Hospice or Palliative Care? How to Tell the Difference
Updated September 15, 2026
All hospice care is palliative care, but not all palliative care is hospice. Palliative care is extra support for symptoms at any stage of a serious illness, alongside ongoing treatment. Hospice is comprehensive comfort care for the final stage of an illness, once curative treatment has stopped. The difference comes down to where your loved one is in their illness, whether they're still pursuing treatment, and how much support comes with the care.
Many families use the two words interchangeably. That's understandable, since both focus on relieving pain and improving quality of life. But not knowing which one applies can mean waiting too long for help, or missing support your family already qualifies for.
What palliative care is
Palliative care is an extra layer of support for anyone living with a serious illness, such as cancer, heart failure, COPD, kidney disease, or dementia. There's no prognosis requirement. It can start at diagnosis and continue for years.
Your loved one can keep pursuing treatment. Someone receiving chemotherapy, dialysis, or cardiac care can have a palliative team focused on managing pain, shortness of breath, nausea, fatigue, and anxiety alongside that treatment.
In most home-based programs, the care team is a nurse practitioner with occasional visits from a social worker. Hospital-based palliative teams often add physicians and chaplains. Expect visits once or twice a month, depending on needs.
Palliative care is billed like a specialist visit, so Medicare Part B copays, deductibles, and coinsurance usually apply. Medications and equipment aren't included; those go through your regular insurance. Most programs don't offer after-hours visits. If pain gets out of control at 3 a.m., the answer is usually still the emergency room.
What hospice care is
Hospice is comprehensive comfort care for people in the final stage of an illness. To qualify, a physician must certify that the patient likely has six months or less to live if the illness runs its normal course. The patient chooses to focus on comfort rather than on treatment aimed at curing the illness.
Hospice comes with a full team: a medical director who oversees care and can order medications, an RN case manager who visits weekly or more and coordinates the plan of care, a hospice aide who helps with bathing and personal care several times a week, a social worker, a chaplain, and trained volunteers who give caregivers a break.
Symptom management is available 24 hours a day, 7 days a week. If something flares at night, you call the hospice and a nurse can come to the home, with a physician on call to order medications. That said, 24/7 means scheduled visits plus on-call support, not a caregiver living in the home full-time. Day-to-day care still comes from family, private caregivers, or facility staff.
Hospice is paid for by the Medicare Hospice Benefit under Part A, Medicaid, VA benefits, and most private insurance, with little to no out-of-pocket cost. It covers medications, equipment, and supplies related to the hospice diagnosis. One exception: if your loved one lives in assisted living or a nursing home, hospice doesn't pay the room and board.
Hospice isn't all or nothing. Patients can still get care for conditions unrelated to their hospice diagnosis through regular insurance, and can leave hospice at any time to try a new treatment or because their health improved, then return later if they qualify again.
Which one is right for us?
If your loved one is still pursuing treatment and wants help living better with their symptoms, palliative care is a good fit. It's also a good way to build a relationship with a care team early, before a crisis.
It may be time to ask about hospice when treatments stop working or become more burden than benefit, when hospital and ER visits come closer together, when your loved one is sleeping more or eating less, or when they tell you they're tired of treatment and want to be comfortable at home.
Many people start with palliative care and move to hospice when the time comes. They're steps along the same path, not competing choices.
Hospice and palliative care, side by side
| Hospice | Palliative care | |
|---|---|---|
| Who qualifies | Life expectancy of six months or less, certified by a physician | Anyone with a serious illness, at any stage |
| Can treatment continue | Curative treatment for the hospice diagnosis stops | Yes, alongside chemotherapy, dialysis, or other treatment |
| Care team | Medical director, RN, hospice aide, social worker, chaplain, volunteers | Usually a nurse practitioner, sometimes a social worker |
| Visit frequency | Weekly or more, aide visits several times a week | One to two visits a month |
| After-hours help | On-call nurse and physician, 24/7 | Usually none; a flare-up often means the ER |
| What's covered | Medications, equipment, and supplies tied to the diagnosis | Not included; billed through regular insurance |
| Cost | Little to no out-of-pocket cost through Medicare, Medicaid, or VA benefits | Specialist copays, deductibles, and coinsurance apply |
| Family support | Caregiver support and grief support after a death, often for 13 months | Some social work support, no bereavement program |
How to get started
You don't have to wait for a doctor to bring it up. A patient or family member can call a hospice and ask for an informational visit. It's free and doesn't commit you to anything. If your loved one qualifies and you decide to move forward, the hospice coordinates with their physician. For palliative care, ask your loved one's doctor for a referral.
The earlier these conversations happen, the more choices your family has.
Can someone move from palliative care to hospice later?
Yes. Many patients start with palliative care and move to hospice when treatment stops helping or their goals shift toward comfort. The two teams often coordinate that handoff directly.
Does choosing hospice mean giving up?
No. Hospice is a change in goals, from fighting the illness to living as fully and comfortably as possible. Many families say they wish they'd started sooner. See our guide to common hospice myths for more on this.
If some of these misconceptions sound familiar, our guide to hospice myths that keep families from getting help walks through the five that come up most, including the "six months" rule and whether a DNR is required.
Weighing hospice, palliative care, and a move to assisted living or memory care at the same time? This short quiz helps sort out what your loved one needs right now.
This guide is for general education and isn't a substitute for advice from your loved one's physician or care team. Coverage details can vary by insurance plan.