Questions people ask
Which two conditions must be present for a patient to enroll in hospice?
Two things must both be true. First, a doctor certifies that the person has a terminal illness with a life expectancy of six months or less if the illness runs its usual course. Second, the person chooses hospice and signs an election statement, which means giving up Medicare treatment meant to cure that illness. Anyone can call a hospice. Only a doctor can certify.
Reviewed by our medical director, October 12, 2026
On this page (5 sections)
Where the two conditions come from
Both are in Medicare's hospice rules. 42 CFR 418.20 says a person is eligible when a doctor certifies that they are terminally ill, and 418.22 defines that as six months or less if the illness runs its usual course. 42 CFR 418.24 covers the election: the person signs a statement with the hospice they choose, acknowledging that hospice is comfort care and waiving Medicare treatment meant to cure the terminal illness.
Hospice is for people with a serious illness when a doctor certifies that life expectancy is six months or less if the illness runs its usual course. Our medical director and your doctor make that determination. A website cannot.
The two conditions side by side
| Condition | Who does it | What it looks like |
|---|---|---|
| A terminal illness is certified | A doctor. For the first period, the hospice doctor and the person's own doctor | A written certification of six months or less if the illness runs its usual course. Any diagnosis can be appropriate, not only cancer |
| The person elects hospice | The person, or their representative if the person cannot sign | A signed election statement naming the hospice and giving up Medicare treatment meant to cure the terminal illness |
Neither condition is a verdict about how long someone will live. People can stay on hospice longer than six months as long as a doctor continues to certify that they are eligible.
What this means for your family
- Anyone can call a hospice with a question. A nurse can explain what the next step would be.
- The certification is the doctor's job. If you think it may be time, ask the person's doctor, or ask the hospice to talk with the doctor.
- The election is the person's decision. Choosing hospice is your decision. You can stop hospice at any time and return to regular Medicare coverage. You have the right to choose your hospice.
- Electing hospice does not end Medicare. Medicare continues to cover conditions unrelated to the terminal illness.
Related questions
Does the same standard apply with Medi-Cal?
Yes. The same standard applies under Medicare and Medi-Cal: a doctor certifies eligibility and the person chooses hospice. See Medi-Cal and hospice.
What if the person lives longer than six months?
Hospice continues as long as a doctor keeps certifying that the person is eligible. There is no fixed limit. See how long Medicare pays for hospice.
How do we know if it is time to ask?
Repeated hospital stays, weight loss, sleeping most of the day, and needing more help with daily care are reasons to talk with a doctor or a hospice nurse, not a verdict. See is it time for hospice.
Read more
The fuller pages: hospice care, is it time for hospice and questions and answers.
About this page
- Written by
- Beta Hospice care team
- Clinically reviewed by
- our medical director
- Last reviewed
- October 12, 2026
- Next review
- April 12, 2027
How we write and review this site
Sources
- 42 CFR 418.20: Eligibility requirements (opens in a new tab)
- 42 CFR 418.22: Certification of terminal illness (opens in a new tab)
- 42 CFR 418.24: Election of hospice care (opens in a new tab)
- Medicare.gov: Hospice care coverage (opens in a new tab)
These sources support the general information on this page. For one personās care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (844) 646-4434 any time, or leave your number and someone from Beta's hospice team will call you. No decision is needed to call. Most families start with a question.
Only a hospice doctor, together with the personās own doctor, can confirm hospice eligibility. A website cannot.
- A nurse answers 24 hours a day, 7 days a week
- You can stop hospice at any time
- You have the right to choose your hospice