One of the first questions families in California ask when a loved one is seriously ill is simple: will Medicare pay for hospice care at home? For most eligible beneficiaries, the answer is yes. This guide explains how the Medicare Hospice Benefit works, what it typically covers, what it does not, and how families in Orange County can get started. Coverage rules can change, so always confirm details with Medicare or your plan.
The Medicare Hospice Benefit in Brief
Hospice is covered under Medicare Part A (hospital insurance). The benefit is the same in California as in other states. It is designed so that people with a terminal illness can receive comfort-focused care, most often in the place they call home.
Who Is Eligible?
In general, a person qualifies for Medicare hospice coverage when all of the following are true:
- They have Medicare Part A.
- A hospice doctor and the patient’s regular doctor (if they have one) certify a terminal illness with a life expectancy of six months or less if the illness runs its normal course.
- The patient accepts comfort care instead of care meant to cure the illness.
- The patient signs a statement choosing hospice care.
Eligibility is about prognosis, not a specific diagnosis. People with cancer, heart disease, lung disease, dementia, kidney failure, and other conditions may qualify.
What Medicare Typically Covers at Home
For care related to the terminal illness, Medicare’s hospice benefit generally covers:
- Nursing visits to manage pain and symptoms
- Hospice aide visits for personal care such as bathing
- Medical equipment such as a hospital bed, wheelchair, or walker
- Medical supplies such as bandages and incontinence supplies
- Prescription drugs for pain relief and symptom control
- Short-term inpatient care for symptoms that cannot be managed at home
- Short-term respite care to give caregivers a rest
- Guidance and support for the family
What Families Usually Pay
For hospice-related care, out-of-pocket costs are usually small. Medicare may charge a copayment of up to $5 per prescription for pain and symptom drugs, and 5% of the Medicare-approved amount for inpatient respite care. Medicare generally does not pay for room and board, whether at home or in an assisted living or nursing facility, and it does not cover around-the-clock private caregivers.
Medicare continues to cover care for health problems that are not related to the terminal illness under the patient’s regular Medicare coverage.
How Long Does Coverage Last?
Hospice care is provided in benefit periods: two 90-day periods followed by an unlimited number of 60-day periods. At the start of each period, a doctor recertifies that the patient is still eligible. A patient may also stop hospice at any time to return to curative treatment, and may choose hospice again later if eligible.
What Does Hospice at Home Look Like?
Hospice at home means the team comes to you. At Maxcare Hospice, registered nurses (RNs) and licensed vocational nurses (LVNs) visit to assess comfort and adjust the care plan, and hospice aides help with personal care. Families often worry most about nights and weekends, so our nurses are on call 24 hours a day, 7 days a week. Our office in Westminster is open Monday through Friday, 9:00 a.m. to 5:30 p.m.
For many Orange County families, language matters too. Maxcare Hospice has Vietnamese-speaking nurses and aides who can explain Medicare coverage and care plans in Vietnamese. Learn more on Chăm sóc Hospice bằng tiếng Việt.
How to Get Started
- Talk with your loved one’s doctor about whether hospice may be appropriate.
- Call a hospice provider to ask questions; you do not need to have every answer first.
- Have the patient’s Medicare card and any other insurance information ready.
- Ask what equipment and visits will be arranged in the first days of care.
Maxcare Hospice is family-owned and has served Orange County since 2011. In the Medicare family survey for 10/2023–9/2025, 78% of families said they would definitely recommend us. For more answers, see our Hospice Care FAQ.
Frequently Asked Questions
Does Medicare pay for hospice care at home in California?
Yes. For eligible beneficiaries, the Medicare Hospice Benefit under Part A covers hospice care provided at home, including in California. The patient generally must have a terminal illness with a life expectancy of six months or less, certified by a physician, and choose comfort care instead of curative treatment.
How much does hospice cost with Medicare?
For hospice-related care, Medicare typically covers most costs. There may be a copayment of up to $5 for each prescription drug for pain and symptom management and 5% of the Medicare-approved amount for inpatient respite care. Room and board at home or in a facility is generally not covered.
Does Medicare pay for a 24-hour caregiver at home?
Generally, no. The Medicare Hospice Benefit covers scheduled visits from the hospice team and on-call support, not round-the-clock private caregivers. Short-term continuous care may be available during a medical crisis when criteria are met.
Can my loved one keep their regular doctor on hospice?
In most cases, yes. Patients can usually keep their regular physician as their attending doctor while receiving hospice care.
What if my loved one lives longer than six months?
Hospice benefit periods can be renewed. After the first two 90-day periods, patients can be recertified for unlimited 60-day periods as long as a physician confirms they remain eligible.
