Hospice vs. Palliative Care: What's the Difference?

When a loved one is diagnosed with a serious illness, navigating the healthcare system can feel overwhelming. Two terms that are often used interchangeably—but mean very different things—are hospice care and palliative care.

The short answer: All hospice care is a form of palliative care, but not all palliative care is hospice. Palliative care provides comfort and symptom relief while a patient continues to seek curative treatments. Hospice care also provides comfort, but it is specifically for patients who are nearing the end of life and have chosen to stop curative treatments.

Understanding the difference between palliative and hospice care is crucial for making the right medical, financial, and emotional decisions for your family.

The Main Difference: Curative Treatment

The most significant distinction between these two types of care comes down to the goal of the patient's medical treatment.

Palliative Care (Comfort + Cure)

Palliative care focuses on improving the quality of life for anyone facing a serious, chronic, or life-threatening illness.

• The Goal: To manage pain, alleviate symptoms (like nausea, shortness of breath, or fatigue), and reduce the stress of the illness.
• The Treatment: You can receive palliative care at the same time you are receiving treatments meant to cure your illness. For example, a cancer patient can receive chemotherapy to fight the cancer while simultaneously receiving palliative care to manage the side effects of the chemo.

Hospice Care (Comfort Only)

Hospice care is a highly specialized form of palliative care designed specifically for the end of life.

• The Goal: To ensure the patient is as comfortable, pain-free, and peaceful as possible during their final months.
• The Treatment: When a patient enters hospice, they forgo curative treatments for their terminal illness. The medical focus shifts entirely from curing the disease to maximizing the quality of the time remaining.

Eligibility and Timing

When can a patient start receiving these services? The timeline and eligibility requirements differ significantly.

• When to start Palliative Care: Palliative care can begin at any stage of a serious illness—right from the moment of diagnosis. You do not need a terminal prognosis to qualify. According to the National Institute on Aging (NIA), early integration of palliative care can actually prolong life and improve mental health.
• When to start Hospice Care: Hospice is reserved for patients who are terminally ill. To qualify, a doctor must certify that the patient has a life expectancy of six months or less if the disease runs its normal course.

Where is Care Provided?

A common misconception is that hospice or palliative care are physical places you go to. In reality, both are services that come to the patient.

• Palliative Care Locations: Often provided in hospitals, outpatient clinics, or specialized cancer centers. It can also be provided in the home or a skilled nursing facility.
• Hospice Care Locations: The vast majority of hospice care is provided wherever the patient calls home. This could be a private residence, an assisted living facility, or a nursing home. In cases of severe symptom crisis, short-term inpatient hospice care may be provided in a hospital or dedicated hospice facility.

Medicare Coverage Differences

Understanding how to pay for care is one of the biggest sources of anxiety for families. Fortunately, Medicare provides coverage for both, but under different parts of the program.

Does Medicare Cover Palliative Care?

Yes, but it is treated like standard medical care. Palliative care consultations and treatments are typically covered under Medicare Part B.

• This means you will still be responsible for standard copayments, deductibles, and coinsurance, just as you would for a regular visit to a specialist.
• Prescription medications for symptom management are covered under your Medicare Part D plan.

Does Medicare Cover Hospice?

Yes. The Medicare Hospice Benefit is incredibly comprehensive. If you meet the eligibility criteria (a prognosis of 6 months or less), hospice is covered 100% under Medicare Part A.

• This covers everything related to the terminal illness, including nursing care, medical equipment (like hospital beds or wheelchairs), medications for pain and symptom relief, and grief counseling for the family.
• You will pay little to nothing out-of-pocket for hospice care. You can read the official guidelines on Medicare.gov.

When to Switch from Palliative to Hospice

Transitioning from palliative care to hospice is a deeply personal decision made between the patient, their family, and their medical team. It may be time to consider hospice if:

1. Curative treatments (like chemo or dialysis) are no longer working, or the side effects outweigh the benefits.
2. The patient is experiencing frequent trips to the emergency room or repeated hospital admissions.
3. There is a rapid decline in the patient's physical abilities, such as difficulty eating, walking, or performing basic activities of daily living.
4. The patient decides they no longer want to pursue aggressive medical interventions and prefer to focus on comfort at home.

How to Find the Right Provider Near You

Choosing the right care team is one of the most important decisions you will make. Because hospice and palliative care require a deeply compassionate approach, you want to ensure you are working with a highly-rated, Medicare-certified agency.

The National Directory of Post-Acute Providers (NDPAP) makes it easy to find verified, high-quality care in your exact location.

• Search Hospice Providers in Your City
• Search Home Health Agencies in Your City

Our directory allows you to filter by location, services offered, and Medicare acceptance so you can focus on what truly matters: spending quality time with your loved one.

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Frequently Asked Questions

Can you have home health and hospice at the same time?

Generally, no. Medicare will not pay for both home health care and hospice care at the same time if they are treating the same terminal illness. However, if you need home health for a condition completely unrelated to your hospice diagnosis, exceptions can sometimes be made.

Do I have to give up my primary care doctor if I go on hospice?

No. You have the right to choose your attending physician. Your primary care doctor can work directly with the hospice medical director and nursing team to oversee your care plan.

What happens if a hospice patient lives longer than 6 months?

Hospice care does not automatically end after six months. As long as the hospice medical director continues to certify that the patient remains terminally ill, Medicare will continue to pay for hospice services indefinitely.

(For more answers to common questions about finding post-acute care, visit our FAQ page. Are you a provider looking to update your information? Claim your listing here.)