Eligibility You Don’t Want But Should Know

hospice eligibility

Hospice eligibility is something that no one really wants but everyone should know. As an advisor on end-of-life planning, I get a lot of questions thrown my way. Some are generic (like “What is hospice?”), while others are more specific (like “Does Medicare pay for hospice?”). We’re going to cover one that lands in the middle of the spectrum — How do you know if you or your loved one is hospice eligible?

The short answer to this is talk to your doctor. The long answer is, let’s check medicare.

Talk to Your Doctor

Step one to getting hospice care is having the conversation about eligibility with your doctor. He/She is the gatekeeper from writing the order for hospice. What’s that? A hospice order is a written or verbal certification that you meet the requirements for hospice according to Medicare rules.

I always give this analogy. If you went to a pharmacy to get medication, you would need a prescription from a doctor. In the same way, if you want to receive hospice care, you need an order from a doctor.

Your doctor will probably have some hospice suggestions for you to use. Chances are he or she is affiliated with that hospice or is getting some type of compensation for telling you that. That doesn’t necessarily discredit the hospice recommendation or the doctor. Just know that going into it.

Let’s Check Medicare

Medicare part A covers the cost of hospice entirely. For that reason, they set stringent rules for who can and can’t cash in on that benefit. Here’s a little cheat-sheet for breaking down hospice eligibility:

  1. Your doctor certifies that you are terminally ill and you have a life expectancy of fewer than 6 months
  2. You want to shift all medical treatment from curative to comfort care
  3. You are willing to sign a statement that you are choosing hospice care over any other medical treatments covered by medicare

If you want to weigh your options, do you research online or use tools to help you navigate the selection process.


Grace is a service that helps families find and compare quality hospice providers in their area. Visit www.meetgrace.com to start comparing options with our best-in-class search tool. To talk with a Grace Specialist, call 844-472-2323 or email [email protected] today.

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