Hospice Care: TRICARE Benefits, Costs, and Rules (2026) | TRICARE.com

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## Definition TRICARE hospice care is a specialized program designed to provide palliative care and support for terminally ill beneficiaries with a life expectancy of six months or less, focusing on comfort and quality of life rather than curative treatment.

## What it means in practice When a TRICARE beneficiary is diagnosed with a terminal illness, they can elect to receive the hospice benefit. To qualify, a physician must certify that the patient has a life expectancy of six months or less if the disease runs its normal course. Once hospice is elected, the beneficiary waives their right to TRICARE benefits for curative treatment of the terminal condition, though they can still receive TRICARE coverage for unrelated medical issues.

The benefit is comprehensive and typically provided in the patient's home, though it can occur in a hospice facility or hospital. Coverage includes nursing care, medical social services, counseling, dietary services, and physical or occupational therapy. It also covers medical supplies and durable medical equipment (DME). For medications specifically related to symptom management and pain relief for the terminal illness, beneficiaries pay a 5% cost-share, not to exceed $5.00 per prescription (2026 rates).

One of the most critical components of the TRICARE hospice benefit is **respite care**. This allows the primary caregiver (usually a family member) to take a break while the patient is cared for in an inpatient setting for up to five consecutive days. For respite care, beneficiaries are responsible for a 5% cost-share of the TRICARE-allowed rate for the level of care provided, up to the annual catastrophic cap.

TRICARE follows the Medicare hospice model, which is structured into three election periods: two 90-day periods followed by an unlimited number of 60-day periods. At the start of each period, a physician must re-certify the terminal prognosis. Beneficiaries have the right to revoke the hospice election at any time to resume curative treatment, and they may re-elect the benefit later if they still meet eligibility requirements.

## Related terms * **Palliative Care:** Medical care focused on providing relief from the symptoms and stress of a serious illness, which can be provided alongside curative treatment. * **Catastrophic Cap:** The maximum out-of-pocket amount a beneficiary pays for covered services each calendar year. * **Durable Medical Equipment (DME):** Reusable medical tools like hospital beds or oxygen tanks that TRICARE covers when medically necessary. * **Cost-Share:** The percentage of the total cost of a covered health care service that the beneficiary pays after the deductible is met. * **T-5 Contract:** The current TRICARE managed care contract (effective 2025) which transitioned West Region administration to TriWest Healthcare Alliance.

## Sources * TRICARE.mil: Hospice Care [https://www.tricare.mil/hospice] * TRICARE Policy Manual: Chapter 9, Section 1.1 (Hospice Program) [https://manuals.health.mil/] * Humana Military (East Region Provider): Hospice Services [https://www.humanamilitary.com/]