Palliative Care vs Hospice: How They Differ

Palliative care can begin at any stage alongside treatment; hospice is comfort care under a terminal prognosis. Learn how each works and who pays.

Updated 2026

This guide is informational and is not medical advice.

Category: choosing-care · Updated 2026

Both palliative care and hospice put comfort and quality of life first, which is why people mix them up. Two things separate them: when they start and what they intend. Palliative care can begin at any point in a serious illness and may continue alongside treatment aimed at a cure. Hospice begins after a physician certifies a terminal prognosis—typically 6 months or less if the disease follows its expected course—and the goal becomes comfort rather than curing that illness. One is not better than the other; they fit different phases.

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

Palliative care: comfort at any stage

Palliative care is specialized medical care for people living with serious illness. It treats pain and symptoms, helps with decisions, and coordinates the many pieces of care. It is not limited to the end of life and does not require giving up treatment. A person can receive it while still pursuing cure-directed care. It may be delivered in a hospital, a clinic, or at home, usually by a team that can include doctors, nurses, social workers, and chaplains.

Hospice: a defined benefit tied to a prognosis

Hospice is a defined benefit for people with a terminal illness. Under the Medicare hospice benefit, a physician certifies a prognosis of 6 months or less if the illness runs its normal course, and the person elects hospice. 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 stays eligible and is recertified. A person may revoke the hospice election and return to standard Medicare coverage at any time.

The central 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

The choice is not permanent

Palliative care can shift into hospice as an illness advances. A person may also leave hospice if their condition improves or they want to resume treatment. These decisions should involve the physician, the person, and the family, and should reflect the person's goals. Palliative care teams are often the best resource for those conversations.

How hospice works with facility care

Hospice can be provided in a nursing home, an assisted living community, or the person's home, with the hospice team coordinating with facility staff. Medicare structures payment so that hospice covers the terminal illness while the facility may bill for room and board, depending on the setting and payer. Before signing, ask both the hospice and the facility how billing and care coordination work. If the person lives 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.

Related guides

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 prioritizes comfort, so medications for symptom relief continue. Drugs 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 may revoke the hospice election at any time and return to standard Medicare coverage. To re-enroll later, 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. 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—heart failure, advanced lung disease, dementia, and kidney failure among them—when a physician certifies that the prognosis criteria are met.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is provided for information and is not medical advice. Processing date: 2026-10-06.

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