When a loved one is dealing with a serious or advanced chronic illness, families often hear terms like Palliative Care and Hospice Care. While both focus on providing comfort, pain management, and holistic support, they are not the same service. Knowing the differences is crucial for ensuring the individual receives the right care at the right time.
This post breaks down the key distinctions between Palliative Care and Hospice based on their focus, timing, and coverage.
Palliative Care vs. Hospice: A Core Difference
The most important distinction between the two services is when they are introduced and whether the patient is still pursuing curative treatment.
| Question | Palliative Care | Hospice Care |
| Focus | Works together with primary, curative, or disease-modifying treatment. It is an adjunct service. | Focuses on comfort, pain, and symptom management when curative treatments are no longer beneficial (or the burden outweighs the benefit). |
| Eligibility Timing | Any individual with a serious illness, regardless of age, life expectancy, or prognosis. It is not time-limited. | Individuals with a serious illness and a terminal prognosis, typically a life expectancy of six months or less if the disease runs its natural course. |
| Curative Treatment | Yes, the patient can continue to receive curative or disease-modifying treatments. | No, the goal shifts entirely to comfort and symptom management. |
Palliative care is not hospice care. Palliative care can be provided far “upstream” of a terminal prognosis and does not require the patient to stop receiving primary treatment.
Services and Providers
Both types of care provide comprehensive support, but the size of the team and the included services can differ.
What Services Are Provided?
Both services manage pain and other symptoms, including psychosocial or spiritual/existential distress.
- Palliative Care offers help navigating treatment options, advance care planning, and referrals to community resources.
- Hospice Care includes a broader set of services, such as 24-hour on-call service, medical equipment, related medications, volunteer services, bereavement and counseling services, and four levels of care (routine, inpatient, continuous, and respite care).
Who Provides the Services?
Palliative Care is typically provided by a physician, nurse practitioner, or nurse, often with consultative support from a social worker and chaplaincy services.
Hospice Care is provided by a more robust interdisciplinary team led by a physician, and includes nurses, social workers, chaplains, volunteers, hospice aides, and therapy disciplines.
Where Are Services Provided?
Both Palliative Care and Hospice Care can be provided in a wide range of settings, including the patient’s home, a hospital, a Skilled Nursing Facility, an Assisted Living Facility, or a Long-term Care Facility. Hospice care may also be provided in a dedicated Hospice facility
Duration and Payment
The way an individual receives and pays for care is another major difference.
How Long Can Services Be Received?
- Palliative Care is not time-limited. How long an individual receives care depends on their needs and insurance coverage (Medicare, Medicaid, or private insurance).
- Hospice Care is measured in months, not years. Care continues as long as the individual meets the criteria for a terminal prognosis set by Medicare, Medicaid, or their private insurer
Does Insurance Pay?
Medicare/Medicaid/Private Insurance generally cover Palliative Care (often through Medicare Part B), though some treatments and medications may not be covered, and copays may apply.
The Medicare Hospice Benefit pays for all related costs associated with the care related to the terminal prognosis. Medicaid in most states also covers all related costs. Most private insurers also have a hospice benefit that covers related costs.
When Should I Refer?
Understanding the appropriate time for each service is key to optimizing patient and family well-being
| Palliative Care Referral | Hospice Care Referral |
| For patients with serious or advanced chronic illness who have burdensome symptoms or whose caregivers are distressed. | If you would not be surprised if this patient died within the next 12 months, they are likely appropriate for hospice. |
| When the patient may have received maximum medical therapy and is at risk of using the hospital for decompensation. | When a patient has received maximum therapy, and the focus has shifted to symptom management and comfort care. |
Source: Debbie Crause (CSA in training)
We hope this information is helpful to you in the important work you do as a family caregiver.
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