Continuous home care in hospice is short-term care designed for people who are experiencing severe or rapidly worsening symptoms. It provides intensive medical and personal support in the comfort of home, typically for at least eight hours within a 24-hour period, with nurses delivering most of the care. The goal is to manage pain, breathing issues, or other acute symptoms so your loved one can return to routine hospice care. In many cases, this type of care is fully covered by Medicare, Medicaid, or private insurance.
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According to the U.S. Centers for Medicare and Medicaid Services (CMS), continuous home care in hospice is a level of care provided during a medical crisis, requiring at least eight hours of care in 24 hours, with most of that care delivered by licensed nursing staff.[01]
To be considered continuous home care, this intensive level of care must:[02]
CMS requires all Medicare-certified hospice programs to provide continuous home care, as well as three other types of hospice care:[01]
When someone is receiving continuous home care in hospice, a medical professional visits their home to manage their symptoms, such as intense pain, trouble breathing, or agitation. Once their symptoms have been relieved or brought under control and they need less intensive care, they return to routine hospice.
Continuous home care in hospice services include:
Read more:What Is Hospice Care at Home? Services, Benefits, and Eligibility
Because continuous home care is medical care, it’s provided by registered nurses (RNs), licensed vocational nurses (LVNs), or licensed practical nurses (LPNs). Other professionals may also be involved, such as:
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The amount your family pays for continuous home care depends on whether your loved one has health insurance that covers hospice care and what kind of coverage their insurance provides.
The cost of private-pay hospice can vary, but most hospice providers follow the CMS rate schedule, which defines how much Medicare and Medicaid will pay. In 2026, Medicare and Medicaid pay $69.76 per hour for 24/7 care, or $1,674.29 for a 24-hour period.[03]
Most families pay nothing for hospice care, including continuous home care, because most seniors are covered by Medicare,[04] and Medicare covers the cost of hospice as long as the recipient meets specific conditions. If your loved one isn’t receiving Medicare benefits, there are other payment options available, including other publicly funded programs and private insurance.
Medicaid, a joint program of the federal and state governments, also covers the cost of hospice, but eligibility requirements vary from state to state.[05] For example, some states require shorter or longer life expectancies than six months to provide Medicaid benefits for continuous home care.
The U.S. Department of Veterans Affairs (VA) will pay for hospice, including care that’s considered continuous home care, for eligible veterans and their dependents.[06]
Private insurance policies may pay for care that’s considered continuous home care in hospice. Talk with an insurance agent or read through your loved one’s policy to see if they qualify for these benefits. If your relative bought a long-term care insurance policy earlier in life, their policy may cover various types of hospice care at home.
Costs for treatment of an illness when someone is receiving hospice care aren’t covered by Medicare, Medicaid, or VA benefits. While Medicare will pay for medications and equipment,[07] other insurance providers may limit their coverage of these expenses.
When arranging for continuous home care in hospice with a provider or hospice agency, ask for an itemized list of costs for the types of care and services and what you can expect to be covered by Medicare, Medicaid, VA benefits, or private insurance. Also ask what services, if any, will be billed separately.
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Continuous home care services are generally billed in 15-minute increments, and agencies track how much of that care is provided by medical professionals.[08]
Medicare requires that a senior need at least 8 hours of mostly nursing care in a 24-hour period to manage an acute medical crisis. Those 8 hours include the time nurses and home aides spend providing care. [09]
Your loved one may need continuous home care if:
If this is the case, contact their doctor and request an evaluation. If the doctor agrees they need continuous home care, your next step is to contact a hospice program. The doctor may be able to provide a list of programs that offer continuous home care, or to connect you with a specific provider if you have one in mind.
Once your loved one’s symptoms are stabilized, you may find that there are aspects of their care and home that still need attention, such as nonmedical care and homemaker activities such as cooking and cleaning. If your family needs help with those responsibilities, or if you need time to step away from caregiving, a Senior Living Advisor can help you explore home care options and connect you with local providers at no cost to your family.
A Place for Mom doesn’t refer to hospice agencies or providers.
Not necessarily. Continuous home care doesn’t have to be 24 hours a day — it can be provided for a minimum of eight out of every 24 hours, with at least four of those hours provided by medical professionals.
Medicare usually covers continuous home care if hospice eligibility criteria are met, including a doctor’s certification and a documented medical crisis requiring at least eight hours of care.
A hospice physician and care team determine when continuous care is needed and when it can end, based on whether acute symptoms are stabilized.
Families can request an evaluation, but a doctor must prescribe continuous home care, and the hospice provider must confirm that eligibility requirements are met.
U.S. Centers for Medicare and Medicaid Services. Hospice levels of care. Medicare.gov.
U.S. Centers for Medicare and Medicaid Services. (2003, February). Program memorandum intermediaries: Continuous home care under Medicare hospice.
Centers for Medicare and Medicaid Services. (2025, July 31). Pub 100-04 Medicare Claims Processing.
United States Census Bureau. (2024, April 18). Dual health insurance coverage declining for adults age 65 and over.
U.S. Centers for Medicare and Medicaid Services. Hospice benefits. Medicaid.gov.
U.S. Department of Veterans Affairs. (2026, March 6). Geriatrics and extended care.
U.S. Centers for Medicare and Medicaid Services. (2026, March). Medicare hospice benefits. Medicare.gov.
CGS. (2021, December 8). Continuous home care.
U.S. Centers for Medicare and Medicaid Services. (2023, December 6). Pub 100-02 Medicare Benefit Policy.
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