Hospice Eligibility: information for patients and families

Hospice is available to patients with a terminal diagnosis and life expectancy of six months or less, as determined by the patient's doctor and a hospice medical director. The patient or the family must be aware of the prognosis and decide on comfort care rather than curative treatment for the terminal condition.


Determining a prognosis of six months or less can be challenging. Awareness of decline require understanding a patient's condition over time. That's why primary care doctors are essential for determining hospice eligibility.


The second step for hospice eligibility is typically an assessment by a hospice medical director. They work together with the patient's doctor to offer experience with hospice criteria, guidelines and clinical judgement.



Hospice pre-election consultations are free to patients and family and without obligation


Medicare allows and reimburses for a one-time visit by a physician who is either the medical director of or employee of a hospice agency.


  • Evaluate the need for pain and symptom management
  • Counsel the individual regarding hospice and other care options
  • Advise the individual regarding advanced care planning
  • Hospice Pre-Election Evaluation and Counseling information - CMS-R386CP.pdf


Staff at our hospice locations are available for no-obligation consultations.


Patients may receive care anywhere they live, including a private home, nursing facility, hospice inpatient facility or hospital. 

Eligibility in context with the hospice decison

For many patients and families, hospice offers peace and a chance to focus on what's important. If a patient is eligible for hospice, we know the decision to choose hospice is difficult. Open communication is key. That’s why we encourage patients and families to start conversations with each other and with the patient's doctor. Advance care planning can bring clarity to a patient's end-of-life goals and help doctors and families understand the wishes of the patient.


It is important for patients and families to know that anyone can make a referral to hospice. Experts say that patients who receive care for 30-60 days benefit substantially over those who enter hospice during the final days or hours of life.

Hospice-appropriate individuals may experience some or all of the following:

  • Frequent hospitalizations
  • Progressive weight loss
  • Deteriorating mental abilities
  • Recurrent infections
  • Specific decline in condition
hospice for mother

Hospice is a fully covered Medicare benefit

Coverage includes nurses, other caregivers, medicines, supplies, equipment and support, with no out-of-pocket expenses for the hospice diagnosis.


Call a program near you for information