Does Blue Cross Blue Shield cover hospice or palliative care?
Short answer
Insurance question
Generally yes — BCBS plans typically cover hospice care for terminal illness and palliative care for serious conditions, but the specific benefits, eligibility criteria, and cost-sharing depend on your plan type and the BCBS company that issued your policy.
This is an independent research summary, not official coverage information. Your plan is the final word.
Key facts
Under Medicare Part A hospice, most covered services cost $0 (small copays apply for drugs and respite care).
Federal law requires Medicare Advantage plans to cover hospice through Original Medicare Part A, not the MA plan.
BCBS is a federation of 33 independent companies; hospice benefits vary by plan and state.
Here's the nuance
A one-liner rarely tells the whole story. This is the honest detail behind the short answer above.
Hospice care is covered under Medicare Part A when a patient has a terminal illness with a life expectancy of six months or less, certified by two physicians, and elects comfort-focused care over curative treatment. If you are enrolled in a BCBS Medicare Advantage plan, federal rules require that hospice still be covered through Original Medicare Part A — your MA plan handles other benefits, but hospice goes through Medicare directly. Under Medicare Part A hospice, covered services are generally at $0 for most hospice care, with a small copay for outpatient symptom-relief drugs and approximately 5% coinsurance for inpatient respite care.
For commercial (employer-sponsored or individual market) BCBS plans, hospice coverage is typically included but the benefit structure varies. Most commercial BCBS plans require that the patient be certified as terminally ill and that services be provided through a hospice program the plan approves. Cost-sharing — copays, deductible, and coinsurance — depends on your specific plan.
Palliative care is broader than hospice: it focuses on symptom management and quality of life for patients with serious illness, without requiring a terminal prognosis or giving up curative treatment. Under the ACA, commercial BCBS plans and Medicare Advantage plans must cover the same services as Original Medicare (Parts A and B), which includes palliative care services when medically necessary — such as pain management visits, specialist consultations, and related services.
Because BCBS is a federation of 33 independent companies, your actual benefits depend on which company and plan you have. Check your Evidence of Coverage (EOC) or Summary of Benefits, or call the Member Services number on your insurance card to confirm what hospice or palliative services are covered under your specific policy.
The key points
The handful of things that decide the answer — skim these if you only read one section.
Medicare Advantage BCBS routes hospice through Medicare Part A
Federal law requires that even if you have a BCBS Medicare Advantage plan, hospice benefits are provided through Original Medicare Part A. Your MA plan covers your other benefits; the hospice election goes through Medicare directly.
Medicare Part A hospice is largely $0 for covered services
Under Medicare Part A hospice, most covered services cost $0. There is a small copay for outpatient symptom-management drugs and approximately 5% coinsurance for inpatient respite care — but no copay for core hospice services.
Commercial BCBS plans typically include hospice as a covered benefit
Most employer and individual-market BCBS plans cover hospice when certified as medically necessary by a physician. Cost-sharing (deductible, copays) varies by the specific plan and BCBS company.
Palliative care is covered when medically necessary
Palliative care — symptom relief and quality-of-life support for serious illness — is generally covered as a medical benefit when ordered by a provider. It does not require a terminal diagnosis and can be combined with active treatment.
Prior authorization may be required
Some BCBS plans require pre-authorization for hospice admission or extended palliative care. Your care team's social worker or case manager typically coordinates this with the insurer.
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
Federal rules require that hospice be covered through Original Medicare Part A even for Medicare Advantage members, including those enrolled in BCBS MA plans. You elect hospice through Medicare, not through your BCBS MA plan. Covered services under Medicare Part A hospice are generally at $0 for core care, with small copays for symptom-relief drugs and inpatient respite care.
No. Palliative care is not the same as hospice. Palliative care focuses on symptom management and quality of life and can be provided alongside curative or active treatment for cancer or other serious conditions. Most BCBS plans cover palliative care services (pain management, specialist consultations, care coordination) when medically necessary — without requiring you to stop treatment.
Yes, in most cases. Home hospice — where a team of nurses, aides, social workers, and chaplains supports the patient at home — is typically a covered benefit. Under Medicare Part A (which applies to MA plans including BCBS MA), home hospice is a standard covered benefit. For commercial BCBS plans, home hospice coverage is generally included but confirm with your plan documents or Member Services.
Generally, two physicians must certify that the patient has a terminal prognosis of six months or less if the illness runs its normal course, and the patient must elect comfort-focused care rather than curative treatment. This mirrors the federal Medicare Part A hospice eligibility standard. Commercial BCBS plans may use similar criteria — confirm with your specific plan's coverage documents.
Under Medicare Part A (which applies to BCBS MA plans), hospice is covered in benefit periods — two initial 90-day periods, followed by unlimited 60-day periods — as long as the patient continues to meet eligibility criteria and a physician recertifies. Commercial BCBS plans may structure benefits differently; check your plan's evidence of coverage for any time limits or recertification requirements.
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.