When someone you love has a serious illness, you will probably hear the words "palliative care" and "hospice." They're related, and both focus on comfort and quality of life, but they are not the same thing. Understanding the difference can open doors to support that many families wish they had asked about sooner.
Palliative care vs. hospice: the short version
The National Institute on Aging explains that hospice is a specific kind of palliative care. Palliative care is for anyone with a serious illness, at any age and any stage. Hospice is for people near the end of life, when doctors expect six months or less if the illness follows its usual course.
| Palliative care | Hospice care | |
|---|---|---|
| When it starts | Any time, as early as diagnosis | When life expectancy is about 6 months or less |
| Curative treatment | Can continue alongside it | Stops for the terminal illness; comfort care continues |
| Main goal | Relieve symptoms and stress; support decisions | Comfort, dignity, and support for the person and family at the end of life |
| Where | Hospital, clinic, home, nursing home | Usually at home; also nursing homes, hospice facilities, hospitals |
| Who pays | Regular health coverage, with usual copays | Medicare hospice benefit, Medicaid, most private insurance |
What palliative care does
A palliative care team usually includes specialist doctors and nurses, along with social workers, chaplains, nutritionists, and others. They work with your loved one's regular doctors to manage pain, shortness of breath, nausea, fatigue, anxiety, and other symptoms. They also help families think through hard decisions and plan ahead.
As NIA puts it, "in palliative care, a person does not have to give up treatment that might cure a serious illness." Someone getting chemotherapy or dialysis can receive palliative care at the same time.
Medicare, Medicaid, and private insurance may cover palliative care services, usually under regular medical benefits with the normal deductibles and copays. If no one has suggested it, you can ask your loved one's doctor for a referral.
Who qualifies for the Medicare hospice benefit
According to Medicare.gov, a person qualifies for hospice when all of these are true:
- They have Medicare Part A.
- Their hospice doctor and regular doctor (if they have one) certify that they're terminally ill, with a life expectancy of 6 months or less if the illness runs its normal course.
- They accept comfort care instead of care to cure the illness.
- They sign a statement choosing hospice instead of other Medicare-covered treatment for the terminal illness and related conditions.
Hospice is covered in benefit periods: two 90-day periods, then an unlimited number of 60-day periods. Before each new period, the hospice doctor must recertify that the person is still terminally ill, and after the first six months that requires a face-to-face visit. A person can change hospice providers once per benefit period.
Six months is an estimate, not a deadline. Some people live longer and stay on hospice; some improve and leave it.
What Medicare hospice covers and costs
Hospice care is usually given at home, with a team that may include doctors, nurses, social workers, counselors, hospice aides, homemakers, therapists, and volunteers. Medicare's hospice booklet notes that a hospice nurse and doctor are on call 24 hours a day, 7 days a week. Hospice covers services in the plan of care, including:
- Nursing and doctor services
- Medical equipment such as a hospital bed or wheelchair, and supplies
- Drugs for pain and symptom control
- Hospice aide and homemaker services
- Physical, occupational, and speech therapy
- Social work, dietary counseling, and spiritual and grief counseling for the person and family
- Short-term inpatient care for pain and symptoms that can't be managed at home
- Short-term inpatient respite care so the caregiver can rest
Costs: Medicare.gov says you pay nothing for hospice care from a Medicare-approved provider, with two small exceptions: a copay of up to $5 per prescription for outpatient pain and symptom drugs, and 5% of the Medicare-approved amount for inpatient respite care. Respite stays can last up to 5 days at a time. See respite care.
What hospice doesn't cover
- Treatment meant to cure the terminal illness
- Care from providers the hospice team didn't arrange
- Room and board at home, in a nursing home, or in a hospice residence (except short inpatient or respite stays the hospice arranges)
- Hospital or ambulance care related to the terminal illness unless the hospice team arranges it
Original Medicare still pays for care of health problems unrelated to the terminal illness, with the usual deductibles and coinsurance.
Hospice is not 24-hour caregiving
Families are sometimes surprised that hospice at home doesn't mean a nurse in the house all day. Hospice staff visit and are on call, but family or paid caregivers usually provide most daily care. Ask the hospice what support it offers during a crisis, and plan for help with the rest. See in-home care.
Choosing a hospice and your rights
You can choose which Medicare-approved hospice to use. Medicare lists these rights for hospice patients: choosing home or inpatient care, taking part in the treatment plan, getting effective pain management, refusing treatment, and choosing your own physician.
You can stop hospice at any time. The Medicare hospice booklet says plainly, "You always have the right to stop hospice care at any time." No one should ask your loved one to sign a form stopping hospice unless they asked to stop.
Questions to ask hospice providers:
- How quickly can you start care, and how often will a nurse visit?
- How fast will someone come out at night or on a weekend?
- Which inpatient facility do you use if symptoms can't be managed at home?
- How do you arrange respite for the family?
- What grief support do you offer families, and for how long?
- For veterans: does your team have experience with veterans' needs?
Veterans enrolled in VA health care can also get hospice and palliative care through VA. See VA long-term care.
Starting the conversation
Many families wait too long to ask about hospice, often because it feels like giving up. It isn't. Hospice is a choice about how to spend the time that's left: with less pain, at home if possible, and with more support for everyone.
If you're not sure whether it's time, ask your loved one's doctor directly: "Would you be surprised if Dad died in the next six months?" and "Would hospice or palliative care help him now?" Having an advance directive in place makes these decisions easier for everyone.
If there's an emergency
If your loved one is on hospice and something changes suddenly, call the hospice's 24-hour line first. They can often come to you and avoid an unwanted hospital trip. If you're not on hospice, call 911 for emergencies. For emotional crisis, call or text 988.
Check before you decide
Benefit rules, dollar amounts, and state programs change, and every family's situation is different. This guide is general information, not medical, legal, or financial advice.
- Confirm eligibility and current amounts with the agency itself: Medicare, your state Medicaid office, or the VA.
- For legal documents and Medicaid planning, talk with a licensed elder law attorney in your state.
- For health questions, talk with the person's doctor. In an emergency, call 911.
Common questions
Who qualifies for the Medicare hospice benefit?
A person with Medicare Part A whose hospice doctor and regular doctor (if they have one) certify a life expectancy of 6 months or less if the illness runs its normal course. They must choose comfort care instead of curative treatment for that illness and sign a hospice election statement.
Does choosing hospice mean giving up?
No. Hospice shifts the goal from cure to comfort and quality of life. People can stop hospice at any time and return to treatment aimed at a cure if they're still eligible.
What happens if someone in hospice lives longer than 6 months?
Hospice can continue. After the first two 90-day periods, Medicare allows an unlimited number of 60-day periods as long as the hospice doctor recertifies that the person is terminally ill.
Is palliative care the same as hospice?
No. Palliative care can start at diagnosis and continue alongside curative treatment. Hospice is a type of palliative care for the final months of life, when curative treatment has stopped.
Sources
- Hospice care — Medicare.gov. medicare.gov/coverage/hospice-care
- Medicare Hospice Benefits (booklet) — Medicare.gov. medicare.gov/publications/02154-medicare-hospice-benefits.pdf
- What Are Palliative Care and Hospice Care? — National Institute on Aging. nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care
- Rights & protections — Medicare.gov. medicare.gov/what-medicare-covers/what-part-a-covers/rights-protections-in-a-nursing-home
- Eldercare Locator — Administration for Community Living. eldercare.acl.gov
Last reviewed October 19, 2026. General information only, not medical, legal, or financial advice. Benefit rules and amounts change, so confirm with the agency before you decide. See our disclaimer.