Hospice Care

Hospice Care: What It Is and How It Helps

Hospice care is supportive, holistic medical care for people who are no longer seeking curative medical treatments and instead are seeking supportive comfort, dignity and an enhanced quality of life for their remaining time. The goal is to provide the patient and their families and loved ones wrap-around support through to the end of life. 

Besides Hospice being a philosophic concept, it is a Medicare coverage benefit for those patients who are eligible.  It describes the services, medications and treatments that are covered to provide relief from pain and other symptoms, emotional and spiritual support, and help for family and caregivers—so people can live as fully and comfortably as possible. 

There are a few hospice houses in New Hampshire, but most patients receive hospice care at home or in their care facility. 

Importantly, hospice does not hasten death. Many people actually live longer and feel better when care is focused on comfort rather than aggressive treatments.

👉 Learn more about hospice  Hospice Foundation of America 

👉 Good short essay: Hospice Care: Not a Place but a Philosophy

Where Hospice Care Takes Place

Hospice care is usually provided where a person lives, such as:

• At home
• In a nursing home or assisted living community
• In other residential care settings

Being at home allows people to stay close to family, friends, pets, and familiar surroundings.

When hospice is provided at home, most day-to-day hands-on care is given by family members, friends, and/or other caregivers who are paid for by the patient and family. Hospice staff visit regularly and are available 24/7 by phone or telehealth. In person visits by staff may be available 24/7 although there may be a delay based on availability. Hospice volunteers may also be available on a designated schedule.

Who Provides Hospice Care?

Hospice care is delivered by an interdisciplinary team of professionals who work together to support the patient and their care partners. The hospice team may include:

• Doctors and nurse practitioners
• Nurses and nurses aides
• Hospice aides
• Social workers
• Chaplains and Spiritual counselors
• Bereavement counselors
• Therapists (physical, occupational, or speech, as needed)

The focus is always on the whole person—not just the illness.

Who Is Eligible for Hospice?

In general, a person may be eligible for hospice if:

• They have Medicare Part A (or qualifying insurance) and obtain care from a Medicare-certified hospice.
• Their doctor and a hospice physician certify that they have a life expectancy of six months or less, if the illness runs its usual course
• They choose comfort-focused care rather than treatments aimed at curing the illness

If someone lives longer than six months, they can continue hospice care as long as they remain medically eligible.

Common conditions for hospice include (but are not limited to):

• Cancer
• Heart disease
• Dementia or Alzheimer’s disease
• Parkinson’s disease
• Lung disease
• Stroke
• Kidney disease
• ALS (Lou Gehrig’s disease)
• Frailty
• Learn more about Hospice Eligibility

When Do People Begin Hospice?

Hospice is not only for the final days or weeks of life. Many people benefit most when hospice begins earlier.

Families often consider hospice when:

• Treatments no longer seem to help—or feel too burdensome
• Symptoms such as pain, breathlessness, weakness, or fatigue are increasing
• Doctors estimate life expectancy to be six months or less
• The focus shifts toward comfort and quality of life

Starting hospice earlier can provide more support, less crisis, and better symptom control. Patients, their loved ones, and care partners may all benefit.

What Does Hospice Typically Cover?

For people enrolled in Medicare, Medicare Advantage, Medicaid, or many private insurance plans, hospice agencies are provided a maximum daily reimbursement rate that generally covers:

• Visits from hospice doctors and nurses
• Medications for pain and symptom relief
• Medical equipment (such as hospital beds or oxygen)
• Medical supplies
• Hospice aides and homemaker support
• Physical, occupational, or speech therapy (as needed)
• Social work and counseling
• Spiritual care
• Grief and loss support for family members (before and after death)

That fixed maximum daily rate must cover all care related to the terminal illness — including medications. In 2025-2026 that rate approximated $250 per day.

Short-term inpatient or respite care may be available when symptoms cannot be managed at home or when caregivers need brief relief.

If the cost of therapies or medications is high and above their daily reimbursement rate,  the agency may not bill you for the remainder but they may need to seek and offer less expensive alternative treatments.

What Hospice Does Not Provide

Hospice care does not include:

• Treatments or medications meant to cure the terminal illness
• Room and board in nursing homes or residential facilities
• Emergency room visits or hospital stays unless arranged by the hospice team
• 24-hour home or bedside caregiving. Hospice works alongside—not instead of—family or paid care partners or residential care staff.

How Is Hospice Care Paid For?

Most hospice care in New Hampshire is covered by insurance, and for many families there is little or no out-of-pocket cost for the hospice related therapies and care.

For people with Medicare Part A, hospice is a fully covered benefit when a person is medically eligible and enrolls with a Medicare-certified hospice. Some people may have co-payments for certain medications or short inpatient stays, but most hospice services are covered in full but with some consideration of the maximum daily hospice reimbursement rate.

People enrolled in Medicare Advantage plans also receive hospice care. A hospice provider can help explain how coverage works for a specific plan.

In New Hampshire, Medicaid covers hospice care for people who qualify. Coverage is similar to Medicare hospice benefits.

Many private insurance plans include hospice benefits, though coverage details vary. Hospice providers can contact an insurer directly to help families understand what is covered.

👉 Learn more about the Medicare hospice benefits:

• Center for Medicare and Medicaid Services Hospice Coverage
• Medicare.gov Hospice Care 

If the patient is not Medicare eligible

People who are not eligible for Medicare may still be able to receive hospice care through:

• Medicaid, if they qualify
• Private insurance
• Nonprofit hospice programs that provide care regardless of ability to pay, depending on resources

Hospice providers routinely help families understand coverage, apply for benefits, and explore options. Asking questions does not obligate anyone to enroll.

Hospice eligibility is based on medical need—not income.

The Hospice Help Foundation may help people with financial support.

How Long Can Someone Stay in Hospice?

Hospice care is provided in renewable benefit periods:  two 90-day periods followed by an unlimited number of 60-day periods.  Although medical eligibility generally relies on a doctor’s opinion that the patient’s life expectancy is six months or less, some patients outlive that prognosis. If this happens, the patient can be re-certified for hospice care, so long as they are still medically eligible.

Hospice care may end if:

• A person’s condition stabilizes or improves sufficiently. Federal rules may require a hospice to discharge the patient from care. The person’s Medicare benefits then revert to the coverage they had before entering hospice care.
• The person chooses to pursue other curative treatments, or enter a clinical study of a new medication or procedure.
• They decide hospice no longer fits their goals. In these cases, the patient must withdraw from (“revoke”) hospice care.

Patients who are discharged, as well as those who choose to leave hospice care, can re-enroll at any time provided they meet the medical eligibility criteria.