If you are wondering whether it is time for hospice, you are not alone. This guide explains hospice eligibility in Texas in clear terms, gives you a simple checklist to use with your doctor, and answers common coverage questions. You will also find local next steps for families in Dallas County, Collin County, and Tarrant County.

Who Qualifies for Hospice in Texas

You qualify for hospice when comfort becomes the priority and a physician believes life expectancy is about six months if the illness follows its usual course. Medicare lists three core requirements: a doctor certifies terminal illness, you choose comfort-focused care, and you sign an election for hospice instead of curative treatment for the terminal condition. You can continue receiving hospice beyond six months if you remain eligible during recertifications. For details, see the Medicare Hospice Benefit

In Texas, Medicaid follows the same six-month prognosis standard and requires the hospice election to be documented for program participation. Texas Health and Human Services

A Simple Hospice Eligibility Checklist

Use this checklist as a conversation starter with your physician or our care team. If several items are true, it is time to ask for a hospice evaluation.

Clinical signs you may notice

• Two or more unplanned hospital or ER visits in the last three months.
• Increasing weakness or fatigue that limits time out of bed or chair.
• Unintentional weight loss or appetite changes over recent months.
• Progressive shortness of breath, frequent pneumonias, or oxygen needs. vnatexas.org
• Worsening confusion or decline in thinking and memory.
• More help needed with daily activities such as bathing, dressing, or walking. Southern Legacy Hospice

Care goals you may feel

• You prefer to avoid more hospital stays and focus on comfort at home. Texas Health and Human Services
• Treatments meant to cure the disease are no longer helping or are too hard to tolerate. Medicare

What a physician must confirm

• A terminal illness with a prognosis of about six months if the disease runs its normal course.
• Your decision to elect hospice for the terminal illness and related conditions.
  

If this sounds like your situation, you do not have to wait for a doctor to suggest hospice. You can call us for a same-day conversation and a prompt eligibility review.

Conditions Commonly Referred to Hospice

Hospice is not only for cancer. Many serious illnesses meet criteria when they progress despite treatment:

• Advanced heart or lung disease with frequent exacerbations, oxygen dependence, or limited activity.
• Dementia with significant dependence in daily activities or rapid functional decline.
• End-stage kidney or liver disease when curative options are not chosen or no longer possible.
• Neurological illnesses such as ALS or advanced Parkinson’s with increasing weakness and swallowing issues.

Your diagnosis matters, but the overall pattern of decline and goals of care matter just as much. That is why tailored assessments are important.

What Happens After you Qualify

Once you choose hospice, your team creates a plan that fits your home and routine.

• Nursing and nurse practitioner visits manage pain, breathing, nausea, and anxiety.
• CNA visits help with bathing and personal care to preserve comfort and dignity.
• Social work and chaplain support guide family conversations and emotional or spiritual needs.
• Medications, equipment, and supplies related to the terminal diagnosis are arranged and delivered.
• After-hours support is available every night, weekend, and holiday.
  

You can receive care at home, in assisted living, in a nursing facility, or in a contracted inpatient setting if symptoms require 24-hour management.

Timing Matters: Why Earlier Referrals Help

Families who start hospice at the first signs of decline often see better comfort, fewer ER trips, and more time together. Starting earlier gives you time to adjust medications gently, deliver equipment before a crisis, and introduce your care team so you know who to call at 2 a.m. If you are unsure, you can begin with an evaluation. There is no penalty for asking questions.

How Coverage Works

Medicare, Medicaid, and most private plans cover hospice services when eligibility is met. Covered items typically include clinical visits, home health aide support, medications related to the terminal illness, and medical equipment and supplies. You may continue to see your primary doctor for unrelated conditions, and you can disenroll from hospice if goals change. Review the program details at the Medicare Hospice Benefit and ask your care team to explain any potential out-of-pocket costs before you begin.

North Texas Hospice Support for Families

If several checklist items fit your situation, request a hospice evaluation in North Texas today; families in Dallas County, Collin County, and Tarrant County can speak with our compassionate care team who will review symptoms, coordinate with your physician, and schedule a visit that works for you; call (469) 625-0705 now or use our contact form if you prefer to message us first.