What the two sources say, in their own words
The two sources word things a little differently. Both wordings are shown here. They are not merged.
The National Institute on Aging (NIA) says: “Palliative care and hospice care both focus on the comfort, care, and quality of life of individuals with a serious illness. Hospice care is a specific type of palliative care that is provided in the final weeks or months of life.”
Medicare.gov says, on its hospice page: “Hospice is end-of-life care for people with illnesses that can't be cured.” On that same page, Medicare.gov uses the words “comfort care (palliative care)” together. Medicare.gov does not have a separate palliative care definition on that page.
What is palliative care?
The NIA says palliative care is focused on improving quality of life for people with serious illnesses and their care partners.
The NIA says palliative care is available to people of any age who need it, not just older adults.
The NIA says the major elements of palliative care include managing a person's symptoms effectively and ensuring that their care is coordinated.
The NIA says palliative care can help patients understand their choices for medical treatment.
The NIA lists examples of serious illnesses. They include heart failure, chronic obstructive pulmonary disease, cancer, dementia, and Parkinson's disease.
When does palliative care start?
The NIA says palliative care can start as early as a person's diagnosis, or not until later in their illness.
The NIA says a person does not have to give up treatment that might cure a serious illness. Palliative care can be provided along with curative treatment.
Who provides palliative care?
The NIA says a palliative care team is made up of palliative care specialist doctors and nurses. The team also includes others, such as social workers, nutritionists, and chaplains.
The NIA says these providers work together with the patient, the family, and the patient's other doctors. The team provides medical, social, emotional, and practical support.
Where is palliative care provided?
The NIA says palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home.
The NIA's comparison table also lists these places for palliative care: home, assisted living facility, nursing home, hospital, and palliative care clinic.
What is hospice care?
The 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.
The NIA says hospice is designed for the situation where it may not be possible to cure a serious illness, or where a patient may choose not to undergo certain treatments.
The 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.
When is hospice care provided?
The NIA says hospice is provided for a person with a terminal illness whose doctor believes he or she has six months or less to live if the illness runs its natural course.
The NIA's comparison table says hospice is for anyone with a serious illness who doctors think has only a short time to live, often less than 6 months.
The NIA also says palliative care could transition to hospice care if the doctor believes the person is likely to die within six months.
Who provides hospice care?
The NIA says hospice care brings together a team of people with special skills. Among them are nurses, doctors, social workers, spiritual advisors, and trained volunteers.
The NIA says everyone works together with the person who is dying, the caregiver, and/or the family. They provide the medical, emotional, and spiritual support needed.
The NIA says a member of the hospice team visits regularly. Someone is usually always available by phone — 24 hours a day, seven days a week.
Where is hospice care provided?
The NIA says hospice is an approach to care, so it is not tied to a specific place. It can be offered in two types of settings — at home, or in a facility such as a nursing home, hospital, or even in a separate hospice center.
The NIA's comparison table also lists these places for hospice: home, assisted living facility, nursing home, hospice facility, and hospital.
The 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. The hospice team coaches family members on how to care for the dying person. Hospice also provides respite care when caregivers need a break.
The differences, side by side
This table uses the NIA's own comparison table.
| Question | Palliative Care | Hospice |
|---|---|---|
| Who can be treated? | Anyone with a serious illness | Anyone with a serious illness who doctors think has only a short time to live, often less than 6 months |
| Will my symptoms be relieved? | Yes, as much as possible | Yes, as much as possible |
| Can I continue to receive treatments to cure my illness? | Yes, if you wish | No, only symptom relief will be provided |
| How long will I be cared for? | This depends on what care you need and your insurance plan | As long as you meet the hospice's criteria of an illness with a life expectancy of months, not years |
| Where will I receive this care? | Home, assisted living facility, nursing home, hospital, palliative care clinic | Home, assisted living facility, nursing home, hospice facility, hospital |
The NIA table also answers two payment questions. For palliative care, it says whether Medicare pays “depends on your benefits and treatment plan.” For hospice, it says: “Yes, it pays for some hospice charges.” The next section gives Medicare.gov's own coverage wording.
What Medicare.gov says about hospice coverage
This section is coverage information only. It reports what Medicare.gov's hospice page states. It does not decide whether any one person is covered.
Medicare.gov states that Medicare Part A (Hospital Insurance) covers hospice care.
Medicare.gov states: “Once you choose hospice care, your hospice benefit should cover everything you need.” The person and family work with the hospice care team to set up a plan of care.
Conditions Medicare.gov lists for hospice coverage
Medicare.gov lists all of these conditions:
- The person has Medicare Part A.
- The hospice doctor and the person's regular doctor (if the person has one) certify that the person is terminally ill, with a life expectancy of 6 months or less.
- The person accepts comfort care (palliative care) instead of care to cure the illness and related conditions.
- The person signs a statement choosing hospice care instead of other Medicare-covered treatments for the terminal illness and related conditions.
Medicare.gov states that only the hospice doctor and the regular doctor (if there is one) can certify that a person is terminally ill and has a life expectancy of 6 months or less.
Medicare.gov states that after 6 months, hospice care can continue as long as the hospice medical director or hospice doctor recertifies — after a face-to-face meeting with the hospice doctor or hospice nurse practitioner — that the person is still terminally ill.
Medicare.gov states that hospice care can be received for two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods.
Medicare.gov states that a person has the right to change hospice provider once during each benefit period.
What Medicare.gov says Medicare will not cover once the hospice benefit starts
- Treatment intended to cure the terminal illness and/or related conditions.
- Prescription drugs to cure the illness, rather than for symptom control or pain relief.
- Care from any hospice provider that was not set up by the hospice medical team.
- Room and board, if hospice care is received in the home, or if the person lives in a nursing home or a hospice inpatient facility. Medicare.gov states that if the hospice team determines that short-term inpatient or respite care services that they arrange are needed, Medicare will cover the stay in the facility.
- Care received as a hospital outpatient (like in an emergency room), care received as a hospital inpatient, or ambulance transportation — unless it is arranged by the hospice team, or is unrelated to the terminal illness and related conditions.
Medicare.gov states that Original Medicare will still pay for covered benefits for health problems that are not part of the terminal illness and related conditions. Deductible and coinsurance amounts that apply would still be owed.
Costs Medicare.gov lists for hospice care
Medicare.gov states these general cost facts:
- A person pays nothing for hospice care if the care is received from a Medicare-approved hospice provider.
- A person pays a copayment of up to $5 for each prescription for outpatient drugs for pain and symptom management.
- A person may pay 5% of the Medicare-approved amount for inpatient respite care. Medicare.gov describes this as short-term care to help give caregivers a rest. The copayment can't be more than the inpatient deductible amount.
- A person may have to pay for room and board if the person lives in a facility, like a nursing home, and chooses to get hospice care.
Where Medicare.gov says hospice care can be received
Medicare.gov states that Medicare-approved hospice care can usually be received in the home or in another facility where the person lives, like an assisted living facility or a nursing home.
Medicare.gov states that, if certain conditions are met, hospice care can also be received in an inpatient hospice facility.
One more point from the NIA
The NIA says it is important to remember that stopping treatment aimed at curing an illness does not mean discontinuing all treatment. The NIA gives this example: if a person in hospice care has high blood pressure, he or she will still get medicine for that.
The NIA also says the person should talk with their doctor if they think a hospice program might be helpful.
Sources
Every fact on this page comes from one of these two official pages. Both were read in full.
- National Institute on Aging (NIA) — “What Are Palliative Care and Hospice Care?” — https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care — The NIA information line printed on that page is 800-222-2225. The NIA ADEAR Center number printed on that page is 800-438-4380.
- Medicare.gov — “Hospice Care Coverage” — https://www.medicare.gov/coverage/hospice-care