Does Aetna cover hospice or palliative care?
Short answer
Insurance question
Yes — Aetna covers hospice care. If you have an Aetna Medicare Advantage plan, hospice is provided through Original Medicare Part A at generally $0 for covered services. For Aetna commercial health plans, hospice coverage is included but the cost-sharing and eligibility criteria depend on your specific plan. Two physicians must certify a prognosis of six months or less.
This is an independent research summary, not official coverage information. Your plan is the final word.
Key facts
Medicare Part A covers hospice at $0 for covered services when two doctors certify a terminal prognosis of six months or less.
Even Medicare Advantage enrollees receive hospice through Original Medicare Part A, not their MA plan.
Aetna is now part of CVS Health and serves commercial, Medicare Advantage, and other insurance markets.
Here's the nuance
A one-liner rarely tells the whole story. This is the honest detail behind the short answer above.
Aetna, now part of CVS Health, offers coverage for hospice care across its plan lines, but how hospice is covered depends on your plan type.
For Aetna Medicare Advantage members, hospice care is an important exception to the Medicare Advantage framework: by law, even Aetna Medicare Advantage members receive hospice through Original Medicare Part A — not through the Aetna MA plan. Medicare Part A covers hospice for a terminal illness where a physician certifies a life expectancy of six months or less if the illness runs its normal course, and the member chooses comfort-focused care over curative treatment. Under Medicare, covered hospice services cost $0 (with up to a $5 copay per prescription for outpatient symptom-relief drugs, and approximately 5% for inpatient respite care). Medicare Part A covers nursing, aide services, medical equipment, medications for comfort, and counseling.
For Aetna commercial health plans (employer-sponsored, individual, or ACA Marketplace), hospice care is generally a covered benefit. Medical necessity criteria apply — the treating physicians must certify terminal status. Cost-sharing (deductible, copay, or coinsurance) varies by plan. Palliative care — which focuses on symptom relief and quality of life for serious illness, and which can be received alongside curative treatment — is more variable in its coverage under commercial plans. Some Aetna commercial plans cover palliative care consultations and symptom management visits; others cover only inpatient palliative care.
Regardless of plan type, the right starting point is your Aetna Summary of Benefits or a call to Aetna member services. Your care team can also help you understand the enrollment process for hospice and whether your situation qualifies.
The key points
The handful of things that decide the answer — skim these if you only read one section.
Medicare Advantage members get hospice through Original Medicare Part A
Even if you have an Aetna Medicare Advantage plan, federal law routes hospice benefits through Original Medicare — not your MA plan. Covered hospice services are generally $0 under Medicare Part A.
Two doctors must certify a prognosis of six months or less
To qualify for Medicare hospice benefit, two physicians must certify that the patient has a terminal illness with an expected prognosis of six months or less if the illness follows its normal course. Recertification allows continued hospice if the patient lives longer.
Choosing hospice means shifting from curative to comfort care
Electing the Medicare hospice benefit means you agree to receive comfort-focused care rather than curative treatment for the terminal condition. You can still receive care for unrelated conditions.
Commercial Aetna plans cover hospice with plan-specific cost-sharing
Aetna employer and individual commercial plans generally include hospice as a covered benefit with applicable deductibles and cost-sharing. Check your plan documents for your specific benefits.
Palliative care coverage is separate and varies
Palliative care can be provided alongside curative treatment and is not the same as hospice. Coverage for palliative care consultations under Aetna commercial plans varies — confirm with your plan before scheduling.
Confirm before you rely on this
Coverage varies by plan — this is not official
Coverage rules, benefit tiers, and medical-necessity criteria change often and differ by plan type, state, employer, and your specific policy. This page is a general, independent research summary — it is not official information from any insurer, not a benefits determination, and not financial or insurance advice.
Verify your exact coverage by calling the member number on your insurance card or checking your plan documents before you rely on any answer here.
❓Frequently Asked Questions
Your physician or a hospice provider initiates the enrollment process. For Medicare (including Aetna Medicare Advantage members), the hospice provider submits the election paperwork and physician certifications to Medicare directly. For Aetna commercial plans, contact Aetna member services to understand the authorization process and find an in-network hospice provider. Your care team can help coordinate this transition.
Under Medicare Part A hospice, covered services include nursing visits, home health aide assistance, social work, chaplain services, counseling, and medical equipment and supplies related to the terminal condition. Medications for pain relief and symptom control are also covered. These services are provided $0 for covered items, with only minimal cost-sharing for some outpatient drugs and inpatient respite care under Medicare rules.
Yes — Aetna commercial health plans generally include hospice care as a covered benefit for members with a terminal illness. Medical necessity and physician certification are required. The cost-sharing (deductibles, copays, and coinsurance) depends on your specific Aetna plan. Review your plan's Summary of Benefits or call Aetna member services to understand what applies to your plan.
Palliative care for serious but non-terminal conditions is more variable than hospice. Some Aetna commercial plans cover palliative care consultations and symptom management as part of inpatient or outpatient care. Coverage depends on your specific plan and how the service is coded (e.g., as a specialist consultation). Contact Aetna member services or check your plan documents to confirm palliative care benefits before scheduling.
When you elect the Medicare hospice benefit, your care related to the terminal illness shifts to Original Medicare Part A. Your Aetna Medicare Advantage plan continues to cover services unrelated to the terminal condition. This is a federal requirement — Aetna MA plans cannot restrict your access to the Medicare hospice benefit. Contact Aetna to understand how your non-terminal benefits continue during hospice care.
Reviewed by
Curex Editorial TeamReviewed for accuracy
Last reviewed July 2026
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Read moreYour plan has the final say
The surest way to know what's covered is to ask the source. Call the member number on your insurance card or sign in to your plan portal, and have the service or medication name ready — a quick call beats guessing.
This page is independent research, not a benefits determination — your insurer's answer is the one that counts.
This content is for general informational purposes only. It is not official coverage information, a benefits determination, or financial or insurance advice. Coverage rules, benefit tiers, and medical-necessity criteria change often and vary by plan, state, and effective date — always verify your specific benefits directly with your insurer before making any decision.