Originally published on 11/21/25

For years, Medicare and Medicare Advantage have covered hospice reimbursement, allowing seniors to enter into that phase of life without having to worry about money. Now, that could be changing, since Congress has introduced the Medicare Advantage Reform Act. If approved, it would “undermine the integrity, accessibility and quality of hospice care for America’s most vulnerable seniors,” according to the National Partnership for Healthcare and Hospice Innovation, LeadingAge (a consortium of nonprofit organizations serving older adults) and the The National Alliance for Care at Home.  We share everything you need to know about hospice reimbursement as well as what changes might be coming,  below. 

What to know about hospice reimbursement

Hospice reimbursement helps pay hospice bills for Medicare Part A users. The amount given is determined by the Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP (Children’s Health Insurance Program) Services. 

Medicare Advantage users can also benefit from the program, thanks to the Balanced Budget Act of 1997, which automatically enrolls them in Medicare Part A if they elect the hospice benefit.

On average, Medicare Part A users have a $1,676 deductible—a number that will go up to $1,736 in 2026—and a $0 premium. The plan also has an inpatient stay cost and skilled nursing facility stay cost (learn more about both here). To sign up for Part A, as well as the hospice reimbursement, all seniors have to do is enroll during the Medicare open enrollment period, which is from now until Sunday, December 7. 

A look at what might be changing with hospice reimbursement

In May of this year Arizona congressman David Schweikert introduced the Medicare Advantage Reform Act, which would require Medicare Advantage plans to pay for hospice care, meaning they would no longer be enrolled in Part A, and they would have to pay for hospice services when the time comes.

The Medicare Advantage Reform Act would also automatically enroll new Medicare beneficiaries into the lowest-premium Medicare Advantage plan available in their area—a change the National Alliance for Care at Home told Hospice News would be “devastating.” 

“Congressman Schweikert’s bill (HR 3467), while attempting to bring about wide-ranging changes to how Medicare Advantage operates, would also dismantle this vital program by forcing hospice care into Medicare Advantage plans,” a National Alliance for Care at Home spokesperson told Hospice News. “The consequences would be devastating. This proposal represents an unprecedented threat to end-of-life care. We implore Congress to reject it immediately.”

And that criticism isn’t limited to healthcare advocates. Months after the bill’s introduction, Republican Kansas Senator Roger Marshall and Rhode Island Senator Sheldon Whitehouse, a Democrat, released a bipartisan letter detailing their thoughts on the proposed piece of legislation. 

“We write to express our strong, bipartisan support for policies that preserve Medicare’s Hospice Benefit under Original Medicare, including for Medicare Advantage (MA) beneficiaries, which has protected their access to high-quality, timely end-of-life care for nearly three decades,” the senators wrote. “As Congress considers potential reforms to the MA program, we urge you to maintain this critical safeguard and oppose any proposals that would include hospice in the Medicare Advantage program, including repeal or alteration of the Special Rule [which enrolls Medicare Advantage users into Part A when the enroll in the hospice benefit] for Hospice.”

“Adding MA plan management on top of this system would be duplicative and inefficient, creating new administrative barriers without improving care,” they concluded. 

Currently, the Medicare Advantage Reform Act remains under discussion within the House of Representatives. If it passes there, it will go to the Senate. If they decide to pass it it then goes to President Donald Trump’s desk, where he will then either sign it into a law or deny it altogether. 

If the act passes without any amendments the changes will take effect in 2028, which is when the next Presidential election will take place. 

“The proposed carve-in seeks to solve a problem that does not exist, upending hospice as we know it, and subjecting dying patients to new administrative hurdles, reduced choice and the risk of diminished care,” LeadingAge, the National Alliance for Care at Home and the National Partnership for Healthcare and Hospice Innovation stated in a letter. “The bottom line is that patients and well-meaning providers will suffer the consequences of this short-sighted proposal.”

Link to original: https://www.womansworld.com/healthcare/does-medicare-cover-hospice-coverage-and-changes-explained