Palliative care is an extra layer of support for anyone with a serious illness, at any stage, and it can run alongside treatment meant to cure or control the illness. Hospice is a form of palliative care for the final stretch: a doctor expects six months or less to live if the illness runs its usual course, and the person chooses comfort care instead of treatment to cure it. The two are related but not the same, and starting palliative care does not mean starting hospice.
Is palliative care the same as hospice?
No. The National Institute on Aging (NIA) calls hospice a specific type of palliative care, given in the final weeks or months of life. All hospice care is palliative. Not all palliative care is hospice.
| Palliative care | Hospice care | |
|---|---|---|
| Who it is for | Anyone with a serious illness, any age, any stage. A terminal diagnosis is not required. | A person with a terminal illness whose doctor expects six months or less to live if it runs its usual course. |
| When it can start | At diagnosis or later. | When doctors certify the prognosis and the person chooses hospice. |
| Treatment to cure the illness | Can continue alongside it. | Stops. Comfort care continues, and other health problems are still treated. |
| Where | Hospitals, outpatient clinics, nursing homes or at home. | Home, assisted living, nursing home, hospital or a hospice residence. |
Sources: NIA, CaringInfo and the New York State Department of Health. For a wider overview, see our guide to palliative and hospice care in New York.
Who provides each one?
A palliative care team is made up of specialist doctors and nurses and can include social workers, nutritionists and chaplains (NIA). It works with the person’s other doctors. A hospice team includes nurses, doctors, social workers, spiritual advisors and trained volunteers. The state health department also lists a certified home health aide and a medical director. A hospice team member visits regularly, and someone is usually reachable by phone 24 hours a day.
Does hospice mean death, or giving up?
Not in the way many families fear. Hospice is for the time when a cure is no longer the goal, so it often comes near the end of life. But six months is a forecast, not a countdown. NIA notes that doctors have a hard time predicting how long an older, sick person will live, and Medicare can keep paying if the hospice doctor certifies again that the person is still terminally ill. A person can also leave hospice.
- “Hospice means giving up.” CaringInfo, a program of the National Alliance for Care at Home, says choosing hospice is in many ways the opposite of giving up: it is choosing a voice and some control in the last stage of life. Its myth page adds that you need only be ready for comfort care instead of care to cure.
- “Hospice is only for cancer.” Medicare’s hospice booklet says plainly that hospice isn’t only for people with cancer. NIA lists dementia and heart failure among serious illnesses.
- “I would have to stop every treatment.” Treatment meant to cure the serious illness stops, but NIA says a person can keep taking medicine for other conditions, such as high blood pressure.
- “I would lose my own doctor.” Medicare says you can keep your regular doctor, nurse practitioner or physician assistant as the attending professional who helps supervise hospice care.
Does Medicare cover hospice care?
Yes. Medicare.gov says Part A covers hospice if you are eligible. You need Part A, your hospice doctor and your regular doctor (if you have one) must certify a life expectancy of 6 months or less, and you must accept comfort care instead of care to cure and sign a statement choosing hospice.
Palliative care outside hospice works differently. NIA says whether Medicare pays depends on your benefits and treatment plan. CaringInfo says Medicare, Medicaid and many insurers cover the medical part, meaning physician and nurse services, and you may owe copays or coinsurance.
| Hospice (Medicare Part A) | Palliative care outside hospice | |
|---|---|---|
| Included | Doctor and nursing services, hospice aide and homemaker services, drugs for pain and symptom control, equipment, supplies, therapy, social work, counseling, short-term inpatient and respite care. | Mainly the physician and nurse services of the palliative team. Ask what else your plan pays for. |
| You pay | No deductible. Up to $5 per prescription for pain and symptom drugs. 5% of the approved amount for inpatient respite. Room and board are not covered. | Your usual cost sharing. Part B: $283 deductible in 2026, usually 20% after. |
| Cure-directed treatment | Not covered for the terminal illness and related conditions. | Can continue. |
Original Medicare still pays for covered care unrelated to the terminal illness, with the usual deductible and coinsurance. With a Medicare Advantage plan, Original Medicare covers what you need for the terminal illness once hospice starts. See Medicare and home care and Medicare versus Medicaid.
Who pays for hospice, including Medicaid in New York?
The state health department lists Medicare, Medicaid, most commercial health insurance, and gifts and donations, because most hospices are nonprofit. On Medicaid, the state’s hospice page says electing hospice waives standard benefits for treating the terminal illness, and that a patient can rescind the election and reapply later. The same page mentions both six or fewer months and under twelve months, so ask the hospice which rule applies. If the person has Medicaid home care, ask the plan how those hours work with hospice (Medicaid home care).
How long will Medicare pay for hospice care?
As long as the person keeps meeting the criteria. Medicare pays in benefit periods: two of 90 days, then unlimited periods of 60 days.
| Benefit period | Length | What has to happen |
|---|---|---|
| First | 90 days | The hospice doctor and regular doctor (if any) certify a life expectancy of 6 months or less. |
| Second | 90 days | A hospice doctor recertifies that the person is still terminally ill. |
| Third and after | 60 days each, no limit | Recertification at the start of each period. After six months it follows a face-to-face visit with a hospice doctor or nurse practitioner. |
You do not need to choose hospice again for each period, and you can change hospice provider once per period. For dementia, see how long people live in end-stage dementia and when it is time for hospice.
Can you stop hospice and go back to treatment?
Yes. Medicare says you can stop hospice at any time, for example if your health improves or the illness goes into remission. You sign a form with the date care ends. No one should ask you to sign forms about stopping if you did not ask for them. If the doctor decides life expectancy is no longer six months or less, the hospice may discharge the person until a doctor certifies again, and someone eligible can return to hospice later. If the person was in a Medicare Advantage plan, the plan starts again the first day of the following month.
How do you ask the doctor about palliative care or hospice?
You do not have to wait for the doctor to raise it. NIA says that if a provider does not suggest palliative care, you can ask for a referral to a specialist. The state’s palliative care page puts it as “just ask”: the patient, a provider, family, a friend or a social service agency can all bring it up.
- Write down what is changing. The state’s hospice page lists signs such as two or more emergency visits or hospital stays in six months, a steady decline in function, unplanned weight loss over 10% in six months, or uncontrolled pain. Treat it as a conversation starter.
- Ask directly. “Would palliative care help now?” and “Is it time to talk about hospice?” are fair questions.
- Use the one-time consultation. Medicare’s booklet says that before starting hospice you can meet a hospice doctor about your options, even if you decide against hospice.
- Call a hospice yourself if needed. The state says referrals can come from anyone familiar with the patient, and CaringInfo says anyone can call a hospice.
- Check the hospice. Medicare pays only Medicare-approved hospices. Start with the state’s Directory of Hospices and Medicare Care Compare.
Questions to bring: What do you expect over the coming months? Which treatments would continue under hospice, and which would stop? Which hospices do you work with, and can you stay as attending doctor? Who do we call at night if symptoms worsen? What happens if the person improves?
What does New York add: the palliative care law, MOLST and the health care proxy?
The Palliative Care Information Act, Public Health Law section 2997-c, says that when a patient is diagnosed with a terminal illness, expected to cause death within six months, the attending physician or nurse practitioner must offer information and counseling on palliative care and end-of-life options. That covers the options, prognosis, risks and benefits, the legal right to comprehensive pain and symptom management, other treatment options, and the benefits of a health care proxy. A practitioner who is unwilling or not qualified must arrange another.
The Department of Health adds that the law is not meant to discourage palliative care conversations with people who may live longer than six months. Two documents go with these decisions:
- Health care proxy. It names an agent to make medical decisions if you cannot. The state says everyone over 18 should have one.
- MOLST (form DOH-5003). Medical orders recording wishes about CPR and other life-sustaining treatment. The state says it is intended for patients with serious conditions who might die within the next year, live in a long-term care facility or need long-term care services, or want to avoid or receive some or all life-sustaining treatment.
Our guide to the living will, health care proxy and MOLST covers each form. This is general information; an elder law attorney can advise on your own situation.
How do home care aides work alongside a hospice or palliative team?
ProLife Home Care is not a hospice agency. Symptom management and the hospice plan of care belong to the hospice team and the person’s doctors. Hospice includes its own aide and homemaker services, but NIA says most day-to-day care of a person who is dying is given by family and friends, and CaringInfo adds that paid home health aides may help.
That is where a home care agency can fit. Our home health aides and personal care aides can help with daily personal care, meals and company, and give the family a break. Aides support, but do not replace, the hospice team:
- Tell the hospice nurse and social worker who is coming into the home.
- An aide reports changes to the agency’s nurse or coordinator, and the family passes anything important to the hospice team.
- Aides do not decide or change medicines. Those questions go to the hospice nurse.
Hospice does not usually provide round-the-clock care at home. Our guide to hospice at home and 24-hour care covers what families arrange, and end-of-life support at home the day-to-day side. For a caregiver’s rest, see respite care.
Support for the family: advice from our nurse director
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
You can’t do all of it by yourself. Illness changes the whole family’s life, not only the patient’s. The sooner support is in place, the easier it is to keep a safe home and a familiar routine. Even a few hours of professional home care a week gives relatives time to rest. A husband or an adult daughter who has done everything alone for years has usually given up their own rest. A home health aide a few days a week can change that. We want the person safe and well cared for, and the family able to breathe.
We are a licensed home care agency in Brooklyn and Queens (New York State Department of Health licence #2572L001). If you are working out how aide hours could fit alongside a palliative or hospice team, call (718) 232-2777 or use our contact page. You can also read about our in-home care.
General information, not medical or legal advice. Medicare, Medicaid and New York rules change. Everything above was checked on 15 October 2026 against medicare.gov, nia.nih.gov, caringinfo.org, health.ny.gov and nysenate.gov. Confirm details with the person’s doctor, the hospice, the insurer or plan, and an elder law attorney for legal questions.
Frequently asked questions
Is palliative care the same as hospice?
No. Palliative care is for anyone with a serious illness at any stage and can run alongside treatment to cure it. Hospice is a type of palliative care for people with a prognosis of six months or less, when treatment to cure the illness stops.
What is the difference between palliative care and hospice?
The main differences are timing and treatment. Palliative care can start at diagnosis and continue with curative treatment. Hospice starts when a doctor certifies a life expectancy of six months or less and the person chooses comfort care instead of cure.
Does hospice mean death?
Hospice often comes near the end of life, but the six-month estimate is a forecast. Medicare can keep paying if the hospice doctor recertifies, and a person can stop hospice at any time, for example if their health improves.
Does Medicare cover hospice?
Yes. Part A covers hospice from a Medicare-approved provider with no deductible. You may pay up to $5 per prescription for pain and symptom drugs and 5% of the approved amount for inpatient respite care. Room and board are not covered.
How long will Medicare pay for hospice care?
Medicare pays for two 90-day periods, then unlimited 60-day periods, as long as a hospice doctor recertifies that the person is still terminally ill. After six months, recertification follows a face-to-face visit.
Who pays for hospice?
The New York State Department of Health lists Medicare, Medicaid and most commercial health insurance, plus donations to the nonprofit hospices. Ask the hospice and your plan what applies to your case.
Can a person get palliative care and keep treatment for the illness?
Yes. NIA says a person does not have to give up treatment that might cure a serious illness to receive palliative care, and it can begin at diagnosis. Ask the doctor for a referral to a palliative care specialist if it has not been offered.
