Updated September 2026. Written and reviewed by the Lily Hospice clinical team.
For most families in Michigan, hospice costs nothing out of pocket. Medicare Part A, Michigan Medicaid and most private plans pay the hospice directly for nursing, aide visits, medications for the illness, equipment, supplies, social work, chaplain and grief support. The only usual charges are up to $5 per prescription and 5% of a short respite stay.
“How much is this going to cost?” is often the second question a family asks, right after “is it time?” It is usually asked quietly, because people expect the answer to be frightening. It is not. This article lays out what hospice costs in Michigan in plain numbers: what Medicare pays, what a family might pay, what is not covered, and what happens when there is no insurance at all. It is written for families in Oakland, Macomb and Wayne counties, but the rules are federal and the same everywhere in the state.
The short answer
If your loved one has Medicare Part A, which nearly everyone over 65 has, the Medicare hospice benefit pays the hospice a fixed daily rate, and the hospice is then responsible for almost everything related to the terminal illness. There is no deductible. There is no bill for the nurse’s visit, the aide, the hospital bed, the oxygen, the comfort medications, the social worker, the chaplain, or the bereavement support your family receives afterward. Medicare Advantage members are covered the same way, through Original Medicare; here is how that works. Michigan Medicaid has a hospice benefit that mirrors Medicare’s, and most employer and private plans do too.
What a family might actually pay
Under Original Medicare there are only two possible charges, and both are small:
- Up to $5 per prescription for outpatient drugs used for pain and symptom control. Many hospices, including Lily, do not bill this copay at all; ask any hospice you are considering.
- 5% of the Medicare-approved amount for inpatient respite care, the short facility stay of up to five days that lets a family caregiver rest. Medicare’s approved daily rate for respite in fiscal year 2026 is $532.48, so the family’s 5% share works out to roughly $27 a day, and a full five-day respite stay to about $133. Respite is the one level of care where a family sees a bill, and it is capped at what Medicare would pay for inpatient hospital care.
Everything else related to the terminal illness, at every level of care, is $0 to the family. Details are on Does Medicare cover hospice in Michigan?
What Medicare pays the hospice (so you know the scale)
Families sometimes want to know what the care is worth, or what a private-pay arrangement would cost if there were no coverage. Medicare’s published national base rates for October 2025 through September 2026 are a fair benchmark, before local wage adjustments:
| Level of care | Medicare base rate (FY 2026) |
|---|---|
| Routine home care, days 1 to 60 | $230.83 per day |
| Routine home care, day 61 onward | $181.94 per day |
| Continuous home care (a short crisis, mostly nursing, at least 8 hours in a day) | $1,674.29 per 24 hours ($69.76 per hour) |
| Inpatient respite care | $532.48 per day |
| General inpatient care (symptoms that cannot be managed at home) | $1,199.86 per day |
The hospice receives that daily amount whether it visits once that day or three times, and it pays for the medications, equipment and supplies out of it. That is also why every Medicare-certified hospice is paid the same way: the differences between hospices are in what they do with those dollars, not in what they charge you. Our metro Detroit hospice directory compares all 104 hospices serving Oakland, Macomb and Wayne counties on the measures Medicare publishes.
What hospice does not pay for
Room and board in a facility. This is the cost that surprises families. If your mother lives in assisted living, memory care or a nursing home, Medicare hospice pays for the hospice services delivered to her there, not for her room and meals. The monthly facility cost stays what it was, paid by her, by long-term care insurance, or by Medicaid if she qualifies. The exceptions are the short respite and general inpatient stays the hospice arranges, which are covered. How hospice works in assisted living or a nursing home.
Round-the-clock caregiving at home. Hospice visits are scheduled; they are not a live-in aide. When a family needs more hours than visits and volunteers can cover, the social worker helps arrange them through programs such as the MI Choice Medicaid waiver, the Area Agency on Aging, or private-duty care the family pays for. Hospice when your parent lives alone explains how that plan comes together.
Treatment meant to cure the terminal illness, and care for the terminal illness from providers the hospice did not arrange. Care for unrelated conditions continues under regular Medicare with its usual copays. Your loved one can revoke hospice at any time to return to curative treatment.
Michigan Medicaid, VA, private insurance and no insurance
Michigan Medicaid covers hospice in full, on the same model as Medicare. For someone with both Medicare and Medicaid, Medicare pays the hospice and Medicaid may pay nursing-facility room and board, which can be the single biggest relief for a family. How the two programs fit together, and what Michigan looks at when someone applies, is in hospice and long-term-care Medicaid in Michigan.
Veterans enrolled in VA health care can receive hospice through the VA or through community hospices the VA authorizes; most veterans also have Medicare, which pays directly. Our veterans page covers Aid and Attendance and the county veterans offices.
Private and employer plans nearly all include a hospice benefit modeled on Medicare’s. Some use networks and some have copays; the hospice verifies the plan before care starts and tells you what, if anything, you would owe.
No insurance at all is uncommon for someone facing a terminal illness in Michigan, because emergency Medicaid, the MI Choice waiver and disability-based Medicare often apply, and a hospice social worker knows how to apply for them quickly. Where there is a true gap, many hospices, Lily included, will talk with the family about care regardless. Hospice with Medicaid only or no insurance in Michigan.
Palliative care costs differently
If your father is still in treatment and not ready for hospice, palliative care is billed differently: as ordinary Medicare Part B visits, like seeing a specialist, so the usual Part B deductible and 20% coinsurance (or a Medigap or Advantage plan’s copay) can apply. That is the trade for being able to keep treatment going. Lily’s Pathways Palliative Program works this way, and the difference is explained in hospice vs. palliative care in Michigan.
Questions to ask any hospice about cost
Every Medicare-certified hospice must provide the same core services, so the useful cost questions are specific. Do you bill the $5 prescription copay? Which pharmacy do you use, and do they deliver? Which equipment is included as standard, and is a pressure-relieving mattress or a lift covered if the nurse orders it? Where do you place patients for respite, and what will we owe? If my mother is in assisted living, exactly what will the facility keep charging? Will you tell us before anything falls outside the benefit? A hospice that answers those plainly before admission is one you can trust with the bigger conversations later. More in how to choose a hospice.
How Lily handles cost
When you call, we verify your loved one’s coverage, whether Original Medicare, Medicare Advantage, Michigan Medicaid, VA or a private plan, and explain in plain words what is covered before anything begins. Equipment, supplies and medications related to the terminal illness come as part of the plan of care. If something would fall outside the benefit, we tell you before it happens, not after. Lily serves families at home, in assisted living, memory care and nursing facilities across Oakland, Macomb and Wayne counties from our office in Troy, and cost is never a reason to wait to call. If you are still deciding whether it is time, start with Is It Time? A family’s gentle guide.
Common questions
Is hospice free in Michigan?
For nearly everyone with Medicare, Medicaid or private insurance, hospice services cost nothing out of pocket. The only usual charges under Medicare are up to $5 per prescription for comfort medications and 5% of the cost of an inpatient respite stay.
How much does hospice cost per day?
Medicare pays the hospice about $231 a day for routine home care in the first 60 days and about $182 a day after that (fiscal year 2026 base rates), and the family pays nothing for that care. Those figures are also a fair benchmark for what private-pay hospice would cost without coverage.
Does hospice pay for the nursing home or assisted living?
No. Hospice pays for the hospice services delivered there, not room and board. Medicaid may cover room and board in a nursing facility for those who qualify.
Do we pay for the hospital bed, oxygen or medications?
No. Equipment, supplies and medications related to the terminal illness are provided by the hospice as part of the Medicare benefit.
What does respite care cost?
Under Original Medicare the family owes 5% of the Medicare-approved amount, roughly $27 a day at the fiscal year 2026 rate, for up to five consecutive days per respite stay.
What if my parent has Medicare Advantage?
Hospice is still paid by Original Medicare Part A, not the plan. The plan stays in place for unrelated care, and any Medicare-certified hospice in Michigan can be chosen.
What if there is no insurance?
Call anyway. A hospice social worker can usually help a family apply for Michigan Medicaid or other coverage quickly, and Lily will talk with any family about care regardless of coverage.
Does it cost anything to find out whether hospice is right for us?
No. An evaluation visit from a nurse is free and carries no obligation.
Hospice isn’t giving up. It’s showing up. Call (248) 955-5100. A real person answers, 24 hours a day, and will check your loved one’s coverage before you decide anything.
General education, not legal, financial or medical advice. Coverage details are set by Medicare, Medicaid and each plan; the hospice verifies them for every family before care begins. Sources: Medicare.gov, “Hospice care” (medicare.gov/coverage/hospice-care); Centers for Medicare & Medicaid Services, FY 2026 Hospice Wage Index and Payment Rate Update final rule (Federal Register, August 5, 2025) and MLN Matters MM14190, “Hospice Payments: FY 2026 Update”.
