Short answer: Yes. Medicaid covers hospice care in all 50 states, though the federal hospice benefit is technically classified as optional, not mandatory. Every state has chosen to offer it. Coverage usually includes nursing visits, pain and symptom medication, equipment, and support for the family, most often at no out-of-pocket cost. Exact rules on room and board and provider details vary by state.
- Medicaid covers hospice care in every U.S. state, even though the federal rule technically calls it an “optional” benefit.
- Coverage typically includes nursing, pain and symptom medication, medical equipment, and grief support for the family.
- If your loved one has both Medicare and Medicaid, Medicare usually pays for hospice first.
- Medicaid can also cover room and board in a nursing facility, something Medicare hospice does not pay for.
- Eligibility rules, election paperwork, and covered services vary slightly state to state.
- Suncrest accepts Medicaid across its service areas, including California, Illinois, New Jersey, Iowa, Oklahoma, Virginia, Ohio, and Texas.
Is Medicaid Hospice Coverage Required, or Just Optional?
The federal government lists hospice as an “optional state plan service” under Medicaid, according to Medicaid.gov. That surprises a lot of families. It sounds like coverage could vary by whether a state feels like offering it.
In practice, every state does offer it. All 50 states and Washington, D.C. provide Medicaid coverage for hospice care. So while the legal label is “optional,” the real-world answer for your family is simple: your state almost certainly covers hospice through Medicaid.
What Does the Medicaid Hospice Benefit Cover?
Medicaid hospice covers the full team and services your loved one needs for comfort care, not a cure. That includes:
- Nursing and medical social services
- Physician services related to the terminal illness
- Counseling for the patient and family
- Medical equipment and supplies
- Home health aide and homemaker help
- Physical, occupational, and speech therapy
- Short-term inpatient care when symptoms need closer management
Care falls into four levels: routine home care, continuous home care during a crisis, inpatient respite care to give family caregivers a break, and general inpatient care for pain or symptom control that can’t happen at home. Rates for all four are updated every year, based on Medicare’s hospice rate update.
How Is Medicaid Hospice Different from Medicare Hospice?
Medicaid’s hospice benefit was built to match Medicare’s. The biggest real-world difference is room and board.
| What | Medicare Hospice | Medicaid Hospice |
|---|---|---|
| Benefit periods | Two 90-day periods, then unlimited 60-day periods | Same structure, modeled on Medicare |
| Room and board in a facility | Not covered | Can be covered, depends on the state and setting |
| Who’s eligible | Age 65+ or disability-qualified | Income and asset-qualified, any age |
| Care for unrelated conditions | Still covered under regular Medicare | Still covered under regular Medicaid |
What Happens If Your Loved One Has Both Medicare and Medicaid?
This is called being “dual eligible,” and it’s common among hospice patients. Here’s how it works: Medicare pays for the hospice benefit itself first. Medicaid then picks up costs Medicare hospice doesn’t cover, most often room and board if your loved one lives in a nursing facility.
One more thing worth knowing: if your loved one’s Medicare hospice benefit ever runs out, Medicaid hospice coverage does not expire the same way. The hospice must keep providing care until your loved one passes or chooses to stop hospice care.
Medicaid Hospice Coverage in Suncrest’s Service States
Medicaid hospice works a little differently depending on where you live. Here’s what families in Suncrest’s service areas should know.
| State | Program | Good to know |
|---|---|---|
| California | Medi-Cal | Covers pain management, nursing, medication, equipment, and bereavement support. Starting March 2026, hospice providers must complete an online attestation within 5 days of election. |
| Illinois | Illinois Medicaid (HFS) | Standard 90/90/60-day benefit periods. Children through age 20 can keep getting curative treatment alongside hospice care. |
| New Jersey | NJ FamilyCare | For dual-eligible patients, Medicare pays first and Medicaid covers costs Medicare doesn’t, including room and board in a nursing facility. |
| Iowa | Iowa Health Link | Most members get hospice through a managed care organization (MCO). Care can happen at home or in a Medicaid-certified facility. |
| Oklahoma | SoonerCare | Adults waive curative treatment for the terminal illness when they elect hospice. Children keep full SoonerCare benefits alongside hospice. |
| Virginia | Cardinal Care | Members stay enrolled in their managed care plan when they elect hospice. No need to switch out of managed care to access it. |
| Ohio | Ohio Medicaid | Standard 90/90/60-day structure. Ohio Medicaid pays the hospice directly for the full array of services related to the terminal illness. |
| Texas | STAR / STAR+PLUS | Delivered through managed care. Members can’t be denied services or disenrolled from their plan for choosing hospice. |
What Doesn’t Medicaid Hospice Cover?
Once your loved one elects hospice, Medicaid generally stops paying separately for services meant to cure or treat the terminal illness, since the hospice team takes over that care. That can include hospital stays, nursing facility care, home health visits, medications, and equipment, when they’re tied directly to the terminal diagnosis.
Two exceptions matter here. First, care for conditions unrelated to the terminal illness is still covered the normal way. Second, since 2010, Medicaid and CHIP-eligible children under 21 no longer have to give up curative treatment to receive hospice, they can get both at the same time.
How Do You Apply for Medicaid Hospice Benefits?
The process is similar in every state:
- A physician certifies your loved one is terminally ill, typically with a prognosis of six months or less if the illness runs its usual course
- Your family signs an election statement choosing hospice care
- The hospice team builds a plan of care before services start
- You can revoke the election at any time and go back to regular Medicaid coverage
If you’re not sure where to start, Suncrest’s hospice team can walk you through your state’s specific paperwork and timeline. You can also read our guide to Medicare hospice coverage if your loved one qualifies for both programs.
Not sure what Medicaid covers for your family?
Suncrest teams accept Medicaid across our service areas. Find your local office and talk to someone today.
Frequently Asked Questions
Does Medicaid pay for hospice care at home?
Yes. Home is the most common setting for Medicaid hospice care, as long as your loved one has full Medicaid eligibility.
Is hospice care through Medicaid free?
In most cases, families pay little to nothing out of pocket for services related to the hospice diagnosis once the benefit is elected. Costs for unrelated conditions are billed under your regular Medicaid coverage.
Can my loved one still see their regular doctor while on Medicaid hospice?
For anything unrelated to the terminal illness, yes. For treatment of the terminal illness itself, Medicaid generally expects the hospice team to take over, except for children under 21, who can keep both.
Does Medicaid cover hospice room and board in a nursing home?
Often yes, especially for patients who qualify for both Medicare and Medicaid. Room and board rules vary by state, so it’s worth confirming with your local Medicaid office or hospice team.
What if my loved one has Medicare and Medicaid both cover part of hospice?
Medicare typically pays for the core hospice benefit first. Medicaid covers what Medicare doesn’t, most commonly facility room and board.
How do I know if Suncrest accepts Medicaid where I live?
Use the ZIP lookup on this page. It will point you to the Suncrest office serving your area and whether Medicaid is accepted there.
