Resources for families
Can you keep IV fluids, transfusions, a feeding tube, oxygen or chemo on hospice?
It depends on what the treatment is for. Hospice covers care that eases the symptoms of the terminal illness and related conditions. A treatment that brings comfort can often continue, even one that sounds aggressive. A treatment meant to cure or slow the illness usually stops. The hospice decides each one with the person and their doctors, and it must list in writing what it will not cover. Ask about each treatment before you sign.
Medically reviewed by Oscar Chien, MD, Medical Director, November 6, 2026
On this page (7 sections)
How does the hospice decide?
Hospice is comfort care for the illness that is expected to end the person's life, and for the conditions related to it. Medicare asks the hospice to provide every service in the plan of care that is reasonable and necessary to ease and manage that illness (42 CFR 418.202). The medicines it covers are the ones used mainly to relieve pain and control symptoms of the terminal illness. So for each treatment, the question is what it is for, not how big or costly it is.
A treatment aimed at comfort, such as oxygen for breathlessness, can usually be part of the plan. A treatment aimed at curing the illness or slowing it down, such as chemotherapy meant to shrink a cancer, is not hospice care, and the person gives up Medicare coverage for it while on hospice. Many treatments sit in between. The same transfusion can be comfort for one person and not for another.
Medicare lets a hospice use chemotherapy, radiation and other treatments for comfort when it decides they are needed. The manual says that choice rests on the patient's condition and on each hospice's own approach to care, and that Medicare pays the hospice nothing extra for them (Medicare Benefit Policy Manual, chapter 9, section 40.2.4). That is why two hospices can give different answers to the same question. Ask before you choose.
Treatment by treatment
This is what hospices generally do. It is not a promise of what any one hospice, including Beta Hospice, will cover for any one person. The hospice doctor decides with the person, the family and the person's own doctor.
| Treatment | On hospice | Why | What to ask |
|---|---|---|---|
| IV fluids | Usually not | In the last days of life, fluids by vein or under the skin have not been shown to help people live longer or feel better. The harm is usually small, but some people get more swelling or more fluid in the throat and chest. Mouth care and sips ease thirst. Fluids are sometimes tried for a specific problem, such as confusion caused by dehydration, when that fits the person's goals. | What would fluids do for comfort now, and what could they cause? |
| Blood transfusions | Sometimes | Some hospices give a transfusion when it eases a symptom such as breathlessness or deep tiredness. When it helps, the relief is usually modest and short-lived, and experts advise basing the decision on symptoms, not on a lab number. A transfusion usually has to be given in a clinic or hospital, not at home. Policies differ from hospice to hospice. | Do you ever give transfusions for comfort? Where would it be given, and how would you decide? |
| Feeding tube | Sometimes | Having a feeding tube does not keep someone off hospice. The plan of care decides whether to keep using it, slow it or stop it as the body needs less. In the last days of life, tube feeding has no known benefit and may raise the risk of fluid getting into the lungs or of infection. The American Geriatrics Society does not recommend feeding tubes for older adults with advanced dementia. | If we keep the tube, who supplies the formula and tube supplies, and when would you suggest slowing or stopping it? |
| Oxygen | Usually | Medical equipment and supplies that ease symptoms of the terminal illness are part of the hospice benefit. Oxygen helps most when blood oxygen is low. When breathlessness comes without low oxygen, a study found oxygen worked no better than ordinary air, and a fan, an open window, raising the head of the bed or medicine can help. | Will you supply the oxygen, and what happens to the equipment we already have? |
| Dialysis | Sometimes | It depends on the diagnosis. If kidney failure is the hospice diagnosis, dialysis stops. If the terminal illness is something else, dialysis can often continue under regular Medicare, but only when the hospice agrees the kidney failure is unrelated and puts that in writing, so ask. Read can you be on hospice and dialysis? | Will you treat the kidney failure as unrelated, and will you put that in writing? |
| Chemotherapy or radiation for symptom relief | Sometimes | Medicare allows a hospice to use them for comfort when it decides they are needed, such as a short course of radiation for a painful bone. Chemotherapy meant to control the cancer is not hospice care. Read hospice and cancer. | Would you cover a short course of radiation for pain? Who would give it, and where? |
| Antibiotics | Sometimes | Antibiotics are common near the end of life. They may be used when an infection causes a distressing symptom, such as shortness of breath from a chest infection. In the last days of life their benefit is unclear, and some people choose not to treat an infection then. | If an infection comes, how will we decide whether to treat it? |
| Blood thinners | Sometimes | Many people with advanced cancer stay on a blood thinner near the end of life, even though the body changes in ways that raise the risk of serious bleeding and the benefit becomes less clear. Researchers advise the doctor, the person and the family to weigh it together. The hospice reviews it with every other medicine, and the person may decide to keep, change or stop it. | Is the blood thinner still preventing something that would cause discomfort, and is it worth the bleeding risk now? |
| BiPAP or other breathing machines | Sometimes | When a mask machine eases breathing and the person wants it, it can often stay in the plan, as with COPD and ALS. In one trial in people with advanced cancer and breathing failure, the mask eased breathlessness faster than oxygen, though about 1 in 10 stopped because the mask was uncomfortable. If the mask stops helping or becomes uncomfortable, the plan can change. | Who supplies and services the machine, and what is the plan if the person no longer wants the mask? |
"Usually", "sometimes" and "usually not" describe common practice, not a rule. The answer for one person depends on their illness, their goals and the hospice's plan of care.
What to ask before you choose a hospice
Bring the list of every treatment, machine and medicine the person uses now. Ask each hospice you are considering:
- Which of these treatments would you continue, and which would stop?
- For each one that stops, is it because you see it as unrelated to the terminal illness, or because it no longer brings comfort?
- Who pays for the treatments you see as unrelated, and will you list them in the addendum?
- Do you give transfusions, radiation or other treatments for comfort, and where?
- Can the person's own doctor stay involved?
- If the person wants to try a treatment again later, what are the choices?
Children under 21 on Medi-Cal or Medicaid: concurrent care
Children have a different rule. Section 2302 of the Affordable Care Act lets a child on Medicaid or a Medicaid-expansion CHIP program elect hospice without giving up treatment for the illness itself. The federal law leaves the age to each state; CMS guidance and Medi-Cal apply it to people under 21. In California, a Medi-Cal member under 21 may receive hospice alongside curative care (DHCS All Plan Letter 18-020). Chemotherapy, surgery or other treatment for the condition can continue while the hospice team cares for pain, symptoms and the family.
The child must still qualify for hospice: a doctor certifies that life expectancy is six months or less if the illness runs its usual course. Adults 21 and older, and anyone on Medicare hospice, still choose comfort care in place of treatment meant to cure the terminal illness. If a private plan pays for a child's care, ask the plan how it handles concurrent care. Not every hospice cares for children, so ask each one. Beta Hospice cares for adults.
What if you want a treatment the hospice will not provide?
Ask the hospice doctor to explain the decision in plain words and to write it down. Ask whether another approach would bring the same comfort. If you still disagree, you can ask the Medicare Quality Improvement Organization for help (see your patient rights).
You can also leave hospice at any time and return to regular Medicare coverage, for example to try a treatment again. You can come back to hospice later if you still qualify. Read can you leave hospice?. If the person wants to keep treatment for the illness and also get help with symptoms, palliative care may fit better right now.
Common questions
Does hospice give blood transfusions?
Some hospices do, when a transfusion eases a symptom such as breathlessness, and others do not. Medicare leaves this to the hospice's judgment. Ask each hospice before you choose.
Can hospice give IV fluids?
Usually not. In the last days of life, fluids by vein have not been shown to add comfort or time, and some people get more swelling or fluid in the chest. Fluids are sometimes tried for a specific problem, such as confusion caused by dehydration. Mouth care, sips and ice chips ease thirst. Read how long someone can live after they stop eating and drinking.
Can you go on hospice with a feeding tube?
Yes. Having a feeding tube does not keep someone off hospice. The plan of care decides how the tube is used as needs change.
Can you continue chemo on hospice?
Chemotherapy meant to control the cancer stops when hospice begins. A hospice may sometimes use chemotherapy or radiation for comfort, such as a short course of radiation for a painful bone. Ask before you elect hospice.
Does hospice provide oxygen?
Usually, when oxygen eases symptoms of the terminal illness. It is part of the medical equipment the hospice benefit covers. The nurse will go over oxygen safety at home.
Do we have to stop all medicines?
No. Medicines that bring comfort continue. The hospice reviews every medicine with you, and some that no longer help may be stopped. Read hospice medications.
Read more
What hospice does and does not provide, can you be on hospice and dialysis?, hospice medications, can you leave hospice? and hospice vs palliative care.
About this page
- Written by
- Beta Hospice care team
- Medically reviewed by
- Oscar Chien, MD, Medical Director
- Last reviewed
- November 6, 2026
- Next review
- May 6, 2027
How we write and review this site
Sources
- 42 CFR 418.24: Election of hospice care, including the election statement addendum (opens in a new tab)
- 42 CFR 418.202: Covered services (opens in a new tab)
- CMS Medicare Benefit Policy Manual, chapter 9: Coverage of hospice services under hospital insurance (opens in a new tab)
- National Cancer Institute: Last Days of Life (PDQ), health professional version (opens in a new tab)
- National Cancer Institute: Last Days of Life (PDQ), patient version (opens in a new tab)
- HealthInAging.org (American Geriatrics Society): Feeding tubes for those with advanced dementia (opens in a new tab)
- Nava S, et al. Palliative use of non-invasive ventilation in end-of-life patients with solid tumours: a randomised feasibility trial. Lancet Oncology, 2013 (opens in a new tab)
- Jagosh J, et al. Shared decision-making and deprescribing to support anti-thrombotic therapy (dis)continuance for persons living with cancer in their last phase of life: a realist synthesis. PLOS Medicine, 2025 (opens in a new tab)
- CMS State Medicaid Director Letter 10-018: Hospice care for children in Medicaid and CHIP (opens in a new tab)
- DHCS All Plan Letter 18-020: Palliative care and hospice for Medi-Cal members (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 person鈥檚 care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (877) 258-7129 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 person鈥檚 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