Hospice Copays and Coinsurance Under Medicare

Under the Medicare Hospice Benefit, almost everything is covered at $0, and only two small charges can ever apply: a copay of up to $5 per prescription for outpatient symptom medications, and coinsurance of 5% of the Medicare-approved amount for a short inpatient respite stay. There is no deductible for the hospice benefit, and routine home visits, equipment, and terminal-illness medications carry no patient charge.

The two charges, in plain terms

Charge	What it is	Amount (June 2026)
Drug copay	For each outpatient prescription that manages pain or symptoms of the terminal illness	Up to $5 per prescription
Respite coinsurance	For a short inpatient respite stay that gives the family caregiver a break	5% of the Medicare-approved amount; respite limited to up to 5 consecutive days per stay

That is the complete list of patient cost-sharing built into the benefit. Medicare sets these amounts and can adjust them over time, so treat any exact figure as a current value rather than a permanent one.

It is worth noting how small these are in context. The drug copay applies per prescription, not per pill or per refill cycle, and it caps at $5 — so even a patient on several comfort medications faces only a few dollars at most, and many hospices waive it entirely. The respite coinsurance is 5% of the Medicare-approved amount for the stay, and respite itself is capped at up to 5 consecutive days per stay, so it cannot accumulate into a large bill. There is no separate charge for the nurse, the aide, the social worker, the chaplain, or the bereavement counselor.

Worked examples

Concrete numbers make the scale clear. Remember these illustrate how the rules apply; they are not a quote for any specific person.

• A patient on five comfort medications. Each prescription carries a copay of up to $5, so the most the family would pay is a few dollars per fill — and many hospices waive the copay so it is $0.
• A one-time respite stay. The family pays 5% of the Medicare-approved amount for that short stay, which is capped at up to 5 consecutive days. Because the stay is short and the percentage is small, the charge stays modest.
• Routine home care with nursing, aide, equipment, and drugs for the terminal illness. The patient charge for the hospice services is $0. There is no deductible and no visit fee.

What is not on any of these examples is a charge for the bed itself when a patient lives in a facility — that is room and board, a separate matter covered below.

What you do NOT pay for

Just as important is what carries no charge. Under hospice, Medicare covers — at $0 to the family — the hospice team's visits (physician oversight, nursing, aide, social worker, chaplain, volunteers, bereavement), durable medical equipment like a hospital bed or oxygen, supplies, and the medications used to treat the terminal illness. There is also no deductible for the hospice benefit itself. For the full picture, see what the Medicare Hospice Benefit covers and does Medicare cover hospice care.

The big exception: room and board

Copays and coinsurance are small, but there is a larger cost the benefit simply does not include: facility room and board under Routine Home Care. If the patient lives in a nursing home or assisted living, the daily room-and-board charge is not paid by Medicare hospice — only General Inpatient Care and inpatient respite cover “the bed,” and those are short-term (see GIP vs. inpatient respite: who pays for the bed). Room-and-board amounts vary by facility and region. Medicaid may cover the nursing-home bed for dual-eligibles in participating states. See hospice room and board: who pays.

The misconception, corrected

Two myths cause confusion. The first is that hospice has a deductible or large copays like a hospital stay — it does not; the only cost-sharing is the up-to-$5 drug copay and the 5% respite coinsurance. The second is the opposite error: that “hospice is 100% free,” which leads families to overlook room and board. The accurate statement is that hospice services are covered at little or no cost, while a facility's room-and-board charge is a separate bill. Many hospices voluntarily absorb the $5 drug copay, so families often pay nothing at all for medications.

Keeping the two ideas straight avoids both kinds of mistake. “Tiny cost-sharing on the care” and “no coverage for the facility bed” are both true at once, and they are not in conflict. The cost-sharing is about the hospice benefit itself; the room-and-board charge is a separate obligation that belongs to the nursing home or assisted-living community. Once you see them as two different bills with two different rules, the numbers stop feeling contradictory.

How hospice cost-sharing compares to other Medicare care

The contrast is what surprises most families. Under regular Medicare Part A, a hospital stay carries a deductible and, for longer stays, daily coinsurance; Part B care typically involves an annual deductible plus 20% coinsurance on many services. The hospice benefit deliberately strips almost all of that away: no deductible, no 20% coinsurance on visits, no per-visit fee for the nurse, aide, social worker, chaplain, or bereavement counselor. The only built-in cost-sharing is the up-to-$5 drug copay and the 5% respite coinsurance described above. This design is intentional — the benefit is meant to remove financial barriers at the end of life so families can focus on comfort rather than bills. The one expense that does not follow this generous pattern is facility room and board, because that is a living cost rather than a medical service, and it sits outside the hospice benefit entirely.

Frequently asked questions

Is there a deductible for hospice?

No. The Medicare Hospice Benefit has no deductible. The only cost-sharing is the up-to-$5 drug copay per prescription and the 5% respite coinsurance.

Does the $5 copay apply to every refill or every pill?

It applies per prescription, capped at $5 — not per pill or per refill cycle. Many hospices waive it entirely, so families often pay $0 for comfort medications.

How is the respite coinsurance calculated?

It is 5% of the Medicare-approved amount for the inpatient respite stay, and respite is limited to up to 5 consecutive days per stay, so the charge stays small. See is there a copay for inpatient respite care.

If hospice is nearly free, why might we still get a big bill?

The likely bill is facility room and board, which is separate from the hospice benefit and not covered under Routine Home Care. Get that charge in writing for your setting, and ask whether Medicaid could cover the bed.

Practical next steps

• Ask the hospice whether it waives the drug copay — many do.
• Ask about respite coinsurance before a respite stay; learn more in is there a copay for inpatient respite care.
• Get room-and-board costs in writing for your specific setting, and ask whether Medicaid could cover the bed.
• Compare your total expected cost across providers — see how much hospice costs out of pocket and compare hospices near you.

Bottom line: Medicare hospice cost-sharing is deliberately tiny — up to $5 per prescription and 5% for respite, with no deductible. The expense to actually plan for is facility room and board, which sits outside the benefit.