What's the Difference Between Palliative Care and Hospice?

The short answer: palliative care is comfort-focused support for a serious illness that can start at diagnosis and run alongside curative treatment. Hospice is a specific type of palliative care for someone with a terminal prognosis — generally a life expectancy of six months or less if the illness runs its normal course — where the focus shifts fully to comfort instead of a cure. All hospice is palliative care; not all palliative care is hospice.¹

Both types of care aim to relieve pain and other symptoms, support quality of life, and help the family, not just the patient. The difference is timing and intent: palliative care can begin at any age, at any stage of a serious illness, and does not require giving up other treatment. Hospice is chosen once curative treatment is no longer the goal, and it requires a physician's certification of a terminal prognosis.¹ Only a doctor makes that certification — this page is a starting point for the conversation, not a determination of what applies to your situation.

What palliative care is

Palliative care is specialized support for people living with a serious illness, aimed at managing symptoms effectively and coordinating care around quality of life. It's available to people of any age, at any stage of illness, including right alongside treatments meant to cure or slow the disease.¹ It can include advance care planning, symptom management, and support for family caregivers well before end of life becomes the focus.

What hospice is

Hospice is a specialized form of palliative care delivered when a person and their doctors have shifted away from treatments meant to cure or slow the illness and toward comfort care only. Medicare covers hospice when a hospice doctor and the person's regular doctor (if they have one) certify a terminal prognosis of six months or less if the illness runs its normal course, the person accepts comfort care instead of curative treatment, and they sign an election statement choosing hospice.² Hospice can continue past six months if a doctor recertifies the prognosis, and someone can change their mind and leave hospice to resume other treatment.²

How to ask for palliative care

Ask the treating physician: "Is a palliative care consult available for this diagnosis?" You don't need a terminal prognosis to ask, and asking does not mean stopping other treatment. A palliative care team can be brought in alongside oncology, cardiology, or any specialist already managing the illness.

How to ask about hospice

Ask directly: "Given where things stand, would a hospice evaluation make sense?" You can also contact a local hospice organization to request an evaluation independently, without waiting for a physician referral. Whether hospice applies to a specific situation is a medical certification, not a family decision — the physician's evaluation is the next step, not a guarantee either way.

What to check before enrolling in hospice

• Confirm who is certifying the terminal prognosis (the hospice doctor and the regular doctor, if there is one).
• Ask what "comfort care" will and won't cover for this specific illness.
• Ask whether hospice can be provided at home, or whether it requires a facility, nursing home, or hospital setting.
• Verify current coverage details (Medicare, Medicaid, or private insurance) with the hospice program and the plan administrator — coverage rules can vary by plan and change over time.
• Ask what happens if the person's condition improves or they want to resume curative treatment.

Common mistakes

• Waiting for a "final" crisis before asking about either option — palliative care in particular can start much earlier than most families realize.
• Assuming hospice means giving up on care altogether; hospice still includes active medical, nursing, and emotional support, just with a different goal.
• Treating a family member's guess about eligibility as a determination — only the certifying physicians can do that.

Sources to verify

• National Institute on Aging: What Are Palliative Care and Hospice Care?
• Medicare.gov: Hospice Care Coverage
• GiveCare Wiki: We're Approaching End of Life

Footnotes

1. National Institute on Aging. "What Are Palliative Care and Hospice Care?" https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care ↩ ↩² ↩³

2. Medicare.gov. "Hospice Care Coverage." https://www.medicare.gov/coverage/hospice-care ↩ ↩²

Common questions

What's the difference between palliative care and hospice?

Palliative care is comfort-focused support for someone with a serious illness. It can start at diagnosis and continue alongside treatment meant to cure or slow the disease. Hospice is a specific form of palliative care for someone a doctor believes has a limited time left to live, typically framed as six months or less if the illness runs its course, and it means shifting away from curative treatment toward comfort. All hospice is a form of palliative care; not all palliative care is hospice.

Do I have to stop treatment to get palliative care?

No. Palliative care can be provided alongside treatments aimed at curing or slowing the illness, and it can start as early as diagnosis. Hospice is different: choosing hospice generally means stopping treatments meant to cure the illness in favor of comfort-focused care, though a person can change their mind and leave hospice to resume other treatment.

Is hospice eligibility the same for everyone, and how do I actually ask about it?

No — only a hospice physician and, if there is one, the person's regular doctor can certify a terminal prognosis of six months or less for Medicare hospice coverage, and coverage rules can vary by plan. Ask the treating physician directly, "Would a palliative care consult or a hospice evaluation make sense right now?" and verify current coverage details with the hospice program and the insurance plan administrator rather than assuming eligibility.