The Four Levels of Hospice Care That Medicare Covers

Medicare benefits cover four levels of hospice care: routine home care, continuous home care, general inpatient care and respite care. Hospice coverage from private insurance plans typically match the levels of care defined by Medicare.

Every person and every family has unique needs for end-of-life care. Patients and their families may move in and out of each level of hospice service as their needs change.

What Are the Four Levels of Hospice Care?

Medicare hospice covers four levels of care designed to meet a patient’s changing needs. These include:

(1) Routine Home Care, the day-to-day care provided wherever the patient calls home

(2) Continuous Home Care during a symptom crisis at home

(3) General Inpatient Care for short-term management of uncontrolled symptoms

(4) Respite Care, which provides short-term inpatient care to give family caregivers time to rest.

While there are four levels of hospice care, patients don’t move through them like stages. Most people receive Routine Home Care, while the other levels are available if a patient’s needs change. Your hospice team continually assesses your condition to ensure you receive the right level of care at the right time.

Understanding the Four Levels of Hospice Care That Medicare Covers

Hospice care is designed to meet patients where they are: physically, emotionally and spiritually. As needs change, the hospice team can adjust the level of care to provide additional support while helping patients remain as comfortable as possible.

Routine Home Care

Routine Home Care is the most common level of hospice care and is where most patients begin.

Despite the name, this level of care is anything but routine. It provides comprehensive, comfort-focused care wherever a patient calls home, whether that’s a private residence, assisted living community or nursing facility.

The interdisciplinary hospice team develops a personalized plan of care that may include:

Regular nursing visits

Hospice aides for personal care

Social workers

Chaplains and spiritual care

Volunteers

Medications related to the diagnosis

Medical equipment and supplies

Bereavement support for loved ones

The goal is to help patients live each day with comfort and the support they need.

Continuous Home Care

Sometimes symptoms become difficult to manage at home.

Continuous Home Care provides short-term, intensive nursing care during a medical crisis, allowing patients to remain at home whenever possible instead of going to the emergency department or hospital.

This level of care may be appropriate when symptoms such as severe pain, shortness of breath, nausea or anxiety require close monitoring until they are under control.

Once the crisis resolves, patients typically return to Routine Home Care.

General Inpatient Care

If symptoms cannot be safely managed at home, General Inpatient Care provides short-term treatment in a Medicare-certified hospice inpatient unit or hospital.

This level of care focuses on stabilizing symptoms through around-the-clock clinical care.

Patients generally return home once their symptoms are controlled and can be safely managed with Routine Home Care.

Respite Care

Caring for someone with a serious illness can be physically and emotionally demanding.

Respite Care allows a patient to stay in a Medicare-approved facility for up to five consecutive days while their family caregiver takes time to rest, attend personal obligations or simply recharge.

Supporting caregivers is an important part of hospice care because caring for yourself helps you continue caring for someone else.

How Does the Hospice Team Decide Which Level of Care Is Needed?

Your hospice team continually evaluates your condition and works closely with you, your family and your physician to determine the most appropriate level of care.

The goal is always the same: providing the right care at the right time while honoring your goals and preferences.

Paying for Hospice with Medicare

How do you know if hospice is covered by Medicare? Generally, hospice care is 100 percent covered when it’s provided to those enrolled in Medicare Part A. Patients may still be responsible for copayments or coinsurance fees and hospice medications depending on individual plans. Medicare Part B may cover hospice services such as hospice care provided in a nursing facility or hospice respite care when it is used for more than five consecutive days.

It’s important to speak with a hospice care specialist to determine the specifics of hospice Medicare coverage and what hospice services are covered by this program.

Frequently Asked Questions

Which level of hospice care is most common?

Routine Home Care is the most common level of hospice care. Most patients receive hospice services in the place they call home.

Do patients move through all four levels?

No. Most patients receive Routine Home Care throughout their hospice journey. The other levels are used only if a patient’s condition changes or additional support is needed.

Does Medicare cover all four levels?

Yes. The Medicare Hospice Benefit includes coverage for all four levels of hospice care when patients meet eligibility requirements.

Compassionate Care, Wherever You Call Home

Every hospice journey is unique. Whether you’re just beginning to explore hospice or need additional support during a change in condition, Compassus is here to help.

Our interdisciplinary team provides personalized, compassionate care that meets patients and families where they are—ensuring comfort, dignity and support every step of the way.

Learn more about hospice care or contact Compassus to speak with a care specialist today.

Contact Compassus to Learn More

With 200 locations across 30 states, Compassus hospice care professionals are here to answer questions and help you understand hospice care options. Navigating hospice Medicare coverage can be complex, so it’s important to have the support of hospice care professionals.

Whether you’re looking for hospice care locations in your area or need help understanding hospice coverage, our team is here to support you and your loved one every step of the way. Reach out to us at 833.380.9583 today to learn more about hospice Medicare coverage.