Who Is Eligible for Hospice?

Families often wait too long to receive hospice because they think you have to be dying; or they could benefit for the services but do not meet eligibility criteria.

What are the criteria to receive hospice?

  • You have Medicare Part A (Hospital Insurance) or hospice coverage through a private insurance company. Private insurance will stipulate whether you have coverage for home hospice, inpatient hospice, or both. Some hospices have Foundations that cover indigent care or are able to make arrangements for payment directly when no insurance is available.
  • Your physician and the Medical Director of the hospice agency agree that you have a terminal illness and have 6 months or less to live * (more on this later).
  • You and the person who makes medical decisions for you agree that you are choosing hospice instead of curative treatments such as chemo therapy, transfusion, or radiation. This is a very tricky area, and some chemotherapy is permissible while on hospice. Discuss your treatment with the hospice team or your physicians. Stopping treatments does not mean giving up hope or stopping care. Hospice care shifts from cure to aggressive comfort measures.

* No one can predict how long we are going to live. There is no crystal ball with an answer to that question. What we do know is that certain illnesses follow predictable trajectories, and physicians can guesstimate life expectancy. However, we also know that hospice, along with loving care, and emotional and spiritual wellbeing can prolong life. A hospice will not discharge you after 6 months unless your condition has improved to the point that you no longer qualify for their care. This is just a guideline.