Two kinds of comfort-focused care
Hospice vs palliative care
Palliative care is extra support for the symptoms and stress of a serious illness, and it can start at any stage while treatment to cure or control the illness continues. Hospice is comfort-focused care for the last months of life, when a doctor certifies a life expectancy of six months or less and treatment to cure the illness has stopped. Hospice includes palliative care. Not all palliative care is hospice.
Medically reviewed by Oscar Chien, MD, Medical Director, September 24, 2026
On this page (11 sections)
- How is hospice different from palliative care?
- Who is palliative care for, and who is hospice for?
- When do palliative care and hospice start?
- What are the goals of palliative care and hospice?
- What happens to treatment in palliative care and hospice?
- Who pays for hospice and palliative care?
- Where do hospice and palliative care happen?
- Who is on the hospice and palliative care teams?
- How long do palliative care and hospice last?
- Examples of how families use each one
- Common questions about hospice and palliative care
How is hospice different from palliative care?
Hospice and palliative care differ in who they are for, when they start, what happens to treatment, who pays and how long they last. Palliative care can start at any stage while treatment continues. Hospice is comfort-focused care for the last months of life, when treatment to cure the illness has stopped.
| Palliative care | Hospice | |
|---|---|---|
| Who it is for | Anyone with a serious illness and symptoms or stress that need attention | People with a serious illness when a doctor certifies that life expectancy is six months or less if the illness runs its usual course |
| When it starts | Any stage, including at diagnosis | When the person chooses comfort-focused care and is certified eligible |
| Goals | Better symptom control and clearer decisions during treatment | Comfort, dignity and support for the person and family at the end of life |
| Treatment | Continues. Chemotherapy, dialysis, surgery and hospital care remain available | Treatment to cure the terminal illness stops. Comfort treatment continues |
| Who pays | Regular insurance: Medicare Part B, Medi-Cal managed care plans, private plans. Copays may apply | One bundled benefit under Medicare Part A, Medi-Cal and most private plans |
| Where | Hospital, clinic, facility or home, depending on the program | Wherever the person lives. Short inpatient stays when medically necessary |
| Team | Varies by program. Often a doctor or nurse practitioner, nurse and social worker | Set by Medicare: doctor, nurse, aide, social worker, chaplain, volunteers, grief support |
| How long | No time limit | Benefit periods that renew as long as a doctor keeps certifying eligibility |
Who is palliative care for, and who is hospice for?
Palliative care is for anyone with a serious illness, based on need, while hospice has a defined entry point. If a serious illness is causing pain, breathlessness, exhaustion, repeat hospital stays or hard decisions, palliative care may help, whatever the prognosis.
Hospice is for people with a serious illness when a doctor certifies that life expectancy is six months or less if the illness runs its usual course. Our medical director and your doctor make that determination. A website cannot.
When do palliative care and hospice start?
Palliative care can begin the day of diagnosis and run for months or years. Hospice begins when two things are true: doctors certify eligibility, and the person chooses comfort-focused care. Many families say afterward that they wish they had called hospice sooner. A call to ask questions commits you to nothing.
What are the goals of palliative care and hospice?
In palliative care, the goal is to live as well as possible while fighting or managing the illness. In hospice, the goal is comfort and dignity in the time that remains, and support for the family through the death and after it. Neither one speeds up or slows down dying.
What happens to treatment in palliative care and hospice?
Treatment is the main practical difference between palliative care and hospice. With palliative care, nothing is taken away. With hospice, the person agrees to stop treatment aimed at curing the terminal illness. Treatment for comfort continues, and Medicare still covers care for unrelated conditions. Under Medi-Cal, children and young people under 21 can receive hospice and curative treatment at the same time.
Who pays for hospice and palliative care?
Medicare covers hospice care related to the terminal illness. Under Medicare, most people pay nothing for hospice care itself. There can be a copay of up to $5 per prescription for symptom medicines and 5% of the Medicare amount for inpatient respite care. Medicare does not pay room and board where you live.
Palliative care has no single benefit. Visits are billed to Medicare Part B or your health plan like other specialist care, so deductibles and copays can apply. In California, Medi-Cal managed care plans must offer a palliative care benefit to members who meet their criteria, under SB 1004. See paying for care.
Where do hospice and palliative care happen?
Hospice comes to the person: a private home, an assisted living or board-and-care home, or a nursing facility. See where care happens. Palliative care started in hospitals and clinics, and more programs now visit at home. Ask any palliative program where its visits take place.
Who is on the hospice and palliative care teams?
Medicare defines the hospice team and what it must provide, including medicines, equipment, supplies and bereavement support. See what hospice provides. Palliative teams are not standardized. Some are a single nurse practitioner. Others include nurses, social workers and chaplains. What Beta's palliative team includes is described on our palliative care page.
How long do palliative care and hospice last?
Palliative care has no limit. Hospice is provided in benefit periods: two 90-day periods, then unlimited 60-day periods, as long as a doctor continues to certify that the person is eligible. People whose condition stabilizes can be discharged from hospice and return later.
Examples of how families use each one
Families often use palliative care while treatment continues and symptoms are hard, and hospice when treatment has stopped working or the person does not want more hospital care. These are examples, not advice for your situation. The right fit depends on the person's illness, goals and coverage, and it is decided with their doctors.
Still in treatment, struggling with symptoms
A man with lung cancer is continuing chemotherapy but has pain and nausea and has been to the emergency room twice. A family in this situation might ask his oncologist about palliative care.
Treatment has stopped working
A woman with advanced heart failure has been in the hospital four times this year and says she does not want to go back. A family in this situation might ask her doctor whether hospice is appropriate.
A slow decline with dementia
A father with dementia now needs help with everything, is eating less and has had pneumonia twice. A family in this situation might ask for a hospice evaluation. If he is not eligible yet, palliative care may be an option.
Not sure at all
Many callers do not know which one they are asking about. That is fine. A nurse can listen, explain both, and tell you what the next step would be. See is it time for hospice.
Common questions about hospice and palliative care
How do palliative care and hospice differ in timing and goals?
Timing: palliative care can begin the day of diagnosis and run for months or years while treatment continues. Hospice begins when doctors certify eligibility and the person chooses comfort-focused care. Goals: palliative care aims to help a person live as well as possible while fighting or managing the illness. Hospice aims for comfort and dignity in the time that remains, with support for the family through the death and after it.
Can you have hospice and palliative care at the same time?
Hospice already includes palliative care: the symptom control and support are built in. A person does not receive a separate palliative program while on hospice. People commonly move from a palliative program to hospice when treatment stops, and can move back if they leave hospice.
Does choosing palliative care mean stopping treatment?
No. Palliative care is given alongside treatment. Nothing is stopped unless you and your doctors decide to stop it.
Can someone go from hospice back to treatment?
Yes. Choosing hospice is your decision. You can stop hospice at any time and return to regular Medicare coverage. You have the right to choose your hospice. Some people leave hospice to try a new treatment and return later if they are eligible.
How long can a patient live on palliative care?
Palliative care is not tied to life expectancy, so there is no typical length. Some people use it briefly during hard treatment. Others use it for years.
What are the four stages of death in hospice patients?
There is no official set of four stages, and people differ. Families often notice a general pattern: weeks of sleeping more and eating less, then days of little intake and more confusion or restlessness, then hours of changed breathing and cool hands and feet. Your hospice nurse will tell you what they see and what to expect for your person.
Who decides which one a person gets?
The person does, with their doctors. A doctor's order or plan authorization is usually needed for palliative care. For hospice, two doctors certify eligibility and the person or their representative signs an election statement. No one can be placed on hospice without consent.
About this page
- Written by
- Beta Hospice care team
- Medically reviewed by
- Oscar Chien, MD, Medical Director
- Last reviewed
- September 24, 2026
- Next review
- March 24, 2027
How we write and review this site
Sources
- National Institute on Aging: What are palliative care and hospice care? (opens in a new tab)
- Medicare.gov: Hospice care coverage (opens in a new tab)
- 42 CFR 418.20: Eligibility requirements for hospice (opens in a new tab)
- California DHCS: Palliative care policies (SB 1004) (opens in a new tab)
These sources support the general information on this page. For one personās care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (877) 258-7129 any time, or leave your number and someone from Beta's hospice team will call you. No decision is needed to call. Most families start with a question.
Only a hospice doctor, together with the personās own doctor, can confirm hospice eligibility. A website cannot.
- A nurse answers 24 hours a day, 7 days a week
- You can stop hospice at any time
- You have the right to choose your hospice