No. Medicare Advantage plans do not pay for hospice care. The moment you elect the hospice benefit, Original Medicare (Part A) takes over payment for everything tied to your terminal illness, even though you stay enrolled in your MA plan. The plan keeps running in the background for unrelated care, but hospice itself moves to fee-for-service Medicare.
This is often called the hospice “carve-out,” and it catches families off guard. Two coverage streams end up running at once, each responsible for different things. Understanding which is which before you sign an election form saves a lot of confusion later.
How the Carve-Out Works
When you elect hospice, claims for hospice services go to Medicare’s administrative contractors, not to your MA insurer. Your MA plan does not manage the care, does not pay the bills, and cannot impose network restrictions on hospice providers.
You remain enrolled in your MA plan the whole time. You keep paying its premium if it has one, and it continues to cover certain non-hospice services described below. But anything related to the terminal diagnosis, from the nursing visits to the pain medications, is paid by Original Medicare.
What Original Medicare’s Hospice Benefit Covers
To qualify, your doctor and a hospice medical director must certify that you have a terminal illness with a life expectancy of six months or less, and you must choose comfort-focused care instead of curative treatment.1Medicare.gov. Hospice Care Coverage Once you’re on the benefit, Medicare pays for:
- Physician, nurse practitioner, and registered nurse visits
- Medications for pain and symptom management related to the terminal illness
- Medical equipment and supplies such as hospital beds, wheelchairs, and oxygen
- Home health aide and homemaker services
- Physical, occupational, and speech-language therapy
- Medical social services, dietary counseling, and grief support for you and your family
- Short-term inpatient care when symptoms can’t be managed at home
- Up to five consecutive days of respite care so your caregiver can rest
Care can happen at home, in a hospice inpatient facility, in a hospital, or in a nursing home. One important gap: Medicare does not cover room and board. If you live in a nursing home or hospice residential facility, you or another payer such as Medicaid must cover the daily room charge. Medicare only picks up room costs during a short-term inpatient stay or respite arranged by the hospice team.1Medicare.gov. Hospice Care Coverage
What Your MA Plan Still Covers During Hospice
Your MA plan continues to cover two categories of care. Any health issue unrelated to your terminal illness stays under the plan. If you’re on hospice for lung cancer and need cataract surgery, the MA plan handles the cataract surgery. Supplemental benefits the plan offers beyond Original Medicare, such as dental, vision, and hearing, also remain available.2Medicare.gov. Medicare Hospice Benefits
For non-hospice care, you can choose whether to use your MA plan’s network or Original Medicare. If you go through Original Medicare and end up with a higher copayment than you would have paid under the MA plan, your MA plan must reimburse the difference.2Medicare.gov. Medicare Hospice Benefits If the MA plan includes Part D drug coverage, it keeps paying for prescriptions unrelated to the terminal illness. Drugs tied to the terminal illness come through the hospice, not through Part D.
What You’ll Pay
Most hospice care through Original Medicare costs nothing. Two small copays apply:
- Prescription drugs: 5% of the drug’s cost for each outpatient hospice-related prescription, capped at $5.3Centers for Medicare & Medicaid Services. Hospice
- Respite care: 5% of the Medicare-approved amount for each day.3Centers for Medicare & Medicaid Services. Hospice
Beyond those two items, a Medicare-approved hospice cannot bill you for covered services. The larger financial risk is facility room and board, which the hospice benefit does not cover and can run several hundred dollars a day.
Choosing a Hospice and Keeping Your Own Doctor
Because hospice runs through Original Medicare, your MA plan’s network rules don’t apply. You can pick any Medicare-certified hospice, regardless of whether it participates with your plan.
You also name an attending physician when you elect hospice. This is the clinician who has played the biggest role in managing your terminal illness, and it doesn’t have to be someone employed by the hospice. If your existing doctor works independently of the hospice, Medicare pays that doctor directly for care related to the terminal illness.4Centers for Medicare & Medicaid Services. Medicare Benefit Policy Manual – Chapter 9: Coverage of Hospice Services Under Hospital Insurance You can keep your regular doctor involved.
Benefit Periods and Recertification
Medicare structures hospice as two initial 90-day periods followed by an unlimited number of 60-day periods.5Office of the Law Revision Counsel. 42 USC 1395d – Scope of Benefits There is no lifetime cap. At the start of each period, your hospice doctor (and your regular doctor, if you have one) must recertify that you remain terminally ill with six months or less to live. After the first six months, recertification requires a face-to-face visit with a hospice doctor or nurse practitioner.1Medicare.gov. Hospice Care Coverage
Revoking Hospice and Returning to Full MA Coverage
You can revoke hospice at any time, usually because you want to pursue curative treatment again or your condition has improved. You give up the remaining days in that benefit period but can re-elect hospice later if you become eligible again.5Office of the Law Revision Counsel. 42 USC 1395d – Scope of Benefits
Timing matters for MA enrollees. Fee-for-service Medicare keeps paying claims through the end of the month in which you revoke. Your MA plan resumes full responsibility on the first day of the following month. You can also switch hospice programs once per benefit period without it counting as a revocation.
What About the MA Hospice Pilot You May Have Heard About
Between 2021 and 2024, CMS ran a pilot under the Value-Based Insurance Design (VBID) model that let a small number of MA plans cover hospice directly, to see whether integrating the benefit would improve care coordination.6PMC. The 2021 Medicare Advantage Hospice Carve-In CMS ended the hospice component of VBID on December 31, 2024. Everyone receiving hospice through a participating MA plan moved back to Original Medicare on January 1, 2025. As of 2026, no Medicare Advantage plan covers hospice; the carve-out applies to every MA enrollee who elects the benefit.