Can You Switch or Fire Your Hospice Provider?

Yes — you can switch hospices, and it doesn't cost you your benefit. Medicare lets you change your designated hospice provider once per benefit period with no penalty and no gap in coverage. Choosing hospice care is not the same as marrying one agency. If the team isn't responsive, the on-call line doesn't answer, or symptoms aren't being managed, you have the right to move to a different Medicare-certified hospice.

Switching is not the same as quitting hospice

This is the key distinction. Revoking the hospice benefit means leaving hospice entirely and returning to standard curative care. Transferring means staying on hospice but changing which agency provides it. A transfer keeps your benefit intact — you don't start over, you don't lose coverage, and the change of provider does not count as revoking. You can do this once in each benefit period (the 90- or 60-day windows that structure the hospice benefit) without it being treated as a penalty.

How a transfer actually works

• Pick the new hospice first. Identify a Medicare-certified agency that serves your area and is ready to admit before you leave the current one, so there's no gap.
• Sign the transfer paperwork. You file a statement naming the date the change takes effect and the new provider. The new hospice typically helps coordinate this.
• Care continues. Medications, equipment, and visits carry over to the new team. You should not experience a break in covered care during a proper transfer.
• You don't need the old agency's permission. It's your choice as the patient (or your representative's).

If your loved one lives in a nursing home or assisted-living facility, confirm the new hospice serves that facility before transferring.

When switching is the right call — and when to fix it first

Good reasons to switch include an after-hours line that doesn't get a nurse to you, repeated missed visits, poorly controlled pain or breathlessness, or a hospice that can't provide a level of care you need (such as inpatient crisis care). But sometimes the faster fix is to escalate within the current agency — ask for the clinical manager or medical director and state the problem plainly. Our guide on what to do if you're unhappy with your hospice walks through raising concerns before, or instead of, leaving.

What to confirm about the new agency before you move

A transfer only helps if the replacement is genuinely better, so vet it the way you would a first choice:

• After-hours responsiveness — ask specifically how fast a nurse can reach the bedside at night and on weekends.
• Access to higher levels of care — confirm they can provide General Inpatient and continuous home care during a crisis.
• Service to your location — if your loved one is in a nursing home or assisted-living facility, verify the new hospice serves that building.
• Quality signals — review CMS Care Compare and family-survey (CAHPS) scores.
• Continuity — ask whether you'll have a consistent assigned nurse rather than a rotating cast.

Transfer vs. revoke: two very different actions

	Transfer (switch agency)	Revoke (leave hospice)
What changes	Which agency provides hospice	You stop hospice entirely
Benefit status	Stays intact, same benefit period	You return to curative/standard care
Coverage gap	None with a proper transfer	You forfeit unused days in the current period
How often allowed	Once per benefit period	Anytime, no limit on returning

If your problem is the company, transfer. If your goal is to pursue curative treatment, that is a revocation — a different decision entirely.

The misconception, corrected

Many families believe: “Once you sign with a hospice, you're locked in” or “changing hospices means losing Medicare coverage or starting the clock over.” Not true. You are not locked in, you don't lose the benefit, and a transfer doesn't reset your eligibility — it continues in the same benefit period. The only limit is one transfer per benefit period, which is generous given how rarely a well-run agency needs to be replaced. Fear of being “stuck” should never keep a family with a hospice that isn't delivering.

Frequently asked questions

Will I lose coverage during a transfer?

No. With a proper transfer — lining up the new hospice before signing the change — medications, equipment, and visits carry over and there is no break in covered care. The benefit continues in the same period.

How many times can I switch?

Once per benefit period. Given the 90- and 60-day structure of hospice periods, that allows a change whenever a well-run agency genuinely needs replacing, without it counting as revoking the benefit.

Do I need my current hospice's permission to leave?

No. Switching is the patient's (or representative's) choice. The new hospice typically helps coordinate the paperwork and timing.

Should I try to fix the problem before switching?

Often yes. Many issues — missed visits, slow callbacks, uncontrolled symptoms — can be resolved by escalating to the agency's clinical manager or medical director. See what to do if you're unhappy with your hospice. If the agency still cannot deliver, transfer.

Practical next steps

• Compare alternatives objectively. Compare hospices near you and review each agency's CMS Care Compare and family-survey (CAHPS) scores before you move — see how to read a Care Compare star rating.
• Browse by state — for example, Texas hospices — to see who serves your area.
• Use a clear checklist when vetting the replacement: our 10-step guide to choosing a hospice covers after-hours coverage, GIP access, and responsiveness.
• Document your concerns with the current agency in case you decide to escalate first.
• Line up the new admission before signing the transfer so care never lapses.

Bottom line: you can fire and replace a hospice once per benefit period with no penalty and no loss of coverage. The choice is yours, it's reversible, and you should use it if the care isn't meeting the moment.