Do You Pay Anything to Keep Your Own Doctor While on Hospice?

Usually, yes — if your own doctor is not employed or paid by the hospice, their visits are billed to Medicare Part B, so the normal Part B deductible ($283 in 2026) and coinsurance (generally 20% of the Medicare-approved amount) apply. The hospice care itself has no deductible. Keeping your doctor is your right; it simply runs through a different part of Medicare than the rest of your hospice care.

This surprises many families, because Medicare describes hospice as care you pay almost nothing for. Both things are true. The hospice's own services are covered under Part A with only small copays. Your chosen outside doctor is treated as a separate Part B service, and Part B has its own cost sharing.

Why your doctor's bill is separate from the hospice

When you elect hospice, you name an attending physician — the doctor (or nurse practitioner or physician assistant) you identify as having the most significant role in your medical care. You can choose your long-time doctor; see can you keep your own doctor on hospice.

By electing hospice, you give up Medicare Part B payment for professional services related to your terminal illness — with one exception. CMS's Medicare Claims Processing Manual (chapter 11, section 40.1.3) carves out an independent attending physician: one who is not a hospice employee and is not paid by the hospice for those services. That doctor's professional services for your terminal illness are not Part A hospice services. They are billed to Medicare Part B, and Medicare pays them "based on the payment and deductible rules applicable to each covered service." In plain terms, the usual Part B cost sharing applies.

What you may owe, depending on who the doctor is

Who provides the care	How it is billed	What you may owe
Hospice team (nurse, aide, social worker, hospice physician)	Part A, through the hospice	Nothing for hospice care; up to $5 per prescription for symptom drugs; 5% of the Medicare-approved amount for inpatient respite care
Attending physician who is a hospice employee or paid under arrangement with the hospice	The hospice bills Part A	No Part B deductible or 20% coinsurance; the hospice may charge coinsurance only for drugs and respite care
Your own independent attending physician, for the terminal illness	The doctor bills Part B	Part B deductible and coinsurance
Any covered doctor visit for a problem unrelated to the terminal illness	Original Medicare, as usual	The normal deductible and coinsurance
A different doctor, for the terminal illness, not your attending and not arranged by the hospice	Must look to the hospice for payment	You could owe the full cost if the hospice did not arrange it

The hospice-employed row is supported by the claims manual's rule that, during a hospice election, hospices may charge coinsurance only for drugs and biologicals and inpatient respite care, and no other coinsurance or deductibles may be imposed. For the full hospice cost picture, see hospice copays and coinsurance under Medicare.

How much is the Part B share in 2026?

Medicare.gov lists the 2026 Part B deductible as $283. After you meet it, you usually pay 20% of the Medicare-approved amount for each covered Part B service. Medicare.gov notes that the 20% figure usually applies only when the provider accepts assignment, meaning they take the Medicare-approved amount as full payment. If your doctor does not accept assignment, ask the office what you will owe before the next visit.

If you have already paid the Part B deductible this year — for example, from appointments before hospice — you will not pay it again for the rest of that year. You also keep paying your monthly Part A (if you have one) and Part B premiums while on hospice; Medicare's hospice booklet lists the premiums among what you still pay.

Nurse practitioners and physician assistants as attending

Since 2019 for physician assistants (and since 2003 for nurse practitioners), Medicare lets you choose an NP or PA as your attending. The same split applies: if the NP or PA is employed by the hospice, the hospice bills Part A; if not, they bill Part B. Medicare pays NP and PA attending services at 85% of the physician fee schedule amount. Note that an NP or PA cannot certify that you are terminally ill; the hospice physician does that.

If you have Medicare Advantage or a Medigap policy

If you are in a Medicare Advantage plan and elect hospice, Original Medicare pays the hospice and your attending physician's services (CMS Medicare Benefit Policy Manual, chapter 9, section 20.4). If you stay in your plan and keep paying its premium, Medicare's hospice booklet says the plan still covers extra benefits such as dental and vision, and you can get care unrelated to your terminal illness from either Original Medicare or your plan. If you use your plan, you pay only the plan's copayment. If you paid a copayment under Original Medicare instead, keep your receipts: the plan must reimburse you for the extra amount you paid.

A Medigap (Medicare Supplement) policy is designed to fill gaps in Original Medicare, so it may pick up some or all of the Part B deductible and coinsurance depending on your plan. Check your policy or call the insurer to confirm.

How to avoid a surprise bill

• Ask your doctor's office directly: "Will you bill Medicare Part B for my visits while I'm on hospice, and do you accept assignment?"
• Ask the hospice: "Is my attending physician a hospice employee or paid by you, or independent?" The answer tells you which row of the table applies.
• Call the hospice before seeing any other doctor about the terminal illness. Medicare's hospice booklet warns that if you get care the hospice did not arrange, you might have to pay the full cost.
• Keep the election statement addendum. For hospice elections starting on or after October 1, 2026, the hospice must give you this written notice, titled "Patient Notification of Hospice Non-Covered Items, Services, and Drugs," within the first 5 days of your election, and must give you an updated copy within 3 days if changes to your plan of care affect it. It lists the conditions, items, services and drugs the hospice has decided are unrelated to your terminal illness, which go through regular Medicare with normal cost sharing. If you have not received it within 5 days, ask the hospice for it.
• Read each statement carefully. A Part B charge from your own doctor is not a hospice billing error. See hospice billing: what the bills actually mean.

Frequently asked questions

Do I pay anything if the hospice doctor is my attending physician?

Not a Part B deductible or 20% coinsurance. When the attending physician is a hospice employee or works under arrangement with the hospice, the hospice bills Medicare Part A, and during the election the hospice may charge coinsurance only for drugs and inpatient respite care.

Is my own doctor's bill a sign hospice isn't covering me properly?

No. Medicare's rules treat an independent attending physician's services as Part B services rather than hospice services, so a separate bill with Part B cost sharing is expected. If a charge looks wrong, call the doctor's office or 1-800-MEDICARE.

Do I owe coinsurance for care unrelated to my terminal illness?

Yes. Medicare.gov says Original Medicare still covers health problems that aren't part of your terminal illness, and you pay the deductible and coinsurance for those services.

Can I switch to the hospice doctor to avoid the coinsurance?

Yes. You can change your designated attending physician by signing a statement with the hospice that names the new attending and the effective date, which cannot be earlier than the date you sign. Weigh the cost against the value of keeping a doctor who knows you well.

What to do next

Before enrolling, have one short call with your doctor's billing office and one with the hospice, using the questions above. If you are still comparing providers, review how much hospice care costs out of pocket and compare hospices near you, asking each how they coordinate with outside attending physicians.