Medicaid covers hospice care including room and board, but only when you receive care in a Medicaid-certified hospice facility

Medicaid pays for hospice services when a doctor certifies that you have six months or less to live and you choose hospice care instead of curative treatment. This includes the room itself, meals, and the bed you sleep in — but the coverage depends on where you receive that care and whether the facility is enrolled in Medicaid.

If you receive hospice at home, Medicaid does not pay for room and board because you already have a home. If you receive hospice in a nursing home or assisted living facility where you already live, Medicaid typically does not add extra payment for room and board on top of what the facility already receives. The key distinction is whether hospice is an add-on service to existing residential care or a standalone service in a dedicated hospice facility.

Key Takeaways

  • Medicaid covers room and board only when you receive hospice care in a Medicaid-certified hospice facility as your primary residence during end-of-life care.
  • Hospice at home is covered by Medicaid, but room and board costs are your responsibility because you are living in your own home.
  • If you live in a nursing home or assisted living facility and add hospice services, Medicaid typically does not pay extra for room and board beyond the facility's existing rate.
  • Your state Medicaid program determines the exact payment rates and which facilities participate, so coverage details vary by location.
  • You must have a doctor's certification that you have a terminal illness with a prognosis of six months or less to receive Medicaid-covered hospice.

How Medicaid hospice payment works

Medicaid pays hospice providers a single daily rate that is supposed to cover all services — nursing, aides, social work, chaplaincy, medications, medical equipment, and room and board if applicable. This rate varies by state and changes each year. The hospice provider bills Medicaid directly, and you do not receive a separate bill for these services.

The daily rate is meant to be all-inclusive, which means the hospice organization is responsible for managing all costs within that payment. If you are in a dedicated hospice facility, the room and board is bundled into that daily rate. If you are at home, there is no room and board component because you are not paying for housing through the hospice program.

Hospice in a dedicated facility versus at home

A dedicated hospice facility is a standalone building or wing where people receive end-of-life care. These are less common than home hospice but do exist in some areas. If Medicaid covers your care in one of these facilities, room and board is included in the daily payment rate. You would not receive a separate bill for the bed or meals.

Home hospice is far more common. Medicaid covers the hospice services — the nurse visits, medications, equipment — but you pay for your own housing. If you own your home, you continue paying your mortgage or property taxes. If you rent, you continue paying rent. If you live with family, there is no housing cost. Medicaid does not reimburse these expenses.

Some people move into a nursing home or assisted living facility and then add hospice services. In this situation, Medicaid typically pays the facility for room and board under the nursing home or assisted living benefit, and pays the hospice provider separately for hospice services. You do not get a discount or extra Medicaid payment because you are receiving both services at once.

What happens if you cannot afford room and board at home

If you are receiving home hospice and cannot afford to stay in your current home, you have limited options within Medicaid. Medicaid does not pay for housing as part of hospice. However, some hospice organizations have relationships with nursing homes or assisted living facilities and can help you move if that becomes necessary.

If you move to a facility, you would then be covered under that facility's Medicaid rate for room and board, separate from hospice. Some facilities offer reduced rates for hospice patients or have charitable funds to help cover costs. Ask your hospice social worker whether they know of facilities in your area that work with hospice patients and what options might be available to you.

Your state's Medicaid hospice rules

Each state runs its own Medicaid program and sets its own hospice payment rates and rules. Some states are more generous with coverage; others are more restrictive. Your state Medicaid office or your hospice provider can tell you exactly what is covered under your state's plan.

To find your state Medicaid office, search "[your state] Medicaid" or visit Medicaid.gov and select your state. You can also ask your doctor or a hospice provider — they work with Medicaid regularly and know the local rules. If you are already enrolled in Medicaid, your member handbook or the Medicaid website for your state should list hospice coverage details.

How to verify what Medicaid will pay for your situation

Before you commit to a hospice provider or facility, contact your state Medicaid program or your Medicaid managed care plan (if you are in one) and ask specifically: "Will Medicaid pay for room and board if I receive hospice at [this facility]?" or "Will Medicaid pay for room and board if I receive home hospice?" Be clear about where you plan to receive care.

You can also ask the hospice provider directly. They bill Medicaid every day and know exactly what their state pays for. A reputable hospice organization will tell you upfront what Medicaid covers and what you or your family would be responsible for. If they cannot answer clearly, that is a sign to ask your Medicaid program directly before enrolling.

Frequently Asked Questions

If I am in a nursing home on Medicaid and add hospice, do I pay more?

No. Medicaid continues to pay the nursing home for room and board at the same rate. The hospice provider is paid separately by Medicaid for hospice services. You do not receive an extra bill or pay extra out of pocket because hospice is added.

Does Medicaid pay for a private room in hospice?

Medicaid pays the facility's standard daily rate regardless of room type. If the facility charges extra for a private room, you or your family would pay that difference. Ask the facility upfront what room options are available and whether there is an additional cost.

What if I run out of money while receiving home hospice?

Medicaid covers the hospice services themselves, but not housing costs. If you cannot pay rent or mortgage, talk to your hospice social worker about options in your area — some communities have emergency housing funds or can help you move to a facility covered by Medicaid.

Can I switch from home hospice to a facility if I change my mind?

Yes. You can change your hospice setting at any time. If you move to a facility, Medicaid will cover room and board there under the facility's Medicaid rate. Talk to your hospice provider about the transition — they can help coordinate the move.

Does Medicare cover hospice room and board differently than Medicaid?

Medicare also covers hospice services including room and board in a dedicated hospice facility, but the rules and payment rates are different from Medicaid. If you have both Medicare and Medicaid, Medicare is usually the primary payer. Ask your hospice provider which program will pay for your care.