How to Switch Hospice Providers

You can change your designated hospice once during each benefit period, with no penalty and no break in coverage. Switching is your right under the Medicare Hospice Benefit — you are not locked in, and the process is straightforward when you know the steps.

When and how often you can switch

Medicare structures hospice into benefit periods — two 90-day periods followed by an unlimited number of 60-day periods. You may change to a different hospice once per benefit period. Importantly, switching is not the same as revoking the benefit: you stay enrolled in hospice the whole time, your benefit periods continue, and your eligibility clock is unaffected. You are simply moving your care from one Medicare-certified agency to another.

The steps to switch

• Choose the new hospice first. Don't drop your current one until the next agency is ready to admit. Use how to compare hospices in your area to vet options, focusing on after-hours coverage and crisis access.
• Tell the new hospice you want to transfer. They handle most of the paperwork, including a change-of-designation statement that names the date the switch takes effect.
• Sign the change-of-designation form. This document records that you are moving care; it lists the effective date so there is no gap.
• Coordinate timing. The new agency typically admits the same day the old one discharges, so medications, equipment, and visits continue seamlessly.
• Confirm equipment and prescriptions transfer. Ask both agencies how the comfort kit, oxygen, hospital bed, and medications will hand over.

What the change-of-designation form actually does

Families sometimes worry the paperwork is complicated or that they might accidentally drop out of hospice. In reality, the form is short and does one specific thing: it changes which Medicare-certified hospice is named as your provider, effective on a date you choose. Medicare's rules deliberately separate this from "revoking" the benefit. Revoking means leaving hospice altogether and returning to standard Medicare; switching means staying in hospice and just changing the agency. The change-of-designation statement names the date you stop with the old hospice and start with the new one — the same date — which is what keeps coverage seamless. You do not re-elect hospice from scratch and you do not file anything with Medicare yourself; the new hospice handles it.

Good reasons to switch — and when to talk first

Switching makes sense when there's a genuine mismatch: slow or non-clinical after-hours response, poorly controlled symptoms, repeatedly missed visits, no clear plan for a crisis, or a team that doesn't communicate. These are exactly the problems that erode trust when a family needs it most. That said, some frustrations — a single bad shift, a scheduling mix-up, a personality clash with one staff member — can often be fixed by asking the agency to assign a different nurse or escalate to a supervisor. It's worth one direct conversation before transferring; see what to do if you're unhappy with your hospice. If the core problem is responsiveness or safety, don't wait — switch.

Problem	Try fixing first	Switch if…
Clash with one nurse	Request a different nurse	The agency won't reassign or it keeps happening
A single missed or late visit	Raise it with the team lead	Missed visits become a pattern
Slow after-hours response	Ask how the on-call line is staffed	Nights and weekends are unreliable or non-clinical
Symptoms not controlled	Ask for a plan review and physician input	Symptoms stay poorly managed after escalation
No crisis plan	Request a written plan and GIP access	The agency can't provide higher levels of care

What does not change when you switch

Reassuring families is easier when they know what stays put. Your Medicare Hospice Benefit continues uninterrupted. Your benefit-period clock is unaffected — you don't restart the two 90-day, then 60-day periods. Your prognosis certification carries over; the new hospice's physician re-establishes the plan of care but you don't have to "re-qualify" from scratch. And the four levels of care, including access to general inpatient care for crises, remain available through the new agency. The only thing changing is which Medicare-certified team shows up at your door.

How to make the transfer smooth

Most transfers go without a hitch, but a little coordination prevents the small gaps that cause stress at an already hard time. Ask the new hospice to confirm, in advance, the exact date and time it will admit, and have the old agency discharge on that same date so there is no day without coverage. Make a short list of everything currently in the home that the old hospice owns or supplies — oxygen concentrator, hospital bed, wheelchair, the comfort kit of medications — and ask both agencies who will pick up, deliver, or refill each item, and when. Confirm that the new hospice has your loved one's current medication list and prognosis documentation before the first visit so nothing has to be reconstructed from scratch. Finally, ask the new agency the after-hours question directly: when you call at night or on a weekend, who answers, and is it a nurse who can come out? Responsiveness is the most common reason families switch, so it's worth verifying up front that you're moving to something better, not just different.

The misconception, corrected

Many families believe that choosing a hospice is permanent, or that switching means losing coverage, restarting eligibility, or facing a penalty. None of that is true. The change-of-designation process is built into the benefit precisely so families aren't trapped with a poor fit. There is no penalty, no coverage gap when timed correctly, and your prognosis certification carries forward. The only limit is the once-per-benefit-period rule — which is rarely a problem in practice. If your issue is dissatisfaction rather than a fundamental mismatch, it can be worth first reading what to do if you're unhappy with your hospice, since some problems are fixable with a direct conversation.

Frequently asked questions

Will there be a gap in care while we switch?

Not if it's timed correctly. The new agency typically admits on the same day the old one discharges, so visits, medications, and equipment continue without interruption. Line up the new hospice before discharging the current one.

Does switching restart my benefit-period clock or eligibility?

No. Your benefit periods continue uninterrupted and your prognosis certification carries over. You do not re-qualify from scratch; the new hospice's physician simply re-establishes your plan of care.

How many times can I switch?

Once per benefit period. In practice that is rarely a constraint, since benefit periods run 90 days (twice) and then 60 days, unlimited. If a serious safety problem arises, talk to the agency and, if needed, the new hospice about timing.

Who pays for the transfer?

There is no penalty or transfer fee. Your Medicare Hospice Benefit continues to cover care under the new agency exactly as it did under the old one.

Practical next steps

• Line up the replacement before discharging the current agency — compare hospices near you.
• Call the new hospice and say you want to transfer; let them drive the paperwork.
• Sign the change-of-designation form with a clear effective date.
• Verify continuity of medications and equipment, and read can you switch or fire your hospice provider for your rights.

Bottom line: switching hospices is a right, not a hardship. Pick the new agency first, sign the change-of-designation form, and your care continues without a gap or a penalty.