What Is Not Covered Under Hospice Care?
When a patient elects hospice care, the focus shifts from curative treatment to comfort and symptom management. Hospice is designed to help people with terminal illnesses live as well as possible during their final months or weeks. But while hospice covers many supportive and palliative services, not everything is included. Understanding what is not covered is essential, both for patients and caregivers, so there are no surprises or unexpected expenses.
While hospice care offers comprehensive support for individuals with terminal illnesses, certain services and treatments are not covered. These typically include:
- Curative TreatmentsHospice focuses on comfort and palliative care, so treatments aimed at curing the terminal illness are not covered.
- Care Outside the Hospice PlanIf a patient seeks care from providers or facilities not approved by the hospice team, the costs may not be covered under the hospice benefit.
- Room and BoardHospice does not cover the cost of room and board in a nursing home, assisted living facility, or hospice residence unless the patient requires inpatient care for pain or symptom management.
- Unrelated Medical ServicesMedical care for conditions that are not related to the terminal illness is not typically covered under hospice. Patients will need to use their regol class=”number”ar health insurance for treatment of these conditions.
- Emergency CareAmbulance services or emergency room visits that are not related to the hospice care plan are usually not covered, unless arranged by the hospice team.
Patients and families should work closely with the hospice team to understand what is and isn’t covered, and explore other payment options if necessary.
Frequently Asked Questions (FAQs)
No — treatments meant to cure, such as chemotherapy or radiation intended to eliminate cancer, are generally excluded. Hospice care focuses on comfort and symptom control.
Usually not. Hospice doesn’t cover the cost of housing, meals, or facility living, except in the case of short-term stays arranged by hospice for symptom control or respite.
Only medications needed to manage symptoms related to the terminal disease are covered under hospice. Drugs for unrelated or chronic conditions often are excluded.
If the emergency service is related to the terminal illness and arranged through the hospice team, it may be covered. Otherwise, typical ER visits, ambulance transport, or inpatient hospital stays are generally not covered.
Only if they contribute to comfort or symptomatic relief. Rehabilitation aimed strictly at recovery or improvement will generally not be included.
These are usually not part of standard hospice coverage, unless they are integrated as supportive or comfort measures expressly included in the hospice’s plan.
Not under most hospice benefit rules. To elect hospice, patients typically must agree to forgo curative treatments for their terminal condition. If you later decide to stop hospice, you can return to standard medical care.
Your hospice provider should provide a written list (often called a “Notification of Non-Covered Services”) stating which services or items are not covered and the reasons.
Common Services & Treatments Not Covered Under Hospice
1. Curative Treatments
Hospice care excludes treatments intended to cure or significantly delay progression of the terminal illness.
- Chemotherapy, radiation, surgeries, or experimental therapies aimed at cure are typically not covered.
- Prescription drugs for curative purposes (rather than symptom control) are excluded.
2. Room & Board in Facilities
If the patient resides in a nursing home, assisted living facility, or hospice inpatient unit,
room and board (housing, meals, lodging) usually are not included in hospice coverage.
- An exception: if the hospice team arranges and approves a short-term inpatient stay for symptom control or respite care, some or all costs may be covered.
3. Durable Medical Equipment & Supplies (Selective Exclusion)
Hospice typically covers necessary medical equipment tied to comfort (like hospital beds, basic oxygen, commodes)
but does not always cover more advanced or specialized equipment.
- Ventilators, motorized wheelchairs, highly advanced equipment may be excluded.
- Similarly, supplies unrelated to the terminal illness or comfort (incontinence supplies or items considered “personal hygiene”) might be excluded.
4. Rehabilitation / Therapy for Improvement
Because hospice focuses on comfort, services whose aim is rehabilitation or recovery
(e.g. physical therapy to restore mobility, occupational therapy to retrain recovering function)
are generally not included unless they support symptom control or maintaining basic function.
5. Alternative or Complementary Therapies
Treatments such as acupuncture, massage (beyond symptom relief), art therapy, music therapy, or holistic wellness modalities are often
excluded in the standard hospice benefit.
6. Emergency / Hospital Services Unrelated to Terminal Illness
If a patient requires emergency care (e.g., accident, unrelated medical condition) that is not coordinated by the hospice team
or not connected to the terminal diagnosis, those costs may not be covered.
- Hospitalization fees, outpatient surgeries, ER visits initiated without hospice arrangement often fall outside hospice coverage.
7. Medications Unrelated to Terminal Diagnosis
Hospice will cover medications for pain, symptom relief, nausea, anxiety, and other conditions arising from the terminal disease.
But drugs unrelated to that diagnosis — for example, ongoing treatments for chronic conditions not tied to the terminal disease —
may not be included.
8. Private, 24-Hour Non-Hospice Care
Hospice programs generally don’t provide round-the-clock private care or paid caregivers for non-medical day-to-day assistance
unless arranged through other channels.
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