The Medicare Hospice Benefit is a fully covered federal benefit available to Medicare Part A enrollees with a terminal diagnosis and a physician-certified prognosis of six months or less. It covers nursing visits, aide services, medications, medical equipment, social work, spiritual care, volunteer support, and bereavement care, all with no copays or deductibles. 

For families in Tarrant and Johnson County, AlēvCare Hospice delivers every component of this benefit directly to wherever your loved one lives, with a locally based team available 24 hours a day, seven days a week.

What the Medicare Hospice Benefit Actually Is

If your loved one is on Medicare and has been diagnosed with a terminal illness, there is a federal benefit specifically designed to cover the cost of compassionate, comfort-focused care at home. It is called the Medicare Hospice Benefit, and it is one of the most comprehensive and least understood benefits Medicare offers.

A full, coordinated team of clinicians and support professionals, medications delivered to the door, medical equipment set up in the home, and support that extends to the entire family, including after a loss. All of it is covered under Medicare Part A, with no copays and no deductibles for hospice services.

This guide explains exactly what that benefit includes, who qualifies for it, and what it looks like in practice for families in Tarrant and Johnson County who are navigating this decision right now.

Who Qualifies for the Medicare Hospice Benefit

To access the Medicare Hospice Benefit, a patient must meet three criteria as defined by the Centers for Medicare and Medicaid Services (CMS):

1. Enrollment in Medicare Part A. Most people 65 and older who have worked and paid Medicare taxes qualify automatically. Some individuals under 65 may also be enrolled due to a disability or certain diagnoses.
2. A terminal diagnosis with a physician-certified prognosis of six months or less if the illness runs its natural course. This certification must come from the patient’s attending physician and the hospice Medical Director.
3. A decision to choose comfort-focused care rather than curative treatment for the terminal diagnosis.

Eligibility is also not a point-in-time decision. If your loved one’s condition has been progressing and a physician has suggested that hospice may be appropriate, requesting an evaluation is the most direct way to find out whether they qualify. There is no cost to ask, and no obligation to enroll. For a full breakdown of what the eligibility criteria look like in practice, visit: Eligibility Guidelines.

What Medicare Covers: A Complete Breakdown

Under the Medicare Hospice Benefit, the following services are covered in full, with no copays or deductibles for hospice-related care.

• Nursing Care. A Registered Nurse Case Manager makes regular visits to assess the patient, manage pain and symptoms, educate the family on what to expect, and adjust the care plan as the illness progresses. Visit frequency is based on the patient’s individual needs and increases as conditions change.
• Medical Director Oversight. The AlēvCare Medical Director oversees the clinical plan of care. He works directly with the patient’s attending physician to ensure all care decisions align with the patient’s comfort goals and medical needs.
• Aide and Personal Care Services.Certified Nursing Aides (CNAs) provide hands-on personal care assistance: bathing, dressing, grooming, and mobility support, on a regular schedule based on the patient’s level of need.
• Social Work Services. A Licensed Social Worker is part of every hospice care plan. Their role covers a broad range of practical and emotional support: helping families understand what to expect, connecting families with community resources, and more. 
• Spiritual Care. The Chaplain provides spiritual and emotional support that is always tailored to the individual beliefs and preferences of the patient and family.
• Volunteer Support. Trained Volunteers donate their time to provide companionship, run errands, sit with a patient so a caregiver can take a break, or offer practical help in whatever form the family needs. Medications Related to the Hospice Diagnosis All medications directly related to the terminal diagnosis and the patient’s comfort are covered under the Medicare Hospice Benefit. This includes pain medications, anti-anxiety medications, medications for symptom management, and other comfort-related prescriptions. Medications for unrelated conditions, such as a blood pressure medication for a patient whose hospice diagnosis is cancer, may require a small copay. 
• Medical Equipment and Supplies. All medically necessary durable medical equipment related to the hospice diagnosis is covered and delivered to the home. This includes hospital beds, wheelchairs, walkers, oxygen equipment, bedside commodes, and wound care supplies. For patients with complex wound care needs, AlēvCare’s Wound Care services are integrated directly into the hospice plan of care at no additional cost.
• Respite Care. Inpatient Respite Care is a covered Medicare benefit that provides a short-term inpatient stay up to five consecutive days, so that the primary family caregiver can temporarily rest and recover. 
• Bereavement Care. Support does not end at the time of a loved one’s death. Under the Medicare Hospice Benefit, Bereavement Care is provided to family members for a period following the loss. 

What Medicare Does Not Cover Under the Hospice Benefit

Understanding coverage gaps helps families plan and avoid surprises. A few things Medicare’s Hospice Benefit does not cover:

• Room and board at home or in an assisted living community. If a patient is receiving Routine Home Care at an assisted living facility, the facility’s room and board costs are separate from the hospice benefit and are the responsibility of the patient or family.
• Curative treatment for the terminal diagnosis. Once enrolled in hospice, Medicare will not cover treatments aimed at curing the terminal condition. Treatment for unrelated conditions may still be covered under Medicare Parts A and B.
• Medications unrelated to the hospice diagnosis. As noted above, these may require a small copay or may be covered under Medicare Part D, depending on the patient’s plan.

The AlēvCare team explains all of this in plain language at the time of enrollment so families know exactly what to expect before care begins.

The Four Levels of Care Covered by Medicare

The Medicare Hospice Benefit covers four distinct levels of care, each designed for a specific clinical situation. Patients can move between levels as their condition changes.

• Routine Home Care – Regularly scheduled visits at home during stable periods
• Continuous Home Care – Intensive nursing support at home during an acute medical crisis
• Inpatient Respite Care – Short-term inpatient stay for caregiver relief
• General Inpatient Care – Inpatient care for symptoms too severe to manage at home

Learn more: The 4 Levels of Hospice Care Explained (And When Each Applies).

Hospice Coverage for Veterans in Tarrant and Johnson County

Veterans who receive care through the VA may be eligible for hospice benefits through the VA system in addition to or in place of the Medicare Hospice Benefit. AlēvCare’s Veterans care program is specifically designed to honor the unique needs of veterans and their families – including recognition, emotional support tailored to the military experience, and coordination with VA benefits when applicable.

Your Next Step Is a Conversation, Not a Commitment

Requesting an evaluation does not obligate you to enroll. It starts a conversation. A clinician from the AlēvCare team will visit your home, assess your loved one, answer your questions, and help you understand whether hospice is the right fit for your family right now.

If it is, the team coordinates everything from that point forward – equipment, medications, scheduling, and 24/7 access. You focus on your loved one. The team handles the rest.

Call AlēvCare Hospice at (469) 630-2538 to speak with someone today, or schedule a free in-home consultation and let us come to you.