When a family is considering home hospice, one of the first questions is often the most personal: “Can we keep our doctor?” That question is rarely about paperwork. It’s about trust. It’s about the comfort of a familiar voice, the sense that someone who knows the whole medical story will still be involved, and the fear that choosing hospice means being “handed off” to strangers.
The good news is that Medicare does allow you to keep seeing your regular doctor in hospice under a specific role. On the official Medicare hospice coverage page, Medicare states that you can still see your regular doctor or nurse practitioner if you’ve chosen them to be the attending medical professional who helps supervise your hospice care. At the same time, Medicare also makes clear that once hospice begins, care for the terminal illness must be given by or arranged by the hospice team, or you may be responsible for the full cost. That is where most confusion—and unnecessary stress—comes from.
This article is a plain-English guide to what an attending physician is in hospice, how that role works alongside the hospice medical team, what you can realistically expect from your current doctor, and what to ask so your family can make the choice without guessing.
The Quick Answer: Yes, You Can Often Keep Your Doctor, But the Role Has a Name
In hospice, keeping your current doctor usually means naming them as the attending physician (or attending medical professional) for the hospice episode of care. This is not required, but it is an option, and it’s often the bridge that helps families feel safer during a transition to comfort-focused care.
Medicare’s own wording matters here. Medicare says you can still see your regular doctor or nurse practitioner if you’ve chosen them to be the attending medical professional who helps supervise your hospice care.
So the central question becomes less “Are we allowed?” and more “Is our doctor willing and able to serve in that role in a way that helps the patient and supports the hospice plan?”
What “Attending Physician” Means in Hospice
Families often hear “attending physician” and picture a hospital attending who makes daily rounds. Hospice uses the term differently. The federal hospice regulations define attending physician as a doctor of medicine or osteopathy, or (in hospice) a nurse practitioner or physician assistant, who is identified by the individual at the time they elect hospice care as having the most significant role in the determination and delivery of the individual’s medical care.
That definition explains two things families should know. First, an attending in hospice is chosen by the patient (or representative). Second, the role is about medical leadership and collaboration, not about replacing the hospice team.
If you do not choose an attending physician, hospice still functions. The hospice medical director and hospice physician coverage remain part of the program. Choosing an attending physician simply means your existing clinician remains a formal part of the hospice medical picture, rather than being a background voice the family calls informally.
How Your Doctor Fits Beside the Hospice Team
Hospice is team-based by design. CMS describes hospice care as being delivered under an individualized written plan of care and emphasizes that the hospice interdisciplinary group establishes that plan of care together with the attending physician (if any), the patient or representative, and the primary caregiver.
In practice, that means if your loved one has an attending physician, hospice should coordinate with them, not work around them. It also means the hospice team is still responsible for organizing care related to the hospice diagnosis. Even when your doctor remains involved, hospice remains the hub.
This is the part families often need to hear clearly: keeping your doctor does not mean hospice becomes optional. Medicare states that after hospice starts, all care you get for your terminal illness must be given by or arranged by the hospice team, and if you go outside that coordination, you may have to pay the entire cost.
What Your Attending Physician Typically Does in Hospice
What “keeping your doctor” looks like varies by clinician and practice, but it often includes these functions when the doctor agrees to participate:
- Clinical continuity by sharing history and context that can improve symptom management decisions.
- Care collaboration with the hospice medical director and nurses when the plan of care is developed and updated.
- Medication and order input for comfort-focused care, often communicated through the hospice nurse rather than through frequent office visits.
- Decision support for the family when goals-of-care questions arise, especially if the doctor has a long relationship with the patient.
What families sometimes expect—but should clarify—is how often the doctor will actually see the patient. Many primary care doctors do not do home visits, and some do not have the schedule flexibility to participate in frequent symptom calls. That does not mean they can’t remain the attending physician, but it does mean the hospice physician and nurses may handle most of the day-to-day adjustments.
If the idea of “more people in the home” feels overwhelming, it may help to understand another support role families sometimes add: an end-of-life doula. Funeral.com’s guide End-of-Life Doulas: What They Do, How They Work with Hospice, and Questions to Ask Before Hiring explains how doulas complement hospice without replacing medical care.
What Your Attending Physician Usually Does Not Do
Some misunderstandings come from assuming the attending physician will “run hospice.” Typically, they do not. Hospice care is structured so the hospice provider coordinates care related to the terminal illness. Medicare’s hospice page is explicit that you must get hospice care from the hospice provider you chose, and that all care for the terminal illness must be given by or arranged by the hospice team.
This is also why families sometimes feel surprised if a long-time specialist suddenly becomes less central. In hospice, the goal is comfort and symptom relief, and care is consolidated to reduce fragmentation. A specialist may still be consulted, but hospice remains the coordinator.
The Billing and Coverage Reality: “Related” Versus “Unrelated” Care
Another reason families ask about keeping their doctor is fear of losing access to medical care. Medicare’s framework here is specific. Once hospice begins, the hospice benefit covers care related to the terminal illness and related conditions. Medicare also states that Original Medicare will still pay for covered benefits for health problems that aren’t part of the terminal illness and related conditions, but deductibles and coinsurance apply.
In plain language, a person on hospice may still see a doctor for something that is clearly unrelated to the hospice diagnosis, and that care may still be covered under standard Medicare rules. The part that causes trouble is when a visit, test, or hospital trip is related to the terminal illness and happens outside hospice coordination. Medicare warns that outpatient hospital care, inpatient hospital care, and ambulance transportation may not be covered unless arranged by the hospice team or unrelated to the terminal illness and related conditions.
This is why a practical habit matters more than perfect knowledge: before scheduling a visit or going to the ER for a symptom that could be hospice-related, call hospice. Coordination protects both comfort and finances.
One Important Update: Medicare Enrollment for Certifying Physicians
If your family is relying on a specific physician to sign hospice certifications or recertifications, there is a Medicare compliance detail worth knowing. CMS has stated that as of June 3, 2024, Medicare pays for hospice services only if certifying physicians—including hospice physicians and hospice attending physicians—are enrolled in Medicare or have validly opted out.
This does not mean your doctor cannot remain involved if they are not a certifying physician, but it does mean hospice may need to confirm enrollment/opt-out status if your doctor will be part of certification. The hospice team typically manages this in the background, but families often feel calmer when they understand why hospice is asking for specific physician information.
How Families Decide Whether to Keep the Current Doctor as Attending
In real families, the decision is less about policy and more about fit. Keeping your doctor as attending is often a good idea when the doctor knows the patient well, is comfortable collaborating with hospice, and is willing to participate in a comfort-focused plan without pulling the care back toward fragmented, cure-focused interventions that no longer match goals.
Keeping your doctor can be harder when the doctor’s practice model doesn’t support hospice collaboration—no time for calls, no experience with hospice symptom protocols, reluctance to shift from disease-directed treatment to comfort goals, or a tendency to send the patient to the hospital for symptoms hospice could manage at home. None of that means the doctor is “bad.” It means the system may not be designed for this phase.
If you’re unsure, the most useful question is one you can ask kindly and directly: “If we choose hospice, would you be willing to be the attending physician and collaborate with the hospice team on the plan of care?” The answer usually reveals whether keeping the doctor will reduce stress or increase it.
What to Ask Hospice and the Doctor Before You Decide
Families feel most stable when expectations are explicit. If you want to avoid misunderstandings, ask a few practical questions up front—without apologizing for asking.
- Will our doctor serve as the attending physician in hospice, and will that be documented in the hospice election paperwork?
- How will hospice communicate with the attending physician—phone, fax orders, shared portal, scheduled updates?
- For symptom changes at night, who should we call first: hospice, the attending physician, or both?
- If our loved one needs a hospital-level intervention, how will hospice coordinate that so we avoid coverage problems? Medicare.gov
- If the attending physician is asked to certify hospice eligibility, is their Medicare enrollment/opt-out status confirmed? CMS
These questions are not about being difficult. They are about preventing the scenario families fear most: being told “someone should have arranged this” in the middle of a crisis.
If Family Conflict Is Part of the Picture, Documents Matter
When families disagree about hospice, the disagreement is often not about the care team. It is about values—what the patient would want, how much suffering is acceptable, and what “doing everything” means. This is why advance directives and a clearly named decision-maker can protect everyone, including the attending physician and the hospice team.
If your family is trying to make wishes clearer before emergencies force decisions, Funeral.com’s guide Advance Directives and Living Wills: Making Medical Wishes Clear Before the End of Life is a practical starting point, and Talking About End-of-Life Wishes with Family can help reduce conflict during hard conversations.
Planning for the “After” Doesn’t Rush Anything
Even when hospice is focused on living as well as possible right now, families often feel less anxious when a few practical pieces are in place. That might mean organizing essential documents and contacts so nothing becomes a scavenger hunt in grief. Funeral.com’s Important Papers to Organize Before and After a Death is designed for that reality.
If your loved one hopes to die at home, it can also be stabilizing to know what happens when death occurs at home under hospice care. Funeral.com’s guide What to Do When Someone Dies at Home explains expected and unexpected scenarios and the first calls families typically make.
And when families begin thinking about memorial choices, cremation planning often becomes part of the conversation. Some families later choose a home memorial using cremation urns for ashes, while others find comfort in shared memorial options like keepsake urns or discreet tributes such as cremation jewelry. Those are not decisions you have to finalize now. But having a gentle direction can ease future pressure.
A Plain-English Summary
Yes, you can often keep your current doctor on hospice—by choosing them as your attending physician. Medicare explicitly states you can still see your regular doctor or nurse practitioner if you’ve chosen them to be the attending medical professional who helps supervise your hospice care.
At the same time, hospice is still the coordinator of care for the terminal illness. Medicare warns that once hospice begins, all care for the terminal illness must be given by or arranged by the hospice team, or you may be responsible for the cost.
The decision is best made with two practical checks. First, confirm your doctor is willing and able to collaborate with hospice in a comfort-focused plan. Second, ask hospice to explain exactly how communication, ordering, and coverage coordination will work in your situation. When those pieces are clear, “keeping your doctor” becomes what families hope it will be: continuity, not confusion.
