What to Do When Hospice Says Something Is Not Covered
How to request the written addendum, distinguish related from unrelated care, and challenge unclear decisions.
Start here
Ask for the hospice election-statement addendum identifying every item, service, and drug it considers unrelated to the terminal illness and why. Do not rely on a verbal “Medicare won’t pay.”
What to have in front of you
- The notice, bill, decision, or discharge paperwork connected to the problem
- The person’s full name, date of birth, address, insurance information, and identification
- A short timeline with dates, names, phone calls, and what changed
- Copies of medical, school, financial, or care records that directly support the request
What to say when someone answers
“Please give me the written addendum explaining why this item or service is not covered, who made that determination, and how I can request review.”
Small but useful: Write down the person’s name, the date, the exact next step, and when you should call again.
Do this in order
- 1
Identify the exact medication, equipment, visit, transport, or treatment being denied.
- 2
Request the current plan of care and non-covered-items addendum in writing.
- 3
Ask the hospice medical director to review whether the need is related to the terminal illness or related conditions.
- 4
Call Medicare, the insurer, or Medicaid to identify any separate coverage and document every answer.
What happens next
The hospice may revise the plan, maintain the denial with an explanation, or identify another payer.
If they say “we’ll put you on the list”
If the hospice will not provide the required explanation or access remains unsafe, use its complaint process, call Medicare, and interview another hospice before transferring.
Official sources
Checked August 5, 2026. Programs, hours, funding, and enrollment lists can change. Confirm details directly before relying on them.