Skip to main content
    Step 1 of 6
    Government & Civic
    Intermediate
    6 min read 6 stepsMay 8, 2026Verified May 2026

    How to Apply for the Medicare Hospice Benefit

    Step-by-step walkthrough of enrolling in Medicare hospice care, including the doctor certification, election form, and what to expect on day one.

    At a Glance

    Category
    Government & Civic
    Difficulty
    Intermediate
    Read Time
    6 min read
    Steps
    6
    Topics covered
    medicare
    hospice
    enrollment
    seniors
    end of life
    benefits

    In this guide (6 steps):

    1. 1.Confirm the Patient Has Medicare Part A
    2. 2.Ask the Treating Doctor for a Referral
    3. 3.Pick a Medicare-Certified Hospice Agency
    4. 4.Sign the Election Statement
    5. 5.Complete the Two Required Certifications
    6. 6.Expect the First Nurse Visit Within 48 Hours
    1

    Confirm the Patient Has Medicare Part A

    ~42s
    The hospice benefit comes from Medicare Part A, the hospital insurance side of Medicare. Almost everyone over 65 who paid Medicare taxes during their working years has Part A. To confirm, look at the patient's red, white, and blue Medicare card. If the card lists Hospital (Part A) with a start date, the patient is covered. If only Part B is listed, call 1-800-MEDICARE and ask whether Part A can be added retroactively. Patients on Medicare Advantage plans switch back to original Medicare for hospice care automatically once they enroll. The Advantage plan keeps covering other unrelated services.

    Quick Tip

    If a parent receives Medicaid in addition to Medicare, the dual coverage works together to pay for hospice and any room-and-board costs in a nursing home. Mention both at the intake call.

    2

    Ask the Treating Doctor for a Referral

    ~41s
    Hospice enrollment begins with a doctor's certification. Call the patient's main doctor, often a primary care physician, oncologist, or cardiologist depending on the illness. Tell the office staff that the family would like to discuss hospice. Most clinics can schedule a visit within a week, and many do this conversation by phone for patients too frail to travel. During the visit, the doctor will assess whether the illness is likely to end the patient's life within six months. If so, the doctor will write a referral. The doctor can also recommend a hospice agency, but the family is free to pick a different one.

    Warning

    A doctor cannot enroll a patient in hospice without the patient or the patient's health care agent agreeing. Hospice is a voluntary choice.

    3

    Pick a Medicare-Certified Hospice Agency

    ~34s
    Use Medicare's Care Compare website at medicare.gov/care-compare to look up hospices in the patient's zip code, read star ratings, and compare ownership and inspection history. Pick two or three agencies and call each to schedule a free intake visit. During the visit, the hospice nurse explains services, looks at the home setup, and answers questions. The patient or family chooses one agency. Sign-up paperwork can happen at the same visit or be saved for a second appointment after the family has had time to think.

    Quick Tip

    Ask the intake nurse for a same-week start date if pain or symptoms are currently uncontrolled. Faster enrollment usually means faster relief.

    4

    Sign the Election Statement

    ~38s
    The hospice election statement is a single page that tells Medicare the patient is choosing the hospice benefit and waiving curative treatment for the terminal illness. The patient signs and dates the form. If the patient is unable to sign because of confusion or weakness, the named health care agent signs in their place. The election covers the terminal illness only. Medicare still pays for treatments unrelated to the terminal illness, such as routine eye exams or treatment for a broken arm. The patient can revoke the election at any time and return to regular Medicare.

    Warning

    Read the election statement before signing. Make sure it lists the correct terminal illness and the correct hospice agency. Mistakes on the form can delay services.

    5

    Complete the Two Required Certifications

    ~37s
    Within two days of enrollment, two doctors must each sign a certification that the patient has six months or less to live if the illness runs its normal course. The first signature comes from the hospice medical director or the hospice doctor. The second comes from the patient's regular doctor. Both signatures together unlock the Medicare benefit. The hospice agency handles the paperwork and faxes it to the doctors. Families do not usually need to do anything for this step.

    Quick Tip

    If a patient lives longer than six months, the certifications are renewed. The first renewal is for another 90 days, the second for another 90 days, and then for 60-day periods after that, with no upper limit.

    6

    Expect the First Nurse Visit Within 48 Hours

    ~41s
    Most hospices send the first nurse to the patient's home within one to two days of enrollment. The nurse takes vital signs, reviews medications, sets up any needed equipment such as a hospital bed or oxygen concentrator, and helps the family understand what to expect in the days and weeks ahead. The hospice gives the family a small kit of comfort medicines, sometimes called the comfort kit or e-kit, to handle sudden pain, nausea, or trouble breathing. Aides, social workers, and chaplains schedule their first visits within the first week. A 24-hour phone line is in service from day one.

    Quick Tip

    Pin the hospice phone number to the fridge and program it into every family member's phone. Crisis calls go faster when the number is at hand.

    You Did It!

    You've finished reading: How to Apply for the Medicare Hospice Benefit

    How well did this guide stick with you?

    Need more help? Book a TekSure tech

    The Medicare hospice benefit is one of the most thorough and least expensive end-of-life services in American health care, yet many families do not know how to sign up. Once a doctor certifies that a person likely has six months or less to live, Medicare Part A pays for nearly all hospice services in full. There is no premium added to existing Medicare costs. There is no deductible. Copays exist only for outpatient drugs and respite stays, and both are very small. The benefit covers nurses, aides, medical equipment, comfort medicines, social workers, chaplains, and grief support for the family for up to 13 months after the death.

    The sign-up process moves quickly once the family is ready. The patient or the patient's legal representative chooses a Medicare-certified hospice agency, the doctor and the hospice medical director sign a short certification form, and the patient signs an election statement that says they are choosing comfort care over treatments aimed at curing the terminal illness. From start to first nurse visit, the whole process often takes one to three days. In urgent cases, hospice agencies can begin care within hours.

    Despite the speed, the choice itself deserves care. Choosing hospice does not mean giving up on the patient. It means choosing a different goal: comfort, dignity, and quality of time together. Patients can leave hospice at any time and return to regular Medicare coverage. Patients can also switch hospice agencies. Nothing about the enrollment is one-way.

    This guide walks step by step through the enrollment paperwork, the conversation with the doctor, the election statement, and the first few days of care. We also cover special situations such as hospice in a nursing home, hospice when a person is too ill to sign their own paperwork, and what happens if a patient lives longer than six months. The information is current as of May 2026. Always confirm details with the hospice intake nurse, since small administrative rules can change.

    Rate this guide

    How helpful was this guide?

    medicare
    hospice
    enrollment
    seniors
    end of life
    benefits

    Official Resources

    USA.gov — Government ServicesSSA — Social SecurityBenefits.govIRS Free File

    Sources used to create and verify this guide. View all sources →

    ← Previous

    How to Write an Advance Care Directive

    Next →

    How to Find a Hospice Volunteer to Sit With a Dying Parent

    Still stuck? Let a pro handle it.

    A real person can walk you through this over the phone, anywhere in the US. If we can't fix it, you don't pay.

    Book a Verified Tech How It Works

    Learn more from official sources

    Related Guides

    How to Set Up a My Social Security Account Online

    Create your free my Social Security account at ssa.gov to view statements, check benefits, and manage your information online.

    3 min read

    How to Use Medicare.gov to Find Your Benefits

    Log in to Medicare.gov to check your coverage, find doctors, compare plans, and understand what Medicare pays for.

    3 min read

    How to File Taxes Online Using Free File (IRS.gov)

    File your federal taxes for free through the IRS Free File program — no cost, no catch, and available to most taxpayers.

    3 min read