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For many Florida families, hospice care becomes part of life during one of its most difficult moments, such as when a loved one is diagnosed with a terminal illness. While hospice is often associated with end-of-life care, federal standards strictly define who qualifies, how long services last and what legal rights patients and families have.
Hospice care is a specialized form of medical care focused on comfort rather than cure. It is designed to provide physical relief, emotional support, and spiritual care to patients whose life expectancy is six months or less if their illness runs its normal course. Services may be delivered in a private home, a hospice facility, a hospital, or a nursing home.
Hospice programs rely on interdisciplinary care teams that include physicians, nurses, social workers, chaplains, and aides. Together, they work to manage pain and symptoms while also supporting family members during what is often an emotionally overwhelming time.
Hospice Use Is Growing
Hospice care is playing a growing role in end-of-life care across the United States and in Florida as the population ages and more families seek comfort-focused treatment. After declining during the COVID-19 pandemic, hospice utilization has rebounded to its highest level since 2019. In 2023, about 51.7% of Medicare beneficiaries were enrolled in hospice at the time of death, according to federal data, meaning more than half of Americans who died that year received hospice services.
That trend is reflected in overall enrollment as well. The most recent Medicare Hospice Fast Facts report shows that approximately 1.8 million Medicare beneficiaries received hospice care in Fiscal Year 2024, underscoring how widely the benefit is used nationwide. Utilization had already begun rising in 2022, when nearly 49.1% of all Medicare decedents received at least one day of hospice care, marking the first increase since before the pandemic.
Industry analysts report that hospice use continued to climb through 2024, with enrollment exceeding 50% of eligible Medicare patients by late in the year. Florida mirrors that national pattern. More than 116,000 Floridians received hospice care in 2024, and some regions of the state reported utilization rates above 60%, reflecting both strong hospice infrastructure and Florida’s large older-adult population.
How Hospice Is Paid For
Hospice care is covered by Medicare, Medicaid and most private insurance plans. Medicare is the primary payer nationwide, which is why Congress established the Medicare Hospice Benefit to ensure uniform coverage. Florida also includes hospice as part of its Medicaid program, allowing low-income residents to receive care even without private insurance.
Once a patient elects hospice under Medicare, nearly all services related to the terminal illness are covered, including nursing care, pain-relief medications, medical equipment and counseling. However, Medicare does not cover treatments meant to cure the terminal condition or room and board in most care settings.
Who Qualifies for Hospice
Federal law strictly governs hospice eligibility. To qualify for Medicare-covered hospice care, a patient must be entitled to Medicare Part A and must be certified as terminally ill by a physician.
That certification must include medical documentation showing that the patient’s life expectancy is six months or less if the illness follows its normal course. It also requires a written clinical narrative and, for later benefit periods, a face-to-face visit with a hospice physician or nurse practitioner. All certifications must be signed, dated and tied to specific benefit periods before Medicare will pay.
How Long Hospice Care Lasts
Hospice care is not approved indefinitely. Patients first receive an initial 90-day period, followed by a second 90-day period. After that, hospice may continue in an unlimited number of 60-day periods, as long as the patient continues to meet eligibility requirements.
Before each 60-day extension, the hospice physician or nurse practitioner must again examine the patient in person to determine whether the terminal prognosis still applies.
Patient Rights and Protections
Patients or their legal representatives must formally elect hospice care by filing an election statement with the hospice provider. The hospice then has five days to notify Medicare so services can be covered.
Patients retain important legal rights, including the right to effective pain control, participation in their care plan, the ability to refuse treatment, the right to choose their attending physician, confidentiality of medical records, and freedom from neglect or abuse. Patients also have the right to receive clear information about what services are covered and any limitations.
Hospice enrollment is not permanent. Patients may revoke hospice at any time and return to traditional Medicare if they choose and may later re-enroll if they remain eligible.
Planning Ahead
Healthcare advocates encourage families to create advance directives that outline a patient’s wishes for end-of-life care. These documents help ensure those wishes are respected and allow loved ones to focus on spending meaningful time together rather than making urgent medical decisions.
For families across South Florida, understanding how hospice works can bring clarity and peace of mind during one of life’s most difficult transitions ensuring that loved ones receive care that prioritizes comfort, dignity and compassion.
Jamaal R. Jones is a Health Law Attorney at Jones Health Law P.A. where he represents healthcare practitioners and facilities in healthcare transactions, regulatory compliance, and licensing matters, healthcare litigation. He is an adjunct professor with the University of Tennessee where he teaches health law compliance. Jamaal is the Immediate Past-Chair of the Health Law Section of the Florida Bar and Vice Chair of Physician Organization Practice Group for the American Health Lawyer’s Association. He also has a YouTube page and Podcast aptly called “Jones Health Law” where he discusses healthcare law issues and interviews healthcare practitioners. (305) 877 5054; @joneshealthlaw; jrj@joneshealthlaw.com
