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Palliative Care vs. Hospice Care: Understanding End-of-Life Choices

By: Emily Wagner • Edited by: Karen Vieira, Ph.D. • 6 cited sources • Updated Oct 29, 2024

Thinking about end-of-life care options can be an overwhelming process — especially when trying to juggle your health, finances, and medical wishes. You might have come across terms like “palliative care” and “hospice care” when researching your options. It’s easy to assume they’re one and the same, but this isn’t quite true.

Palliative and hospice care both offer support for people with serious or life-limiting illnesses. However, there are some key differences that you or a loved one will want to consider before choosing your treatment. 

Key Takeaways

• Palliative care is specialized medical care focused on providing relief from the symptoms and stress of a serious illness.
• Hospice care is designed specifically for patients nearing the end of life, focusing on comfort and quality of life rather than curative treatments.
• Palliative care costs are generally covered by private insurance, with partial coverage by Medicare and Medicaid, while hospice care is fully covered by Medicare, Medicaid, or private insurance, often with minimal out-of-pocket expenses.
• Both types of care involve multidisciplinary teams, including doctors, nurses, social workers, and spiritual advisors.
  
  

What Is Palliative Care?

Palliative care is a type of medical care offered to anyone living with a serious illness who wants to live a healthier, more comfortable life^[2]. It uses a holistic approach to treat the symptoms and complications associated with your illness. Healthcare providers use palliative care in addition to directly treating your illness. This supports not only your physical health — but also your mental, emotional, and spiritual well-being. 

Your palliative care team is made up of healthcare and support professionals from a variety of fields, including^[3,4]:

• Physicians and nurses who manage your medical care
• Social workers who can connect you to resources for medical, financial, or social support
• Counselors offering treatment for mental health conditions 
• Spiritual advisors or a member of your religious community offering encouragement and support

They’ll work together to prescribe medications, manage your symptoms, and enhance your overall quality of life^[3]. Apart from medical care, palliative care offers other support services like talk therapy (counseling), nutritional education, and relaxation techniques^[2]. 

Who Should Be Considered for Palliative Care?

If you’re like many people, you probably think you don’t qualify for palliative care. But remember, these care services are available to anyone living with a serious illness. If your goal is to live a more comfortable life with your illness, then palliative care is right for you. 

People who can greatly benefit include those living with illnesses that cause pain, discomfort, muscle weakness, nutrition problems, or sleep difficulties. Examples include:

• Cancer
• Neurological conditions such as Parkinson’s disease or amyotrophic lateral sclerosis (ALS)
• Heart disease
• Liver disease
• Kidney disease 
• Stroke

The good news is you don’t need to wait to “qualify” for palliative care — you can start it at any time. In fact, the National Institute on Aging (NIA) recommends talking to your doctor about palliative care soon after your diagnosis^[3]. This way, you’ll almost immediately begin receiving the care you need to live a more comfortable life. You might also not need palliative care right away, but you’ll always know it’s an option to use later on. 

What Is Hospice Care?

Hospice care is a specific type of palliative care that provides comfort and improves the quality of life for people with life-limiting illnesses^[3]. These care services are designed to keep you as comfortable as possible as you spend your remaining time surrounded by your loved ones. 

Once you enter hospice care, you stop receiving any treatments aimed at curing your illness or helping you live longer^[3-5]. Instead, your care team dedicates all their efforts to relieving your symptoms and making sure you’re not in any pain or discomfort^[3]. This usually involves a supportive team of doctors, nurses, social workers, spiritual advisors, family members, and friends^[3,4].

One of the great benefits of hospice care is that your family also receives support and services. The loss of a loved one is difficult for everyone involved, and hospice care usually includes bereavement support following a death^[4].

Who Should Be Considered for Hospice Care?

Unlike palliative care, not everyone is eligible to receive hospice care — instead, you need to qualify based on your anticipated life expectancy^[3,4]. Your doctor will need to certify that you have a life expectancy of up to 6 to 12 months^[5]. 

The choice to enter hospice care is extremely personal and, at the end of the day, can only be made by you. You may want to go into hospice if you’re tired of all the tests, treatments, and doctor’s appointments that come along with curing your illness^[3]. Some people also use hospice care if their current treatment plan stops working and they’ve exhausted all other avenues. 

Where you choose to go into hospice care is entirely up to you. Some people prefer to enjoy the familiarity and comfort of their own homes. You can also receive the same care in an assisted living facility, nursing home, hospice facility, or hospital^[3].

The Main Difference Between Hospice and Palliative Care

The main difference between hospice and palliative care is the overall intent of your treatment.

Do you still want to treat your illness but receive support for managing other aspects like pain or treatment side effects? You’re looking for palliative care. Do you want to stop all testing and curative treatments and focus instead on being as comfortable as possible for your remaining days? This is where hospice care comes in. 

The Cost of Palliative and Hospice Care

It’s no surprise that medical costs in the United States can be astronomical. Fortunately, palliative and hospice care are usually partially or fully covered by insurance plans. You’ll want to call your insurance provider to understand exactly how much your care will cost. 

Palliative care is generally covered by private insurance plans^[4]. You’ll need to pay your copays for doctor’s visits and medications, which can vary in cost depending on your coverage. They typically start at $10 and go up depending on who you’re visiting. Medicare and Medicaid only partially cover palliative care^[4]. You’ll need the right insurance to cover doctor’s appointments, specialists, and prescription medications. 

The cost of hospice care is always paid in full by Medicare or Medicaid, and it may be covered by private insurance^[4]. To receive coverage with Medicare or Medicaid, your doctor will need to certify your anticipated life expectancy. At most, you’ll need to pay $5 for medications not covered by hospice benefits^[6]. Private insurance may have copays or deductibles you need to meet. 

What to Look for When Choosing a Supportive Care Team

When choosing a supportive care team, you’ll want to consider the team’s experience, the type of care provided, and where their services are offered. Questions you may have could include:

• How often will you see a palliative care or hospice provider? 
• What services are offered by the providers? What services aren’t?
• Where do you want to receive care, in your home, at a hospital, a nursing home, or a long-term care facility?
• What is the care team’s philosophy on end-of-life care? How do they honor their patient’s medical wishes?

Making Informed Choices for End-of-Life Care

Choosing between palliative and hospice care is a deeply personal decision that depends on your or your loved one’s medical needs, life goals, and values. Understanding the key differences between these two types of care can help you make an informed choice that prioritizes comfort, dignity, and the best possible quality of life during a challenging time. Whether seeking to manage symptoms while continuing treatment or focusing on comfort during the final stages of life, both palliative and hospice care offer compassionate support tailored to your unique situation.

Written by Emily Wagner

Emily earned a Bachelor of Science in Biotechnology from Rochester Institute of Technology in 2018 and a Master of Science in Biomedical Sciences with a focus in pharmacology from University of Colorado Anschutz Medical Campus in 2020. During her thesis work, she studied non-small cell lung cancer and how the immune system plays a role in response to different treatments. Emily currently lives in Colorado where she enjoys the mountains, spending time with her dog, baking, and reading a good book.

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Edited by Karen Vieira, Ph.D.

Dr. Karen Vieira has a Ph.D. in Biomedical Sciences from the University Of Florida College Of Medicine. She has worked in hospitals and clinics conducting clinical research with patients, as well as in biotechnology laboratories, researching the biochemistry and molecular biology of the body at a cellular level. Additionally, she worked in the food industry with the largest food company in America. Her passion is discovering existing research on dietary and lifestyle changes that prevent, cure or improve various health conditions.