Hospice vs Palliative Care: Understanding the Difference

Palliative care can be provided at any stage alongside treatment; hospice is comfort care for a terminal prognosis. Learn how each works and is paid for.

Category: choosing-care · Updated 2026

Palliative care and hospice both focus on comfort and quality of life, which is why they get mixed up. The difference is timing and intent. Palliative care can start at any point in a serious illness and can be provided alongside curative treatment. Hospice begins when a physician certifies a terminal prognosis, generally 6 months or less if the illness runs its normal course, and the focus shifts to comfort rather than curing the terminal illness. One is not better than the other; they fit different stages.

This guide explains how each works, who pays, and how families decide.

Palliative care: comfort at any stage

Palliative care is specialized medical care for people with serious illness. It treats pain and symptoms, supports decision-making, and coordinates care. It is not limited to end-of-life situations and does not require giving up treatment. You can receive palliative care while pursuing cure-directed care. It may be offered in a hospital, clinic, or at home, and it is often delivered by a team that can include physicians, nurses, social workers, and chaplains.

Hospice: a specific benefit with a prognosis

Hospice is a defined benefit for people with a terminal illness. Under the Medicare hospice benefit, a physician certifies that the person has a prognosis of 6 months or less if the illness runs its normal course, and the person elects hospice care. Medicare.gov describes the benefit at Hospice Care. The hospice team provides nursing, aide services, medical equipment, medications for symptom control, and emotional and spiritual support.

Two 90-day benefit periods follow, then an unlimited number of 60-day periods, as long as the person remains eligible and recertified. A person can revoke the hospice election and return to standard Medicare coverage at any time.

The key differences

Question	Palliative care	Hospice
When can it start?	At any stage of serious illness	Terminal prognosis, generally 6 months or less
Can it combine with cure-directed care?	Yes	Focus shifts to comfort for the terminal illness
Where is it provided?	Hospital, clinic, home, facility	Home, facility, or inpatient hospice
Who pays?	Often covered by insurance and Medicare Part B	Medicare hospice benefit, Medicaid, or private insurance

You do not have to choose one forever

Palliative care can transition into hospice when the illness advances. A person can also leave hospice if their condition improves or they want to resume treatment. Decisions should involve the physician, the person, and the family, and they should reflect the person's goals. Palliative care teams are often the best resource for these conversations.

How hospice interacts with facility care

Hospice can be delivered in a nursing home, assisted living community, or the person's home. The hospice team coordinates with facility staff. Medicare payment is structured so hospice pays for the terminal illness while the facility may bill for room and board, depending on the setting and payer. Ask both the hospice and the facility how billing and care coordination work before signing. If the person is in a nursing home, our guide Planning a Move to a Care Facility covers the practical side.

Sources: Medicare.gov hospice care; National Institute on Aging, palliative and hospice care; CMS hospice quality.

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Frequently asked questions

Can you receive palliative care and hospice at the same time?

Once a person elects the Medicare hospice benefit, hospice takes over care for the terminal illness, so the two are not billed together in the usual way. Palliative teams may still be involved in some settings. Ask the hospice and the physician how coordination works.

Does hospice mean the person stops all medications?

No. Hospice focuses on comfort, so medications for symptom relief continue. Medications aimed at curing the terminal illness may be stopped or reduced after discussion. The hospice team and physician decide with the family.

Can someone leave hospice?

Yes. A person can revoke the hospice election at any time and return to standard Medicare coverage. If they later want hospice again, they must be recertified as eligible.

Does Medicare pay for palliative care?

Many palliative services are covered under Medicare Part B when medically necessary, depending on the services and setting. Coverage details vary, so check Medicare.gov and the provider's billing office.

Is hospice only for cancer?

No. Hospice serves people with many terminal illnesses, including heart failure, advanced lung disease, dementia, and kidney failure, when a physician certifies the prognosis criteria are met.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is informational and is not medical advice. Processing date: 2026-10-05.

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