients can choose to keep their primary care physician involved in their hospice care. In many cases, the physician works in partnership with the hospice medical director to coordinate the care plan.
Yes. Medicare covers hospice services regardless of where the patient lives, including nursing homes or assisted living facilities. However, room and board at the facility are typically not covered by Medicare unless the stay meets specific inpatient hospice criteria.
Hospice care does not automatically stop at six months. If the patient’s condition remains terminal, the physician can recertify hospice eligibility, allowing services to continue for as long as needed.
No. Once hospice is elected, Medicare will not pay for separate home health services related to the terminal diagnosis. However, non-hospice-related care may still be covered under certain circumstances and must be clearly documented.
Hospice is a voluntary benefit. A patient can revoke hospice at any time if they choose to pursue curative treatment again. They can also re-enroll in hospice later if they remain eligible and wish to resume comfort-focused care.
Need Help Navigating Medicare and Hospice?
Understanding Medicare coverage can feel overwhelming—but you don’t have to navigate it alone. At Ozark Hospice Care in Poplar Bluff, our team helps families every step of the way, from confirming eligibility to coordinating care and answering benefit questions.
Have Questions About Coverage? We’re here to make sure you have the information and support you need—without added stress during an already difficult time.
