You can stop hospice care at any time. Medicare says you'll sign a form with the date your hospice care ends, and after that your regular Medicare coverage picks up again for treatment of your illness. If you're still eligible, you can return to hospice later.
Why do people stop hospice?
Medicare's hospice booklet gives two common reasons: your health improves or your illness goes into remission, or you decide you want treatment to cure your illness. Some families also stop hospice to try a new treatment, or because a parent's goals change.
Stopping hospice is called "revoking" the hospice benefit. It's your choice, and it isn't permanent.
How do I stop hospice?
Tell the hospice provider you want to stop. Medicare.gov says the hospice will ask you to sign a form that includes the date your care will end.
A few protections in Medicare's booklet are worth knowing:
- Stopping hospice is a choice only you can make.
- No one should ask you to sign forms about stopping hospice if you didn't ask for them.
- Don't sign or date any form until the actual date you want hospice care to stop.
If a parent can't speak for themselves, the person legally allowed to make health decisions for them would make this choice. If you're unsure who that is, ask the hospice social worker.
What to say to the hospice:
"I've decided to stop hospice care. I'd like it to end on [date]. Can you bring the form on that date, and explain what happens to the medicines and equipment you've been providing?"
What happens to my coverage after I stop?
Medicare's booklet says:
- If you were in Original Medicare, you continue in Original Medicare. The usual deductibles and coinsurance apply again for treatment of your illness.
- If you were in a Medicare Advantage Plan when you started hospice and kept paying the plan's premiums, you can keep getting coverage from your plan after you stop.
While you were in hospice, Original Medicare covered care related to your terminal illness, even if you stayed in a Medicare Advantage Plan. That changes back once hospice ends.
What bills should I expect after hospice ends?
The hospice benefit covered most care for your terminal illness, with small copays. After you stop, you may see:
- Doctor and hospital bills with regular Part B coinsurance or Part A deductibles. See the Part B deductible and 20% coinsurance.
- Drug costs through your Part D plan for medicines the hospice used to supply. Check your plan's drug list. See Part D formulary exceptions.
- Equipment rentals that the hospice provided, like a hospital bed or oxygen, which now need to go through Medicare Part B or your plan. See durable medical equipment bills.
- Nursing home room and board, which hospice never covered and Medicare doesn't cover for long-term custodial care.
Ask the hospice for a list of what it's been providing, so you can arrange replacements before the end date.
How do I avoid billing mix-ups around the end date?
Watch the dates on bills from around the time you stopped. A service on or after the end date shouldn't be billed to hospice, and care before it generally should be.
- Write the end date somewhere you'll see it.
- Tell your regular doctors, pharmacy, and equipment supplier the date.
- When your Medicare Summary Notice arrives, check that hospice claims stop on the end date and regular claims start after.
What to say to a billing office if dates look wrong:
"Hospice care ended on [date]. This service was on [date], so it should be billed to [hospice / Medicare / my plan]. Can you check and resubmit the claim?"
See how to read your Medicare Summary Notice.
What if the hospice says I'm no longer eligible?
That's different from choosing to stop. If the hospice decides to end your care, Medicare.gov says you should get a "Notice of Medicare Non-Coverage" at least 2 days before covered services end. You can ask for a fast appeal by following the notice's instructions no later than noon the day before the end date. An independent reviewer called a BFCC-QIO decides.
Medicare.gov says that if the reviewer agrees your services should end, you won't owe for hospice services provided before the end date on the notice.
For more on this kind of notice, see Medicare Advantage plan ended nursing home rehab coverage, which walks through the same fast appeal steps.