Palliative care and hospice care both focus on comfort, dignity, and quality of life, but they serve people at different points in a serious illness. Palliative care can begin at any stage of a serious illness and works alongside curative treatments.
Hospice care is a specialized type of comfort-focused care for people whose physician has determined they have a life expectancy of six months or less if the illness runs its expected course, as defined by the Centers for Medicare & Medicaid Services (CMS). Both prioritize symptom relief, emotional support, and family guidance, and they often share the same care team philosophy.
Quick Comparison: Palliative Care vs. Hospice
| Feature | Palliative Care | Hospice Care |
| When it begins | Any stage of a serious illness | Life expectancy of six months or less |
| Curative treatment | Continues alongside | Treatment focus shifts to comfort |
| Goal | Symptom relief and quality of life | Comfort, dignity, and family support at end of life |
| Prognosis required | No specific prognosis required | Physician certification of terminal prognosis |
| Setting | Hospital, clinic, home, or facility | Most often in the home, but also nursing facilities or inpatient settings |
| Insurance | Typically billed through standard medical insurance | Covered by the Medicare Hospice Benefit, Medicaid, and most private plans |
| Care team | Physician-led, often interdisciplinary | Interdisciplinary hospice team including nurses, aides, social workers, chaplains, and volunteers |
What Is Palliative Care?
Palliative care is specialized medical care focused on relieving the symptoms, pain, and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.
According to the Centers for Medicare & Medicaid Services and the National Institute on Aging, palliative care can begin at any point after a serious diagnosis, including at the time of diagnosis itself. It is appropriate for people living with conditions such as:
- Cancer
- Heart failure
- Chronic obstructive pulmonary disease (COPD)
- Kidney disease
- Parkinson’s disease
- Dementia and Alzheimer’s
- ALS and other neurological conditions
A palliative care team usually includes doctors, nurses, social workers, and sometimes chaplains, dietitians, or therapists. The team works with the patient’s existing physicians, not in place of them. Palliative care is not limited by prognosis. A person can receive palliative care for years while pursuing chemotherapy, dialysis, surgery, or any other treatment aimed at curing or controlling their illness.
In short: Palliative care is about living well with a serious illness, at any stage, alongside whatever treatment a person is pursuing.
What Is Hospice Care?
Hospice care is a specific Medicare-defined benefit for people facing a terminal illness when curative treatment is no longer the chosen path or is no longer effective. To qualify for the Medicare Hospice Benefit, two physicians (typically the patient’s attending physician and the hospice medical director) must certify that the patient has a life expectancy of six months or less if the illness follows its expected course.
Hospice does not mean “giving up.” It means shifting the focus of care toward comfort, dignity, peace, and meaningful time with loved ones. If a patient lives longer than six months, hospice care can be renewed through a recertification process.
Hospice care is delivered by an interdisciplinary team that may include:
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Explore Your Care Options- A Medical Director who oversees the plan of care
- Registered Nurses who manage symptoms and educate the family
- Certified Nursing Assistants who help with personal care and daily comfort
- Social Workers who help families navigate emotional, financial, and logistical needs
- Spiritual Care providers who offer chaplaincy and faith-based support
- Bereavement Care specialists who support the family through grief
Care is most often provided where the patient is most comfortable, usually at home, but it can also be provided in nursing facilities, assisted living, or short-term inpatient settings, depending on the level of care needed.
Learn more: Hospice Care Explained: What It Is, What It Includes, and What It Does Not.
The Six Key Differences Between Palliative Care and Hospice
- Timing in the Illness. Palliative care can start the day of a serious diagnosis. Hospice begins when curative treatment is stopped and a physician certifies a prognosis of six months or less.
- Relationship to Curative Treatment. Palliative care works alongside treatments like chemotherapy, radiation, dialysis, or surgery. Hospice replaces curative treatment with comfort-focused care for the terminal illness, though treatment for unrelated conditions can continue.
- Eligibility Requirements. Palliative care has no specific prognosis requirement. Hospice requires physician certification of a life-limiting prognosis. You can read more about who qualifies here: Hospice Eligibility Guidelines.
- Care Team Structure. Both involve interdisciplinary teams, but hospice teams are typically more comprehensive and include 24/7 on-call nursing, scheduled visits, spiritual care, and dedicated bereavement support for the family before and after the patient’s passing.
- Insurance Coverage. Palliative care services are usually billed through standard medical insurance, Medicare Part B, or private plans. Coverage and out-of-pocket costs vary by provider and visit type. The Medicare Hospice Benefit, by contrast, covers nearly all hospice-related services in full, including medications related to the hospice diagnosis, medical equipment, supplies, and the interdisciplinary team.
- Where Care Is Delivered. Palliative care often happens in clinics, hospitals, or specialty centers, though home-based palliative programs exist in some regions. Hospice care is most often delivered in the home, where patients feel most comfortable, with around-the-clock on-call support available.
When Should You Choose Palliative Care?
Palliative care may be the right fit if your loved one is:
- Newly diagnosed with a serious illness and dealing with significant symptoms
- Continuing aggressive treatment but struggling with side effects like pain, nausea, fatigue, or anxiety
- Experiencing repeat hospitalizations
- Needing help coordinating care among multiple specialists
- Living with a chronic, progressive illness that affects daily quality of life
Ask the treating physician for a palliative care referral if any of these apply. Early palliative care has been shown to improve quality of life and reduce hospitalizations.
When Should You Consider Hospice Care?
Hospice care may be appropriate when:
- A physician believes the illness has progressed to a point where curative treatment is no longer working or is no longer the chosen path
- Hospital visits are becoming frequent and exhausting
- The patient is experiencing a significant decline in weight, strength, or daily function
- The family is overwhelmed by symptom management
- The patient and family want to focus on comfort, presence, and meaningful time together
Many families say they wish they had called sooner. If you are noticing changes, it may already be the right time to talk. Our blog 10 Signs It May Be Time to Consider Hospice Care walks through specific markers to watch for, and the Hospice Assessment Quiz can help you think it through in private.
How Insurance Covers Each
Palliative Care
Palliative care visits, consultations, and medications are typically covered through standard medical insurance, Medicare Part B, Medicaid, or private plans. Coverage and copays vary based on the provider, the setting, and the specific services received.
Hospice Care
The Medicare Hospice Benefit, established by CMS, covers:
- Physician services and the hospice medical director
- Skilled nursing care
- Aide and homemaker services
- Medical equipment and supplies related to the hospice diagnosis
- Medications related to the terminal illness for symptom control and pain relief
- Social work and counseling services
- Spiritual and bereavement care
- Short-term inpatient and respite care when needed
Medicaid and most private insurance plans offer comparable hospice coverage. To understand the different intensities of hospice support, read Understanding the 4 Levels of Hospice Care Under Medicare.
Foundations Hospice Supporting Families Across Southeast Louisiana
Choosing between palliative care and hospice is not just a medical decision. It is a family decision, shaped by what your loved one values and what kind of season you want them to have. If you have questions, our team is here to help you think it through.
Call us at (225) 209-5629 or schedule a care consult to speak with a member of the Foundations Hospice team. We serve families across Southeast Louisiana, and we are honored to walk this season with you.
Foundations Hospice is a locally owned hospice provider serving families across Southeast Louisiana, including Livingston, St. Tammany, East Baton Rouge, Ascension, Jefferson, Orleans, and surrounding parishes. Our team brings decades of combined hospice experience, and licensed palliative care services may be available depending on program approval and eligibility.
