How hospice and the Act fit together
Medicare hospice and Oregon's Death with Dignity Act are separate. Hospice is a Medicare Part A benefit for people with a life expectancy of six months or less who choose comfort care. The Act (ORS 127.800 to 127.897) lets a capable adult with a terminal illness expected to cause death within six months request a prescription for medication they take themselves. Many patients qualify for both, and OHA's numbers show most people who use the Act are in hospice when they die.
What Medicare pays for
| Service | Medicare pays? |
|---|---|
| Hospice nursing, aides, equipment, symptom drugs, family support | Yes, under the hospice benefit |
| Pain relief, even if it may increase the risk of death | Yes (42 U.S.C. 14402(b)) |
| The Death with Dignity medication and visits whose purpose is the request | No (42 U.S.C. 14402(a)) |
The federal Assisted Suicide Funding Restriction Act applies to Medicare and Medicare Advantage alike, so no Medicare plan can pay for the medication.
Hospice policies vary
Oregon law doesn't require any provider to participate. Under ORS 127.885, a hospital, hospice or other provider can bar its staff from participating on its premises or within their employment, as long as it notified them in writing. Even then, staff may give information about the Act and referrals when a patient asks. OHA notes that some health systems prohibit participation, so policies differ from one hospice to another. Because of that:
- Ask before you enroll. Request the hospice's written Death with Dignity policy.
- Tell your attending doctor. The Act requires an attending and a consulting physician; your hospice doctor may or may not take that role.
- Know you can change hospices. Medicare lets you change hospice providers once per benefit period.
- Keep your POLST current. It tells emergency crews what treatment you want.
Timing
The Act requires two oral requests at least 15 days apart and a written request with two witnesses, then a 48-hour wait before the prescription. Since 2020, a patient expected to die sooner is exempt from a waiting period longer than their life expectancy. For Medicare hospice questions, call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). More in our guide to Death with Dignity and Medicare.
Related questions
Does Medicare pay for Death with Dignity?
What federal law says.
Does Medicare cover hospice in Oregon?
Costs and benefit periods.
What is a POLST form in Oregon?
Medical orders that travel with you.
Sources
- Oregon Health Authority — Death with Dignity Act FAQs
- Oregon Health Authority — Death with Dignity Act prescriptions continued to rise in 2025
- ORS 127.885 — Immunities; provider participation
- 42 U.S.C. 14402 — Restriction on use of federal funds
- Medicare.gov — Hospice care
More questions in this guide
- Does Medicare cover hospice care in Oregon?
- Does Medicare pay for Death with Dignity in Oregon?
- How do I make an advance directive in Oregon?
- What is a POLST form in Oregon?
Part of the guide: End-of-Life Medicare in Oregon · All questions
Frequently asked questions
Can my hospice refuse to take part?
Yes. Participation is voluntary for doctors and health care providers, and a provider may bar participation on its premises if it has given written notice of its policy (ORS 127.885).
Will my hospice discharge me if I make a request?
Medicare hospice eligibility depends on your terminal prognosis and choice of comfort care. Ask the hospice for its written policy before you enroll.
Can a hospice nurse give me the medication?
No. Under the Act, the patient takes the medication; OHA notes that the patient, not the doctor, administers it.
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