hospice benefit periods | Hospice in Arapahoe County CO

The Medicare Hospice Benefit is one of the most comprehensive coverage options available to eligible patients and families, yet many people never fully use it because they are not sure how it works.

This guide breaks down what the Medicare Hospice Benefit covers, who qualifies, and what you can realistically expect when your loved one receives hospice care under Medicare in Colorado.

What Is the Medicare Hospice Benefit?

The Medicare Hospice Benefit is a federal program under Medicare Part A that covers the full scope of hospice services for patients who meet specific eligibility requirements. According to the Centers for Medicare and Medicaid Services (CMS), this benefit was designed to support patients with a terminal diagnosis and their families by covering medically necessary comfort-focused care at little to no out-of-pocket cost.

It is not just a coverage plan. It is access to an entire care team, coordinated around your loved one’s comfort, dignity, and quality of life.

Who Qualifies for the Medicare Hospice Benefit?

To be eligible for the Medicare Hospice Benefit, a patient must meet the following criteria as defined by CMS:

Enrolled in Medicare Part A
Certified by two physicians (typically the patient’s attending physician and the hospice medical director) that the patient has a terminal illness with a prognosis of six months or less if the disease runs its natural course
Elects the hospice benefit, which means shifting the focus of care from curative treatment to comfort-focused care for the terminal diagnosis

Electing hospice does not mean giving up. It means choosing a model of care designed to provide the highest possible quality of life in the time that remains.

Learn more: Who Qualifies for Hospice in Colorado: Eligibility, Prognosis, and Common Diagnoses.

You can also visit our Hospice Eligibility Guidelines page to learn more about how eligibility is assessed here in the Denver Metro area.

How Are Medicare Hospice Benefit Periods Structured?

Once a patient elects the Medicare Hospice Benefit, care is organized into benefit periods:

Two initial 90-day periods
Followed by unlimited 60-day periods as long as the patient continues to meet eligibility criteria

At the start of each benefit period, a hospice physician must re-certify that the patient still meets eligibility requirements. If a patient improves and no longer qualifies, they can be discharged from hospice and return to standard Medicare coverage. If they later decline again, they can re-elect the benefit.

What Does the Medicare Hospice Benefit Cover?

This is where the Medicare Hospice Benefit truly stands apart. Under this benefit, Medicare covers a wide range of services, all focused on comfort, symptom management, and family support.

Medical Care and Nursing. Medicare covers visits from a Registered Nurse as part of your loved one’s ongoing care. Nursing visits are scheduled based on the patient’s needs and can be increased during periods of symptom changes or health decline. A Medical Director oversees the plan of care and collaborates with the patient’s physicians throughout the process.
Medications. Medicare covers medications that are related to the terminal diagnosis and aimed at managing symptoms such as pain, nausea, anxiety, or shortness of breath. Medications unrelated to the hospice diagnosis may still be covered through Medicare Part D.
Medical Equipment and Supplies. The benefit includesDurable Medical Equipment (DME) such as hospital beds, wheelchairs, oxygen equipment, and other supplies needed for comfort and safety in the home.
Aide and Personal Care Services. Certified nursing aides help with personal care tasks such as bathing, grooming, and mobility support.
Social Work Services. A licensed Social Worker provides guidance on care decisions, community resources, advance directives, and the emotional weight that families carry during this time.
Spiritual Care. Non-denominational Spiritual Care is available to patients and families regardless of religious background. This support addresses existential questions, meaning-making, and peace.
Bereavement Support. The Medicare Hospice Benefit includesBereavement Care for the family for up to 13 months following the patient’s death. Grief support is part of the benefit from the very beginning.
Volunteer Support. Volunteer Support services provide companionship, respite, and practical help to families, at no additional cost.

The Four Levels of Medicare Hospice Care

Under the Medicare Hospice Benefit, there are four recognized levels of care. The level provided is based on the patient’s medical needs at any given time.

Routine Home Care – The most common level. Ongoing hospice services provided where the patient lives, whether at home, in a nursing facility, or in an assisted living community.
Continuous Home Care – Short-term, intensive nursing and aide services provided during a medical crisis to keep the patient comfortable at home.
General Inpatient Care – For symptom management that cannot be managed in the home setting and requires a higher level of clinical intervention.
Inpatient Respite Care – Short-term facility-based care (up to five days) to provide family caregivers with a temporary break.

Learn more: Four Levels of Care page.

What Does Hospice Cost Under Medicare?

For most patients, the Medicare Hospice Benefit comes with minimal or no out-of-pocket cost. Here is how cost-sharing works under CMS guidelines:

Routine Home Care, Continuous Home Care, and General Inpatient Care: No copay for the patient
Prescription medications: A small copay, generally no more than $5 per prescription for covered drugs
Inpatient Respite Care: The patient may pay a small daily copay, which CMS adjusts annually

There are no deductibles or premium charges specific to the hospice benefit when enrolled in traditional Medicare Part A.

What Happens After Your Loved One Passes

Many families do not realize that Medicare-covered hospice support continues after their loved one’s death. Bereavement care for families is a required component of the Medicare Hospice Benefit and is provided at no cost for up to 13 months. This may include grief counseling, check-in calls, and support groups.

Grief is not a moment. It is a process that looks different for every person and every family. Read more about what that journey can look like in our post: Understanding the Different Types of Grief After Hospice Loss in Colorado.

Ready to Talk About Starting Care?

If your loved one may be eligible for the Medicare Hospice Benefit and you want to understand your options, the best first step is a conversation. Contact us to learn what the process looks like, or call us directly at (720) 999-9854. Our team can help you understand eligibility, walk you through the enrollment process, and answer every question you have without pressure.

You can also schedule a free in-home consultation with our team. We serve families across Aurora, Denver Metro, and surrounding Colorado communities, and we are here whenever you are ready to talk.

One of the most common fears families carry into a hospice conversation is this: What if we change our minds?

It is a fair and important question. Deciding to enroll in hospice feels enormous, and the last thing anyone wants is to feel trapped in a decision made during one of the hardest seasons of their life. The good news is that hospice care under Medicare is not a permanent, one-way door. You have more flexibility than most people realize, and understanding that flexibility often makes it easier to say yes to the support your family truly needs right now.

What Hospice Enrollment Actually Means

Understanding hospice possibility in Aurora CO

When a patient enrolls in hospice, they are electing a Medicare benefit, not signing a contract that cannot be undone. Under the Medicare Hospice Benefit, care is organized in benefit periods rather than open-ended commitments. The first two benefit periods are each 90 days long, followed by unlimited 60-day periods after that. At the end of each period, a hospice physician recertifies that the patient still meets eligibility criteria. If your loved one’s condition changes, so can the plan.

Understand what recertification involves and what to expect at each stage of care.

Read: Hospice Eligibility Guidelines

You Can Revoke Hospice Care at Any Time

This is the part most families do not know: Medicare allows a patient to revoke their hospice election at any time, for any reason, without penalty. The process is straightforward. The patient or their representative submits a written revocation statement, and the hospice election ends on the date specified in that document.

There are several reasons a family might choose to revoke:

A patient’s condition improves significantly and they want to pursue curative treatment again
The family wants to explore a different care approach or setting
Circumstances at home have changed and a different level of support is needed
The patient simply wants to reassess before continuing

Revoking hospice does not mean the door closes permanently. If the patient later meets eligibility requirements again, they can re-enroll. Medicare allows re-election of the hospice benefit, and the remaining days in the benefit period are typically preserved.

What Happens If a Patient’s Condition Improves?

Sometimes a patient stabilizes or improves enough that hospice is no longer appropriate. In these cases, the hospice team may discharge the patient, not because care has failed, but because the level of illness no longer meets the eligibility threshold. This is actually a sign the care is working.

If that happens, the patient can return to their regular Medicare coverage and resume curative treatment. And if their condition later declines again, they may become eligible to re-enroll in hospice. The system is designed to move with the patient, not hold them in place.

If you are still weighing whether your loved one meets the criteria right now, our post on who qualifies for hospice in Colorado walks through the prognosis standards and common diagnoses in plain language.

You Can Also Change Hospice Providers

Families are not locked into their first choice of hospice agency, either. Under Medicare, a patient can transfer to a different Medicare-certified hospice provider once per benefit period. If your current experience is not what you hoped for, or if you find a provider that feels like a better fit, that option exists.

Choosing the right team matters deeply. The people who come into your home become part of your family’s story during an incredibly tender time. You deserve a team you trust.

How Your Hospice Team Supports Your Decisions

A good hospice team will never pressure you to stay enrolled or make you feel guilty for asking questions about your options. Their role is to support you, inform you, and walk alongside you, not to manage you. That includes your registered nurses, your social worker, and your care team as a whole.

Your social worker in particular is a key resource here. They can help you understand the revocation process, navigate transitions in care, coordinate with Medicare, and connect you with support if your family’s needs shift. Their role goes well beyond paperwork.

What Stays the Same: The Care You Receive

Even knowing that flexibility exists, most families find that once hospice begins, the relief it provides becomes its own answer. Managed symptoms, regular nursing visits, emotional support for the whole family, spiritual care, access to durable medical equipment at no additional cost, and bereavement care that extends after a loved one passes these are the things families often say they wish they had started sooner.

The flexibility is there so you feel safe enough to begin. The care is there so you feel held once you do.

Common Questions About Hospice Flexibility

Can my loved one leave hospice and come back? Yes. A patient can revoke their hospice election and re-enroll later if they still meet eligibility criteria. Remaining benefit period days are generally preserved.

Does revoking hospice affect Medicare coverage? No. When a patient revokes hospice, their regular Medicare Part A and Part B coverage resumes immediately.

What if we are not sure hospice is the right step yet? That uncertainty is completely normal. Our FAQ page answers many of the most common questions families are sitting with, and our team is always available to talk through your specific situation before any decision is made.

Does hospice care look the same for everyone? No. Care is adjusted based on what your loved one needs at any given time.

Get more answers here: FAQs

Learn More About Your Flexibility Options in Hospice

You do not have to have everything figured out before you reach out. When you are ready to talk, Aspen Grove Hospice is here. You can reach us at (720) 999-9854 or schedule a free in-home consultation at a time that works for your family. Asking questions is not the same as committing, and a conversation with our team costs nothing and obligates you to nothing.

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The Medicare Hospice Benefit: Understanding Eligibility and Coverage