What is the difference between palliative care and hospice?
The two words often come up in the same conversation with a doctor, and they are easy to mix up. Knowing which one is on the table tells you what can carry on alongside it.
Arun Verma, co-founder of Triangle · 2026-10-19
This is not clinical evidence and not medical advice. It does not replace your care team. Discuss anything here with your clinician before you act on it.
What is the difference between palliative care and hospice?
Timing, and whether treatment aimed at a cure goes on. Both put comfort and quality of life first for someone with a serious illness. Palliative care can start as early as diagnosis and run alongside treatment for the illness. Hospice, in NIA's words, is a specific type of palliative care provided in the final weeks or months of life, and in hospice the attempts to cure the illness stop. NIA's comparison table, which it credits to the National Hospice and Palliative Care Organization, puts the split in two lines. Will symptoms be relieved? "Yes, as much as possible" for both. Can treatment to cure the illness continue? "Yes, if you wish" for palliative care, and "No, only symptom relief will be provided" for hospice.
What does palliative care involve?
Care aimed at quality of life, for people with serious illnesses and the people caring for them. It is open to people of any age. Its main elements are managing symptoms well and making sure care is coordinated. The providers work with the person and the family so that the treatment plan reflects the person's goals and values. Using palliative care does not necessarily mean someone is dying. NIA's palliative care FAQ puts that question directly, answers "Not necessarily", and says palliative care can be used at any time after a serious illness is diagnosed.
What does hospice involve?
Comfort care for someone with a serious illness who is approaching the end of life. Medicare.gov calls it end-of-life care for people with illnesses that can't be cured. CMS says it shifts the focus to comfort care for pain relief and symptom management instead of care to cure the illness. Like palliative care, hospice also supports the family. Under Medicare, one of the eligibility conditions is a certification by the hospice doctor and the regular doctor, if there is one, that the person is terminally ill with a life expectancy of 6 months or less.
Can treatment aimed at a cure continue?
In palliative care, yes. A person does not have to give up treatment that might cure a serious illness. In hospice, no: once the hospice benefit starts, Medicare.gov says Medicare won't cover treatment intended to cure the terminal illness and related conditions, or prescription drugs meant to cure it rather than for symptom control or pain relief. Stopping cure-focused treatment is not the same as stopping all treatment. NIA says other medical care may continue as long as it is helpful. For health problems that aren't part of the terminal illness and related conditions, Original Medicare still pays for covered benefits, with the usual deductible and coinsurance.
Who provides each kind of care?
Palliative care usually comes from a specialist team working next to the person's other doctors. NIA describes palliative care specialist doctors and nurses, with others such as social workers, nutritionists and chaplains, and says the team varies with the person's needs. A health care provider may refer the person to a palliative care specialist, and if the provider doesn't suggest it, the person can ask for a referral. Hospice comes from one hospice provider's team. Medicare's hospice booklet says you and your family are part of that team, which may also include doctors, nurses, counselors, social workers, pharmacists, physical and occupational therapists, speech-language pathologists, hospice aides, homemakers and volunteers, with a hospice nurse and doctor on call 24 hours a day, 7 days a week. All care for the terminal illness is given or arranged by the hospice team, and the person's regular doctor or nurse practitioner can stay on as the attending medical professional if chosen for that role.
Where is each one given?
Both can happen at home. Palliative care can also be given in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics. Hospice is an approach to care rather than a place, NIA says, and can be offered at home or in a facility such as a nursing home, a hospital or a separate hospice center. Medicare.gov says hospice care is usually given in the home or other place where the person lives, like an assisted living facility or a nursing home, and in an inpatient hospice facility when certain conditions are met. At home, NIA notes, the day-to-day care comes from family and friends, and the hospice team coaches the family on how to give it.
How does someone move from palliative care to hospice, or back?
NIA describes two paths when the doctor or the palliative care team believes ongoing treatment is no longer helping. Palliative care could move to hospice if the doctor believes the person is likely to die within six months, or the palliative care team could keep helping with more emphasis on comfort care. Before hospice starts, Medicare's booklet says there can be a one-time consultation with a hospice medical director or hospice doctor about care options and managing pain and symptoms, even if hospice is not chosen. The move is not one-way. Choosing hospice does not have to be a permanent decision. The booklet says there is always the right to stop hospice care at any time, and that someone who is eligible can go back to hospice care at any time.
How do coverage and costs differ?
Medicare spells out what hospice pays for, while palliative care coverage depends more on the plan. NIA's main page says Medicare, Medicaid and insurance policies may cover palliative care and private insurance might pay for some services. Its FAQ says most private plans at least partially cover it, and Medicare and Medicaid typically cover most of these services. For hospice from a Medicare-approved provider, Medicare.gov says you pay nothing for hospice care, though other costs may apply. One of them is room and board: Medicare doesn't cover it for hospice care at home or for someone living in a nursing home or a hospice inpatient facility. As of October 1, 2026, CMS says Medicare hospices must give every patient (or their representative) a written hospice election statement addendum listing items, services and drugs the hospice will not cover because they are unrelated to the terminal illness, and explaining how to appeal. Before that date, CMS says hospices only had to provide the addendum when a patient asked for it. Medicare.gov still describes asking the hospice for that list, with reasons, and receiving it within 3-5 days of the request.
What support does each give the family?
Both make room for the family. In hospice, you and your family work with the hospice provider to set up a plan of care. Medicare's booklet says that plan can include nursing care, medical equipment and supplies, drugs for pain and symptom control, social worker services, and grief and loss counseling for you and your family. CMS lists grief and loss counseling for the family before and after the patient's death as part of the benefit. Palliative care also includes bereavement support. If you are in crisis, call or text 988 in the US.
Sources
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says palliative care and hospice care both focus on the comfort, care, and quality of life of individuals with a serious illness.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says hospice care is a specific type of palliative care that is provided in the final weeks or months of life.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says palliative care can start as early as a person's diagnosis or not until later in their illness, and it can occur alongside other types of treatment for the disease.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says that, like palliative care, hospice provides comprehensive comfort care as well as support for the family, but in hospice, attempts to cure the person's illness are stopped.
- NIA: What Are Palliative Care and Hospice Care?, table "Some similarities and differences between palliative care and hospice care" (NIA credits the table to the National Hospice and Palliative Care Organization) (content reviewed May 14, 2021): NIA's comparison table answers "Will my symptoms be relieved?" with "Yes, as much as possible" for both palliative care and hospice, and "Can I continue to receive treatments to cure my illness?" with "Yes, if you wish" for palliative care and "No, only symptom relief will be provided" for hospice.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says palliative care is focused on improving quality of life for people with serious illnesses and their care partners, and that it is available to people of any age who need it, not just older adults.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says the major elements of palliative care include managing a person's symptoms effectively and ensuring that their care is coordinated.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says palliative care providers work together with patients and their families and care partners to ensure that the treatment plan reflects the person's goals and values.
- NIA: Frequently Asked Questions About Palliative Care (content reviewed February 8, 2021): NIA's palliative care FAQ answers "Does Using Palliative Care Mean I'm Dying?" with "Not necessarily" and says palliative care can be used at any time after diagnosis of a serious illness.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says hospice is end-of-life care for people with illnesses that can't be cured.
- CMS: Hospice, Medicare fee-for-service providers page (last modified 09/08/2026): CMS says hospice care changes the focus to comfort care (palliative care) for pain relief and symptom management instead of care to cure the patient's illness.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says Part A covers hospice care if, among other conditions, your hospice doctor and your regular doctor (if you have one) certify that you're terminally ill (with a life expectancy of 6 months or less).
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says that in palliative care, a person does not have to give up treatment that might cure a serious illness.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says that once your hospice benefit starts, Medicare won't cover treatment intended to cure your terminal illness and/or related conditions, or prescription drugs to cure your illness (rather than for symptom control or pain relief).
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says stopping treatment aimed at curing an illness does not mean discontinuing all treatment, and that other medical care may continue as long as it is helpful.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says Original Medicare will still pay for covered benefits for any health problems that aren't part of your terminal illness and related conditions, but you'll owe any deductible and coinsurance amounts that apply.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says the palliative care team is composed of palliative care specialist doctors and nurses, and includes others such as social workers, nutritionists, and chaplains, and that a person's team may vary based on their needs and level of care.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says a palliative care team works with the patient, family, and the patient's other doctors.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says a person's health care provider may refer them to a palliative care specialist, and if the provider doesn't suggest it, the person can ask for a referral.
- Medicare.gov: Medicare Hospice Benefits, CMS Product No. 02154, March 2026 (p. 3): Medicare's hospice booklet says you and your family members are part of a team that may also include doctors, nurses or nurse practitioners, counselors, social workers, pharmacists, physical and occupational therapists, speech-language pathologists, hospice aides, homemakers and volunteers.
- Medicare.gov: Medicare Hospice Benefits, CMS Product No. 02154, March 2026 (p. 3): Medicare's hospice booklet says a hospice nurse and doctor are on call 24 hours a day, 7 days a week to give you and your family support and care when you need it.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says all care that you get for your terminal illness must be given by or arranged by the hospice team, and that you can still see your regular doctor or nurse practitioner if you've chosen him or her to be the attending medical professional who helps supervise your hospice care.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says hospice is an approach to care, not tied to a specific place, and can be offered at home or in a facility such as a nursing home, hospital, or even a separate hospice center.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says you can usually get Medicare-approved hospice care in your home or other facility where you live, like an assisted living facility or a nursing home, and, if you meet certain conditions, in an inpatient hospice facility.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says that although hospice provides a lot of support, the day-to-day care of a person dying at home is provided by family and friends, and the hospice team coaches family members on how to care for the dying person.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says that if the doctor or the palliative care team believes ongoing treatment is no longer helping, there are two possibilities: palliative care could transition to hospice care if the doctor believes the person is likely to die within six months, or the palliative care team could continue to help with increasing emphasis on comfort care.
- Medicare.gov: Medicare Hospice Benefits, CMS Product No. 02154, March 2026 (p. 5): Medicare's hospice booklet says that before you start hospice care, you can get a one-time only consultation with a hospice medical director or hospice doctor to talk about your care options and how to manage your pain and symptoms, even if you decide not to get hospice care.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says choosing hospice does not have to be a permanent decision.
- Medicare.gov: Medicare Hospice Benefits, CMS Product No. 02154, March 2026 (p. 9): Medicare's hospice booklet says you always have the right to stop hospice care at any time, and that if you're eligible, you can go back to hospice care at any time.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says Medicare, Medicaid, and insurance policies may cover palliative care, and private health insurance might pay for some services.
- NIA: Frequently Asked Questions About Palliative Care (content reviewed February 8, 2021): NIA's palliative care FAQ says most private insurance plans at least partially cover palliative care services, and Medicare and Medicaid also typically cover most of these services.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says you pay nothing for hospice care if you get your care from a Medicare-approved hospice provider, and its summary adds that other costs may apply.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says Medicare doesn't cover room and board if you get hospice care in your home or if you live in a nursing home or a hospice inpatient facility.
- Medicare.gov: Medicare Hospice Benefits, CMS Product No. 02154, March 2026 (p. 3): Medicare's hospice booklet says that if you qualify, you and your family will work with your hospice provider to set up a plan of care that meets your needs.
- Medicare.gov: Medicare Hospice Benefits, CMS Product No. 02154, March 2026 (p. 5): Medicare's hospice booklet says the plan of care your hospice team creates can include services such as doctor services, nursing care, medical equipment, medical supplies, prescription drugs for pain and symptom control, hospice aide and homemaker services, social worker services, and grief and loss counseling for you and your family.
- CMS: Hospice, Medicare fee-for-service providers page (last modified 09/08/2026): CMS lists individual and family or just family grief and loss counseling before and after the patient's death among the items and services included in the Medicare hospice benefit.
- NIA: What Are Palliative Care and Hospice Care? (content reviewed May 14, 2021): NIA says palliative care includes, among other things, end-of-life care, hospice care and bereavement support.
- Medicare.gov: Hospice care (coverage page): Medicare.gov says you can ask your hospice provider for a list of items, services, and drugs that they've determined aren't related to your terminal illness and related conditions, that the list must include why, and that the provider must give it within 3-5 days of your request.
- CMS: Hospice News & Announcements — Initial Implementation of Mandatory Hospice Election Statement Addendum (requirement effective October 1, 2026): CMS Hospice News & Announcements says that starting October 1, 2026, hospices must give every patient (or their representative) a hospice election statement addendum, in writing, for each hospice election; the addendum tells patients about items, services, and drugs the hospice will not cover because they're unrelated to the patient's terminal illness, and explains the right to appeal; before the effective date of the final rule (91 FR 49118), hospices only had to provide the addendum when a patient asked for it.
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