Updated October 2026. Written and reviewed by the Lily Hospice clinical team.
No. Changing, keeping or dropping a Medicare plan during open enrollment (October 15 to December 7) does not change hospice care. Hospice is paid by Original Medicare Part A for every Medicare member, whatever plan they carry. A plan change only affects care and prescriptions unrelated to the terminal illness.
Every fall the mailbox fills with plan brochures, the television fills with advertisements, and families who are caring for someone on hospice, or thinking about hospice, start to worry that they have a decision to get right by a deadline. This guide explains what open enrollment can and cannot change, the few things worth checking, and where Michigan families can get free, unbiased help. It is written for families in Oakland, Macomb and Wayne counties, but the Medicare rules are federal.
The dates, in plain words
October 15 to December 7: Medicare Open Enrollment. Anyone with Medicare can join, drop or switch a Medicare Advantage plan or a Part D drug plan, or move between Medicare Advantage and Original Medicare. Changes take effect January 1.
January 1 to March 31: Medicare Advantage Open Enrollment. Someone who is already in a Medicare Advantage plan can switch to another one, or go back to Original Medicare, once. The change starts the first of the following month.
Special enrollment periods. Some situations open extra chances during the year. Two matter often for hospice families: a person who lives in a nursing home or similar institution can change coverage while living there and for two months after moving out, and people who have both Medicare and Medicaid, or who receive Extra Help with drug costs, have additional opportunities. The dates and rules are on Medicare.gov’s joining a plan page.
Why a plan change does not change hospice
Hospice is the one major benefit that Medicare Advantage plans do not run. When any Medicare member elects hospice, Original Medicare Part A pays the hospice directly, and the hospice provides everything related to the terminal illness: the nurse, the aide, the social worker and chaplain, comfort medications, the hospital bed and other equipment, supplies, respite for the caregiver and grief support for the family afterward. That is true in a zero-premium Advantage plan, an employer retiree plan, or Original Medicare with a supplement. Our guide to Medicare Advantage and hospice explains the rule in detail, and Does Medicare cover hospice in Michigan? lists the whole benefit.
Three things follow from that.
You never need to switch plans to get hospice. No plan gives “better hospice coverage” than another, because none of them pays for it. If a caller or a mailer suggests a new plan is needed for hospice, that is not how Medicare works.
The plan’s network does not choose the hospice. Any Medicare-certified hospice in Michigan can care for a member of any plan. Families can compare all of them in our metro Detroit hospice directory or by ZIP code in the hospice finder.
Hospice does not stop or restart on January 1. The hospice election follows the person, not the plan year. The same team keeps visiting.
What a plan change does affect
Someone on hospice still has health needs that have nothing to do with the terminal illness: eye drops, a thyroid pill, a dentist, a fall that needs an X-ray. Medicare’s own hospice booklet says a person who stays in a Medicare Advantage plan “can continue to get covered services for any health problems that aren’t part of your terminal illness,” and can choose to get those services “from either your plan or Original Medicare.” So the plan still matters for:
- Unrelated prescriptions. The plan’s Part D coverage, or a stand-alone drug plan, pays for medicines not related to the terminal illness. Formularies change every January.
- Unrelated doctors. The plan’s network and copays apply when she uses the plan for unrelated care.
- Extras. Dental, vision, hearing, transportation or an over-the-counter allowance continue only with the plan that offers them.
- Premiums. The plan premium, if there is one, and the Part B premium continue during hospice.
The hospice nurse and social worker help sort out which medicines and visits are related to the terminal illness and which are not, so families are not left guessing which card to use.
A short open-enrollment checklist for hospice families
- Read the Annual Notice of Change. Plans mail it each September. It lists what changes on January 1: premium, copays, drug list, network.
- Check the unrelated medicines. Ask the hospice nurse which prescriptions the hospice covers. For the rest, confirm they are still on next year’s drug list.
- Check the doctors she still sees. If the attending physician or a specialist for an unrelated condition is leaving the network, that is worth knowing before December 7. Her doctor can stay her attending physician on hospice either way; see keeping your own doctor.
- If nothing important is changing, do nothing. Staying put is a perfectly good decision, and the plan renews on its own.
- Before dropping a plan for Original Medicare, ask about a supplement. Outside certain protected windows, Medicare supplement (Medigap) insurers may be able to ask health questions, so get advice first.
- Tell the hospice about any change. We update the record so billing for unrelated care goes to the right place.
If you are thinking about hospice but have not started
Do not wait for January, and do not wait for a plan change to “go through.” Hospice can start under the coverage a person has today, usually within a day or two of the first call; see how fast hospice can start. We verify coverage on the first call and explain it before anything is signed. If you are still deciding whether it is time, start with Is It Time? A family’s gentle guide or the two-minute self-check.
If hospice ends
People sometimes leave hospice: they stabilize, or they decide to try treatment again. When that happens, Medicare coverage returns to the way it worked before, through the Advantage plan or Original Medicare, and hospice can be chosen again later. Nothing about a plan choice this fall closes that door. See how long hospice lasts.
Medicaid, nursing homes and other coverage
For someone with both Medicare and Michigan Medicaid, Medicare pays the hospice and Medicaid may cover nursing-home room and board; open enrollment does not change that arrangement. Our guide to hospice and long-term-care Medicaid in Michigan explains how the two fit together, and the hospice cost calculator estimates what a family would pay in each situation. For nearly every family, the hospice care itself costs nothing out of pocket.
Free, unbiased help in Michigan
Plan agents are paid by plans. These are not:
- MI Options, the State of Michigan’s free counseling line for Medicare and long-term care: 800-803-7174.
- 1-800-MEDICARE (1-800-633-4227), 24 hours a day, and the plan finder on Medicare.gov.
- Your Area Agency on Aging: AgeWays for Oakland and Macomb counties at (800) 852-7795, The Senior Alliance for western and southern Wayne County at (734) 722-2830, and the Detroit Area Agency on Aging at (313) 446-4444.
And for anything about hospice itself, a real person answers at Lily at any hour. We serve all of Oakland County, Macomb County and Wayne County from our office in Troy.
Common questions
Does switching Medicare plans during open enrollment affect hospice?
No. Hospice is paid by Original Medicare Part A for everyone with Medicare, including Medicare Advantage members. Changing, keeping or dropping a plan between October 15 and December 7 changes how unrelated care and unrelated prescriptions are covered, not the hospice care itself.
Do we need to switch plans to get hospice?
No. No plan change is ever needed to start hospice, and the plan’s network does not limit which Medicare-certified hospice you choose. Be cautious of anyone who says a new plan is required for hospice.
Should Mom drop her Medicare Advantage plan now that she is on hospice?
Usually there is no need. She can stay in the plan and keep its extras, and Medicare says she may get care unrelated to her terminal illness from either the plan or Original Medicare. A free counselor at MI Options, 800-803-7174, can compare the choices for her situation.
What should we check during open enrollment if someone is on hospice?
Three things: whether next year’s plan still covers the medicines that are not related to the terminal illness, whether the doctors she still sees for unrelated care stay in the network, and whether the premium or copays are changing. The plan’s Annual Notice of Change lists all three.
What if we miss the December 7 deadline?
Hospice continues unchanged. Someone already in a Medicare Advantage plan can make one change between January 1 and March 31, and people who live in a nursing home or who have Medicaid or Extra Help have additional chances during the year.
Does hospice end on January 1 when the new plan year starts?
No. The hospice election does not follow the plan year. Care continues across January 1 with the same team, whatever plan changes were or were not made.
Who can help us with Medicare choices in Michigan for free?
MI Options, Michigan’s free and unbiased counseling line for Medicare and long-term care, at 800-803-7174, or 1-800-MEDICARE at any hour. Counselors do not sell plans.
General education, not insurance, legal or medical advice. Plan rules and dates can change; confirm details with Medicare or a MI Options counselor. Lily Hospice does not sell or recommend insurance plans.
Hospice isn’t giving up. It’s showing up. Call (248) 955-5100. A real person answers, 24 hours a day.
