Table of ContentsView AllTable of ContentsPalliative CareHospice CareDifferencesHow to Decide
Table of ContentsView All
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Table of Contents
Palliative Care
Hospice Care
Differences
How to Decide
Although hospice care and palliative care are both used to ease symptoms and improve the quality of life of people with serious medical conditions, their aims and intent are different.
Hospice careis intended for people with a terminal illness who decide to forego curative treatment and focus instead on comfort care.Palliative careis intended for anyone with a serious illness, whether or not they are at the end of life. Hospice and palliative care also differ is now how insurance benefits are paid and approved.
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What Is Palliative Care?
Palliative care is a medical specialty aimed at easing the physical, emotional, psychological, and social burden you and your family experience as a result of a serious medical condition.
Palliative care can be arranged as soon as you are diagnosed with a serious illness. A person can continue to receive palliative care as long as they have the condition and a means to pay for it.
The four primary goals of palliative care include:
The treatment plan can vary and evolve based on the status of your condition and your individual needs and preferences.
Is Palliative Care a Step Before Hospice?Not always. Palliative care can sometimes advance to hospice care if your condition worsens and there is no hope of improvement. With that said, many people in palliative care do improve and can return home with no further need for treatment.
Is Palliative Care a Step Before Hospice?
Not always. Palliative care can sometimes advance to hospice care if your condition worsens and there is no hope of improvement. With that said, many people in palliative care do improve and can return home with no further need for treatment.
Conditions Benefiting From Palliative Care
Many medical conditions qualify for palliative care. They are generally serious conditions that have become difficult for you and your caretakers to manage both functionally and emotionally. Insurance coverage can vary, with some providers covering certain conditions and others not.
Some of the conditions that generally qualify for palliative care include:
How Serious Does an Illness Need to Be?Some conditions that qualify for palliative care may lead to early death, although this is not a prerequisite for care. Palliative care can be delivered irrespective of life expectancy.On the flip side, having an end-stage disease doesn’t automatically mean you need hospice care. If your intention is to pursue life-extending treatment, palliative care can be pursued.
How Serious Does an Illness Need to Be?
Some conditions that qualify for palliative care may lead to early death, although this is not a prerequisite for care. Palliative care can be delivered irrespective of life expectancy.On the flip side, having an end-stage disease doesn’t automatically mean you need hospice care. If your intention is to pursue life-extending treatment, palliative care can be pursued.
Some conditions that qualify for palliative care may lead to early death, although this is not a prerequisite for care. Palliative care can be delivered irrespective of life expectancy.
On the flip side, having an end-stage disease doesn’t automatically mean you need hospice care. If your intention is to pursue life-extending treatment, palliative care can be pursued.
What Is Hospice?
Hospice care is a form of palliative care. Like all palliative care, the goal is to manage symptoms and improve the quality of life of someone with a serious illness. However, hospice is intended for people with aterminal (life-ending) illnesswho have decided to stop treatments used to extend life.
Hospice care instead focuses oncomfort care,pain management, symptom relief, and meeting the emotional, spiritual, and psychological needs of people and their families as the end of life approaches.
Hospice focuses more on quality than quantity of life. Generally, hospice is pursued when a person has less than six months to live, but that’s not a hard-and-fast rule. Some people may live longer, but that generally means months and not years.
Transitioning to Hospice
A facet of palliative care is preparing an individual and their caregivers for all contingencies, including a possible transition from palliative care to hospice care.
This is described in the “Five Stages of Palliative Care” which directs the appropriate course of action based on the status of a person’s medical condition:
What to Expect as a Loved One Starts to Die
Palliative Care vs. Hospice: Differences
There is a lot of overlap between palliative and hospice care, from how treatment is dispensed to insurance eligibility and coverage. Here is a snapshot of the key differences:
Who Is Eligible?
Eligibility for palliative care depends on your insurance coverage. Most serious or life-threatening conditions will qualify for coverage.
Hospice care has more stringent rules:
The benefit of hospice is that you can opt to receive care at home, in a nursing home, in the hospital, or at a licensed hospice facility. However, keep in mind that hospice insurance benefits generally do include payment for room and board if you are in a facility.
Can I Leave Hospice?If your situation changes, either because you get better or decide that you would like to pursue treatment, you can leave hospice at any time. You can opt to sign up again if you so choose.
Can I Leave Hospice?
If your situation changes, either because you get better or decide that you would like to pursue treatment, you can leave hospice at any time. You can opt to sign up again if you so choose.
Who Provides Care?
When you enroll in a palliative care or hospice program, you will be assigned a team of specialists covering a wide range of care and services, such as:
These providers can work in collaboration with yourprimary healthcare providerto ensure you get the comprehensive care you need and desire.
Insurance Coverage
Coverage for palliative care varies based on your insurance coverage, and you should check with your plan to see what benefits will be covered. Medicare covers palliative care under thePart B benefit. You can expect to pay a 20% coinsurance for each service you receive.
Hospice pays for all care related to your terminal condition, including hospitalizations. But if you need treatment for an unrelated condition, your Original Medicare benefits will be used, requiring you to pay the usual Part A orPart B costs.
If you have aMedicare Advantage plan (Part C)instead of Original Medicare, your plan may help you pay for non-hospice-related services.Out-of-pocket expenses while in Medicare-authorized hospice care include a $5 co-pay for hospice-approved medications and 5% for respite care.
As a reminder, insurance generally does not cover room and board if you move into a facility like a nursing home. That may need to be paid out of pocket.
What Is Respite Care?
How Long Can a Person Receive Care?
Palliative care can continue as long as you have your condition, although some insurers may have limitations on coverage.
Hospice, however, can only continue as long as your condition is reported to be terminal. If your condition gets better at the end of your hospice benefit period and you are expected to live longer than six months, you may no longer be eligible for hospice
Physicians make the best estimates oflife expectancybased on statistics and factors such as your current health, current symptoms, response to treatment, and available treatment options. You could live much longer than that.
Deciding to Get Palliative or Hospice Care
Deciding to pursue palliative care is easier than choosing to enter hospice care because you continue receiving treatment for your condition. Your condition and overall health are likely to improve from the added services.
The decision to enroll in hospice care can be more difficult to navigate, both personally and emotionally. This is because a terminal diagnosis means that your life expectancy is short even if there are treatments available to you. Those realities alone can take time to come to terms with.
In the end, you must decide whether you want to extend your life for as long as possible or if it is more important to you to approach the end of life with as much comfort and quality of life as possible. There is no right or wrong answer. Speaking with family, loved ones, or spiritual leaders may help you make these complicated decisions.
If you are making this decision for a loved one, be respectful of their wishes. You can turn to any advance care planning documents they may have prepared (such as a living will or advance directive) to ensure that their wishes are respected.
Summary
Palliative care and hospice care are not the same thing. Palliative care is for anyone who has a serious medical condition, while hospice care is for those who are at the end of life. In both cases, a care team will provide services to improve symptoms and quality of life. The primary difference is that you can continue curative treatment with palliative care but not hospice care.
Treatment for palliative care can continue for as long as needed (or until insurance benefits run out), while hospice care benefits last for six months (after which recertification of your terminal diagnosis is needed).
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Aging.What are palliative care and hospice care?International Association of Hospice & Palliative Care.Guidelines and suggestions for those starting a hospice/palliative care service.Centers for Medicare and Medicaid Services.Hospice.Centers for Medicare and Medicaid Services.Medicare hospice benefits.Centers for Medicare and Medicaid Services.Medicare benefit policy manual.Tricare.Hospice care.Department of Veterans Affairs.Hospice care.Centers for Medicare and Medicaid Services.Hospice benefits.National Hospice and Palliative Care Organization.NHPCO facts and figures 2022.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Aging.What are palliative care and hospice care?International Association of Hospice & Palliative Care.Guidelines and suggestions for those starting a hospice/palliative care service.Centers for Medicare and Medicaid Services.Hospice.Centers for Medicare and Medicaid Services.Medicare hospice benefits.Centers for Medicare and Medicaid Services.Medicare benefit policy manual.Tricare.Hospice care.Department of Veterans Affairs.Hospice care.Centers for Medicare and Medicaid Services.Hospice benefits.National Hospice and Palliative Care Organization.NHPCO facts and figures 2022.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute on Aging.What are palliative care and hospice care?International Association of Hospice & Palliative Care.Guidelines and suggestions for those starting a hospice/palliative care service.Centers for Medicare and Medicaid Services.Hospice.Centers for Medicare and Medicaid Services.Medicare hospice benefits.Centers for Medicare and Medicaid Services.Medicare benefit policy manual.Tricare.Hospice care.Department of Veterans Affairs.Hospice care.Centers for Medicare and Medicaid Services.Hospice benefits.National Hospice and Palliative Care Organization.NHPCO facts and figures 2022.
National Institute on Aging.What are palliative care and hospice care?
International Association of Hospice & Palliative Care.Guidelines and suggestions for those starting a hospice/palliative care service.
Centers for Medicare and Medicaid Services.Hospice.
Centers for Medicare and Medicaid Services.Medicare hospice benefits.
Centers for Medicare and Medicaid Services.Medicare benefit policy manual.
Tricare.Hospice care.
Department of Veterans Affairs.Hospice care.
Centers for Medicare and Medicaid Services.Hospice benefits.
National Hospice and Palliative Care Organization.NHPCO facts and figures 2022.
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