End-of-life care quality varies dramatically depending on how cancer patients navigate Medicare's complex insurance landscape, revealing significant disparities in hospice access that could affect millions of aging Americans. This finding challenges assumptions about care continuity in our fragmented healthcare system and highlights how administrative decisions can profoundly impact final months of life. Analysis of nearly 200,000 cancer patients who died between 2010-2020 revealed distinct hospice utilization patterns based on Medicare plan switching behaviors. Patients maintaining continuous traditional Medicare showed different hospice enrollment rates and care settings compared to those switching between Medicare Advantage and traditional plans. The research tracked five switching patterns: continuous Medicare Advantage, continuous traditional Medicare, Medicare Advantage to traditional, traditional to Medicare Advantage, and multiple switches. Each pattern correlated with different hospice enrollment timing, total length of stay, and final care locations including home, nursing facilities, or dedicated hospice centers. These differences emerge because hospice represents an excluded benefit under Medicare Advantage plans, requiring coverage through traditional Medicare instead. This regulatory structure creates potential care coordination challenges when patients switch plans during critical end-of-life periods. The findings illuminate broader systemic issues about care fragmentation in American healthcare, particularly as Medicare Advantage enrollment continues expanding. For health-conscious adults planning long-term care strategies, this research underscores the importance of understanding how insurance choices made years earlier can influence final care options. The study represents observational research tracking administrative patterns rather than controlled interventions, limiting causal interpretations but providing valuable real-world evidence about policy impacts on vulnerable populations.