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Hospice Care FAQs: Honest Answers to Your Most Important Questions
If you’re researching hospice care for a loved one, you probably have questions nobody seems to give you a straight answer on. What does hospice actually cover? Will Medicare pay for it? Does choosing hospice mean giving up? We’ve heard every one of these — and we’ll give you clear, honest answers here.
St. Marie’s Hospice has been serving families across Wayne, Oakland, and Macomb counties since 2012. These FAQs reflect the real questions our care team hears from families at the bedside, in the hospital, and over the phone.
01
When and How Hospice Begins
When is the right time to ask about hospice?
Earlier than most families expect. A common misconception is that hospice is only for the final days of life. In reality, Medicare certifies patients for hospice when a physician estimates a life expectancy of six months or less if the illness follows its expected course — and most patients who start sooner benefit more.
If your loved one has had repeated hospitalizations, is losing weight, requires more help with basic tasks, or their treatments are no longer working, it's worth asking the physician whether hospice eligibility has been considered. You don't need to wait for a crisis.
The harder truth: many families tell us they wish they had called sooner. Hospice isn't about giving up hope. It's about redirecting focus to comfort, quality of life, and time with family — while a full interdisciplinary team manages pain and symptoms.
How does hospice care begin?
Hospice begins with a referral, which can come from a physician, a hospital, a care facility or a family member. A hospice nurse evaluates the patient, and the hospice physician, together with the patient's own doctor where applicable, certifies that the patient meets the eligibility criteria. The patient or their decision-maker then chooses hospice and signs the election. The care team meets with the family to build a plan of care, and nursing visits, medications and equipment related to the illness are arranged.
Can hospice care be provided at home?
Yes — and for most of our patients, it is. Hospice care is designed to meet people where they are: at home, in a family member's home, in a nursing facility, or in an assisted living community. The goal is to avoid unnecessary hospital stays and allow patients to remain in familiar surroundings.
Our in-home hospice care includes regular nursing visits, pain management, medication delivery, aide services, and 24/7 on-call nursing support — so families are never left alone to manage a medical crisis at 2 a.m.
02
What Hospice Covers — and What It Doesn't
Will Medicare pay for hospice care?
In most cases, yes. The Medicare Hospice Benefit covers virtually all hospice-related care at no cost to the patient or family — including physician services, nursing visits, medications related to the terminal diagnosis, medical equipment, aide services, social work, spiritual care, bereavement support, and therapies like music and massage.
Medicare pays hospices a daily rate to cover all of this. For most patients, out-of-pocket costs are minimal: a drug copay of up to $5 per prescription for symptom-related medications, and a small coinsurance for respite care (roughly $24/day for up to 5 days). Beyond that, standard hospice care costs families nothing under Medicare.
Benefit periods begin with two 90-day periods, then continue in unlimited 60-day periods as long as a physician recertifies eligibility. Hospice doesn't have a fixed end date.
What does hospice NOT cover?
Hospice does not cover treatment meant to cure the terminal illness, because the focus is comfort. If someone wants curative treatment, they can stop hospice at any time and return to their regular coverage. Medicare also does not pay for room and board in a nursing home or assisted living community, even when hospice is in place. Care unrelated to the terminal illness, including emergency care the hospice did not arrange, is generally billed to regular coverage. Families can ask the hospice for a written explanation of what is and isn't covered.
03
Care, Comfort, and the Care Team
Will my loved one still see their own physician?
Yes. Your loved one's attending physician remains involved in their care and can continue to direct the medical plan alongside the hospice team. What changes is the goal of care — from curative to comfort-focused — not the relationship with the doctor. St. Marie's also provides hospice physician services as part of the interdisciplinary team. Our medical director works with the attending physician to manage symptoms, review the care plan, and make adjustments as the patient's condition changes.
How does the team manage pain and symptoms at home?
A hospice nurse case manager visits regularly to check pain, breathing, appetite, sleep and anxiety, and adjusts the plan as things change. The hospice medical director works with the patient's own doctor to choose treatments aimed at comfort. Medications and equipment related to the terminal illness are arranged through the hospice, and nurses teach the family how to give medications safely. Hospices must also give families a written policy on handling controlled drugs at home. Alongside medication, the team uses comfort measures such as positioning, music and massage therapy, and emotional and spiritual support. If symptoms change at night or on a weekend, the 24/7 on-call nurse can adjust the plan or send someone to the home.
Is someone available after hours if we need help?
Yes — 24 hours a day, 7 days a week. Our 24/7 on-call nursing line connects you directly with a registered nurse who can triage a situation, adjust orders remotely, or dispatch a nurse to the home when needed. You will never be told to call 911 as a first response.
Will my loved one be the only patient the nurse is responsible for?
No — hospice nurses typically carry a caseload of around 10 to 12 patients, which allows for meaningful, frequent visits. Aides who provide hands-on personal care often visit more frequently based on the care plan. The full interdisciplinary team — nurse, social worker, chaplain, aide, and volunteer — each plays a distinct role, with visit frequency adjusted to the patient's condition and family needs.
04
Common Concerns Families Have
Does choosing hospice mean we're giving up?
This is the question that stops more families from calling than any other — and it's worth addressing directly. Hospice does not mean giving up. It means choosing a different kind of fight: against pain, against isolation, against dying in a hospital without your family around you.
Research consistently shows that patients on hospice often live longer than comparable patients who pursue aggressive treatment, while also reporting better quality of life. Hospice is active care. The team works hard every day to keep your loved one comfortable and to support the whole family through one of the hardest experiences there is.
Can hospice help patients with dementia or Alzheimer's disease?
Yes. Advanced dementia can qualify for hospice when the overall picture shows late-stage decline, such as needing help with most daily care, very limited speech, and problems with eating or swallowing or repeated infections. The hospice physician looks at the whole picture, not a single test. Some people with dementia also qualify through another serious illness, such as heart failure or COPD. Hospice care for dementia focuses on comfort, on recognizing pain and distress in someone who can't describe it, and on supporting the family who are caring for them.
Is hospice only for the last few days of life?
No. Hospice is for people with a physician-certified prognosis of six months or less if the illness runs its usual course, and care continues in 60-day periods for as long as the person remains eligible. Some people are on hospice for months, and others for much shorter periods. Many families say they wish they had started sooner, because earlier hospice means more time with the full care team.
What if our family doesn't agree on whether hospice is right?
This is very common. If the patient can make decisions, the choice is theirs, so start by asking what they want. If they can't, it falls to their legally authorized decision-maker. Family members often disagree because each person is afraid of something different, so it helps to ask each person what worries them most. A hospice nurse can evaluate your loved one so you have facts to discuss, and a family meeting with the hospice social worker and physician often brings clarity. Asking for an evaluation doesn't commit your family to anything.
05
Choosing the Right Hospice Provider
How do we choose the right hospice in Michigan?
Not all hospices are the same. Key things to ask about: nurse caseload size, response time for after-hours calls, which services are actually provided (not just listed), whether the team has experience with your loved one's specific diagnosis, and whether the hospice is nonprofit or for-profit (research suggests nonprofits score higher on family experience metrics on average).
St. Marie's Hospice is CHAP-accredited and Medicare-certified since 2015, with a 4.9/5 rating across 123 Google reviews. We serve Wayne, Oakland, and Macomb counties.
Read our guide: How to Compare Hospice Providers in Detroit.
How quickly can services begin?
After you call, a nurse arranges an evaluation, and the care team begins once the patient or their decision-maker chooses hospice. Urgent situations, such as a hospital discharge, are often evaluated faster. Timing depends on the referral, the paperwork and the patient's situation, so call us and we will tell you what to expect for your family.
When is the right time to ask about hospice?
Earlier than most families expect. A common misconception is that hospice is only for the final days of life. In reality, Medicare certifies patients for hospice when a physician estimates a life expectancy of six months or less if the illness follows its expected course — and most patients who start sooner benefit more.
If your loved one has had repeated hospitalizations, is losing weight, requires more help with basic tasks, or their treatments are no longer working, it's worth asking the physician whether hospice eligibility has been considered. You don't need to wait for a crisis.
The harder truth: many families tell us they wish they had called sooner. Hospice isn't about giving up hope. It's about redirecting focus to comfort, quality of life, and time with family — while a full interdisciplinary team manages pain and symptoms.
How does hospice care begin?
The process starts with a physician certifying that a patient meets eligibility criteria — typically a terminal prognosis of six months or less. Once that certification is in place, our team contacts the patient and family, conducts an initial assessment, and works with you to build a personalized care plan.
At St. Marie's, we aim to have services up and running quickly — often within 24 to 48 hours of a referral. If you're coming from a hospital, we coordinate directly with discharge planners so the transition is as smooth as possible. You can also call us directly to ask questions before making any decision: (800) 489-7977.
Can hospice care be provided at home?
Yes — and for most of our patients, it is. Hospice care is designed to meet people where they are: at home, in a family member's home, in a nursing facility, or in an assisted living community. The goal is to avoid unnecessary hospital stays and allow patients to remain in familiar surroundings.
Our in-home hospice care includes regular nursing visits, pain management, medication delivery, aide services, and 24/7 on-call nursing support — so families are never left alone to manage a medical crisis at 2 a.m.
Will Medicare pay for hospice care?
In most cases, yes. The Medicare Hospice Benefit covers virtually all hospice-related care at no cost to the patient or family — including physician services, nursing visits, medications related to the terminal diagnosis, medical equipment, aide services, social work, spiritual care, bereavement support, and therapies like music and massage.
Medicare pays hospices a daily rate to cover all of this. For most patients, out-of-pocket costs are minimal: a drug copay of up to $5 per prescription for symptom-related medications, and a small coinsurance for respite care (roughly $24/day for up to 5 days). Beyond that, standard hospice care costs families nothing under Medicare.
Benefit periods begin with two 90-day periods, then continue in unlimited 60-day periods as long as a physician recertifies eligibility. Hospice doesn't have a fixed end date.
What does hospice NOT cover?
This is one of the most important things families need to understand upfront. Hospice covers care related to the terminal diagnosis. It does not cover treatments aimed at curing the underlying illness — if a patient chooses to continue chemotherapy, radiation, or other curative treatments for the same condition, they must revoke the hospice benefit to do so.
It also doesn't cover room and board at a nursing facility (the hospice benefit covers the clinical services there, but not the residential cost), or emergency care unrelated to the terminal condition.
If you're unsure whether a specific medication or treatment is covered, you have the right to request a written explanation from the hospice. See our full guide: What Does Hospice Not Cover.
Will my loved one still see their own physician?
Yes. Your loved one's attending physician remains involved in their care and can
continue to direct the medical plan alongside the hospice team. What changes is the
goal of care — from curative to comfort-focused — not the relationship with the doctor.
St. Marie's also provides hospice physician services as part of the interdisciplinary team.
Our medical director works with the attending physician to manage symptoms, review
the care plan, and make adjustments as the patient's condition changes.
How does the team manage pain and symptoms at home?
This is where a good hospice team makes a real difference. Pain and symptom management in hospice is active, not passive. Our nurses assess patients regularly, adjust medications proactively, and respond to changes in condition — including after hours.
Medications related to the terminal diagnosis are covered by Medicare and delivered to the home. For families worried about managing medications safely, our nurses provide guidance and can coordinate with pharmacies to simplify the process. Learn more about our pain & symptom management approach.
Is someone available after hours if we need help?
Yes — 24 hours a day, 7 days a week. Our 24/7 on-call nursing line connects you directly with a registered nurse who can triage a situation, adjust orders remotely, or dispatch a nurse to the home when needed. You will never be told to call 911 as a first response.
Will my loved one be the only patient the nurse is responsible for?
No — hospice nurses typically carry a caseload of around 10 to 12 patients, which allows for meaningful, frequent visits. Aides who provide hands-on personal care often visit more frequently based on the care plan. The full interdisciplinary team — nurse, social worker, chaplain, aide, and volunteer — each plays a distinct role, with visit frequency adjusted to the patient's condition and family needs.
Does choosing hospice mean we're giving up?
This is the question that stops more families from calling than any other — and it's worth addressing directly. Hospice does not mean giving up. It means choosing a different kind of fight: against pain, against isolation, against dying in a hospital without your family around you.
Research consistently shows that patients on hospice often live longer than comparable patients who pursue aggressive treatment, while also reporting better quality of life. Hospice is active care. The team works hard every day to keep your loved one comfortable and to support the whole family through one of the hardest experiences there is.
Can hospice help patients with dementia or Alzheimer's disease?
Yes. Dementia is a terminal illness, and patients with advanced dementia absolutely qualify for hospice. Eligibility is assessed using a functional scale (called the FAST scale) — typically Stage 7a or beyond — along with the presence of a related complication such as recurrent infections, difficulty swallowing, or significant unintentional weight loss.
Many families are surprised to learn that a dementia patient can also qualify through a secondary condition like heart failure or COPD, independent of where they are on the FAST scale. See our detailed guide: What Dementia Symptoms Qualify for Hospice.
Is hospice only for the last few days of life?
No — though this misconception delays care for many families. The median hospice stay in the US is around 18 days, but that number is skewed by very late referrals. Patients who enroll earlier receive more benefit from the full range of hospice services: pain management, therapy, family counseling, and caregiver support.
Medicare allows unlimited recertification periods as long as the patient continues to meet eligibility criteria. Some patients stabilize and remain on hospice for months. See: How Long Can Someone Be on Hospice?.
What if our family doesn't agree on whether hospice is right?
This is more common than people realize, and our social work team has experience helping families navigate it. Disagreements about hospice often come down to different understandings of the prognosis, different emotional processes, or different values around treatment. A family meeting with the physician and a hospice social worker can often bring clarity.
We've written about this specifically: When the Family Disagrees About Hospice.
How do we choose the right hospice in Michigan?
Not all hospices are the same. Key things to ask about: nurse caseload size, response time for after-hours calls, which services are actually provided (not just listed), whether the team has experience with your loved one's specific diagnosis, and whether the hospice is nonprofit or for-profit (research suggests nonprofits score higher on family experience metrics on average).
St. Marie's Hospice is CHAP-accredited and Medicare-certified since 2015, with a 4.9/5 rating across 123 Google reviews. We serve Wayne, Oakland, and Macomb counties.
Read our guide: How to Compare Hospice Providers in Detroit.
How quickly can services begin?
We typically initiate care within 24 to 48 hours of a referral, depending on timing and care plan complexity. If you're in an urgent situation — a patient being discharged from the hospital today, for example — call us directly and we will prioritize your case: (800) 489-7977.
Still Have Questions? We're Here.
You don’t need to have everything figured out before you call. Our team’s job is to help you understand your options — with no pressure and no obligation. If you’re trying to decide whether hospice is the right step for your loved one, we’ll walk you through it honestly.