My grandmother died at home recently, surrounded by her family and loving caregivers with the support of a hospice team. It was exactly how she pictured the end of her life, and it cost our family $145,613.79.

Many people envision their final days like my grandmother did, being comfortable at home surrounded by friends and family. A recent Kaiser Family Foundation (KFF) poll found that 71% of Americans would prefer to die at home. And over the last 20 years, the number of people using Medicare’s hospice benefit has more than doubled.

What a lot of people don’t know is that dying at home can cost a small fortune.

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For this reason, dying at home is often unattainable for many, unless they have family members who are willing to give up their own lives to be caregivers or the patient is willing to spend down their life savings to qualify for Medicaid to pay for around-the-clock help. Currently, Medicare only covers an average of two hours per day, five days a week, of home health aide coverage for a patient in hospice care. This is not sufficient time to meet basic care needs for someone seriously ill, let alone provide necessary supports at the end of life.

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