You're sitting in the oncologist's office, and the word "palliative" just came up in conversation with your mom's doctor. Your heart sinks a little. Does palliative care mean giving up? And if she needs it, does Medicare cover hospice or palliative care? These questions race through your mind as you try to process what comes next.
Here's what you need to know: palliative care is comfort care with or without curative intent, and understanding how Medicare covers these services can give you the confidence to make informed decisions for your loved one.
Key Takeaways
- Medicare Part A covers hospice care at virtually no cost when eligibility requirements are met
- Palliative care can be provided alongside curative treatment and is covered under standard Medicare benefits with normal cost-sharing
- Hospice is not giving up — research shows patients who choose hospice often live longer than those pursuing aggressive treatment
- The 6-month prognosis is flexible — if you live longer and still meet criteria, Medicare coverage continues
- Medicare Advantage members receive hospice benefits through Original Medicare Part A, not their plan
What Is Palliative Care and How Does It Differ from Hospice?
Let's clear up the confusion right away. 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.
Palliative care is available to anyone with a serious illness — cancer, heart failure, COPD, dementia, Parkinson's, or any condition causing significant symptoms. This form of care can start as early as a person's diagnosis or not until later in their illness, and it can occur alongside other types of treatment for the disease. You can be receiving chemotherapy to fight cancer while also getting palliative care to manage pain, nausea, and fatigue.
Hospice care, on the other hand, is for people who have decided to shift their focus from curing their illness to living as fully and comfortably as possible in their remaining time. Hospice care is for people with a terminal illness who are expected to live 6 months or less. It focuses on comfort and symptom relief. Palliative care is available to anyone with a serious illness, regardless of life expectancy. It also focuses on comfort and symptom relief but includes treatments to help cure the illness.
Families in Naperville, Schaumburg, and Arlington Heights often ask us: "If we choose hospice, are we giving up?" The answer is an emphatic no. You're choosing to live differently — focusing on quality, connection, and comfort rather than treatments that may cause suffering without meaningful benefit.
Does Medicare Cover Hospice Care?
Yes — and the coverage is remarkably comprehensive. Medicare Part A (Hospital Insurance) covers hospice care if you're eligible ... Two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods.
Eligibility Requirements for Medicare Hospice Coverage
To qualify for Medicare hospice benefits, you must meet these criteria:
- You have Medicare Part A (either Original Medicare or Medicare Advantage)
- Only your hospice doctor and your regular doctor (if you have one) can certify that you're terminally ill and have a life expectancy of 6 months or less.
- You sign a statement choosing hospice care instead of other Medicare-covered treatments for your terminal illness and related conditions.
Here's what many families don't realize: the 6-month timeline is not a hard deadline. After 6 months, you can continue to get hospice care 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 you're still terminally ill.
And here's the truly remarkable part: patients who choose hospice care live an average of 29 days longer than similar patients who do not choose hospice, according to research published in the Journal of Pain and Symptom Management. Studies show this isn't about hospice "keeping people alive longer" artificially — it's about reducing the stress and harm of aggressive treatments, providing excellent symptom management, and allowing the body to find its natural equilibrium.
What Does Medicare Hospice Coverage Include?
You pay nothing for hospice care if you get your care from a Medicare-approved hospice provider. This includes:
- All visits from your hospice care team (doctors, nurses, social workers, chaplains, home health aides)
- Medical equipment and supplies related to your terminal illness
- Prescription drugs for pain and symptom management (up to $5 copay per prescription)
- Physical, occupational, and speech therapy
- Short-term inpatient care for pain and symptom management when needed
- You may pay 5% of the Medicare-approved amount for inpatient respite care (short-term care to help give caregivers a rest).
- Counseling and spiritual support for the patient and family
- Bereavement support for family members after the patient's death
Whether you're in Crystal Lake, Glenview, or anywhere throughout Cook, Lake, McHenry, and DuPage counties, LifeChoice brings all of this care directly to your home.
What Medicare Does NOT Cover Under Hospice
Medicare doesn't cover room and board if you get hospice care in your home or if you live in a nursing home or a hospice inpatient facility. You'll still be responsible for those costs if you're in a facility.
Medicare also won't cover treatments intended to cure your terminal illness once you've elected the hospice benefit. However — and this is important — Original Medicare will still pay for covered benefits for any health problems that aren't part of your terminal illness and related conditions, but you'll owe any deductible and coinsurance amounts that apply.
For example, if you're on hospice for heart failure and you break your hip, Medicare will cover treatment for the broken hip.
Medicare Coverage for Palliative Care
If you're not ready for hospice but need help managing symptoms of a serious illness, palliative care may be the right choice.
Medicare will cover palliative care, although the specifics depend on whether it's in conjunction with hospice care. Palliative care is designed to make the patient comfortable, but it can be provided alongside curative care or hospice care.
When palliative care is part of your regular treatment plan (meaning you're still pursuing curative treatment), Medicare's regular cost-sharing can apply to medically necessary palliative care. This can include deductibles, coinsurance, and copays for Original Medicare, Medicare Advantage, and Medicare Part D.
Services might include:
- Doctor visits to discuss symptom management
- Pain management consultations
- Physical therapy to maintain function
- Counseling and social work support
- Home health services
The key difference: with palliative care outside of hospice, you pay typical Medicare cost-sharing. With hospice, nearly everything is covered at no cost to you.
How Medicare Advantage Plans Handle Hospice Care
Here's a critical point for the thousands of families we serve in Des Plaines, Palatine, and the northwest suburbs: if you have a Medicare Advantage plan and need hospice care, your hospice coverage automatically shifts to Original Medicare Part A.
If you belong to a Medicare Advantage Plan and want to start hospice care, your plan must help you locate a Medicare-approved hospice provider in your area.
Hospice care is always covered under Original Medicare, even if you have a Medicare Advantage Plan. After electing hospice, your care shifts to Original Medicare, even if you have a Medicare Advantage Plan.
You can choose to keep your Medicare Advantage plan active for coverage of conditions unrelated to your terminal illness, or you can let it lapse and rely on Original Medicare for everything.
Hospice vs. Palliative Care: A Side-by-Side Comparison
| Feature | Palliative Care | Hospice Care |
|---|---|---|
| Prognosis | Any stage of serious illness | Life expectancy of 6 months or less |
| Treatment goals | Comfort alongside curative treatment | Comfort care; no curative treatment |
| Medicare coverage | Standard Part A/B coverage with cost-sharing | Part A with minimal out-of-pocket costs |
| Who oversees care | Your primary doctor | Hospice medical director |
| Location | Hospital, clinic, or home | Primarily at home (or facility where you live) |
| When to start | At diagnosis or any point during illness | When curative treatment is no longer beneficial |
The LifeChoice Approach: Hospice as Life-Affirming Care
At LifeChoice Hospice & Palliative Care, we've spent over a decade serving families throughout the Chicago area with one core belief: hospice is not about giving up. It's about choosing to live fully in the time you have.
Founded in 2012 by registered nurse Alex Roshko, LifeChoice has earned a 98% family satisfaction rate and a 4.9-star rating. We're ACHC accredited and Medicare certified, with a quality score of 80/100 compared to the national average of 67. These aren't just numbers — they represent thousands of families who found unexpected peace, dignity, and even joy during what they feared would be the hardest chapter of their lives.
Hospice doesn't automatically stop all medications. We stop treatments causing suffering without benefit, while continuing medications that support comfort, function, and quality of life. Many of our patients continue heart medications, diabetes medications, and treatments that help them feel better and do more.
The 6-month prognosis isn't a death sentence. It's a medical estimate. Some of our patients live weeks; others surprise everyone and live many months beyond initial expectations. As long as your doctor certifies you still meet hospice criteria, Medicare coverage continues — there's no time limit.
Whether you're in Evanston, Wheaton, or any community across our four-county service area, our team comes to you. We bring medical equipment, medications, and — most importantly — a team that sees your loved one as a whole person, not just a diagnosis.
Frequently Asked Questions
Does Medicare cover 100% of hospice care costs?
Yes, with very limited exceptions. The Medicare Hospice Benefit is an inclusive benefit, in which all services that are related to the terminal illness are covered up to 100 percent by Medicare Part A. You may have small copays (up to $5 per prescription for symptom management drugs, and 5% of costs for respite care), but the vast majority of care is completely covered. This includes all nursing visits, medical equipment, supplies, and medications related to your terminal condition.
Can you be on hospice longer than 6 months?
Absolutely. There is no limit on how long Medicare will cover hospice care. The initial certification is for two 90-day periods, followed by unlimited 60-day periods. At the start of each period after the first 90 days, your hospice doctor must recertify that you still have a terminal prognosis. But there's no maximum time limit. We've had patients in our Downers Grove and Naperville communities who've been on hospice service for a year or more, continuing to receive excellent care and support.
What's the difference between comfort care and hospice?
These terms are often used interchangeably, but there's a subtle distinction. Comfort care is a general term describing care focused on symptom relief and quality of life rather than cure. Hospice is a specific Medicare benefit and program that provides comprehensive comfort care for people with a terminal prognosis. All hospice is comfort care, but not all comfort care is hospice — you can receive comfort-focused care at any stage of illness, whether or not you qualify for the hospice benefit.
Does Medicare cover palliative care at home?
If the patient has opted for hospice care, palliative care is covered with little or no out-of-pocket costs. But if a patient is still receiving treatment for their medical condition (ie, still working toward a cure, as opposed to hospice care), Medicare's regular cost-sharing can apply to medically necessary palliative care. In other words, if you're on hospice, all palliative services related to your terminal condition are covered. If you're receiving palliative care while still pursuing curative treatment, it's covered like any other medical service under Medicare Parts A and B, with applicable deductibles and coinsurance.
Will choosing hospice make my loved one die sooner?
No — in fact, the opposite may be true. For the six patient populations combined, the mean survival was 29 days longer for hospice patients than for nonhospice patients. Our findings suggest that hospice may indeed have a positive impact on patients' longevity or at least not hasten death. Research shows this happens because hospice reduces the physical stress of aggressive treatments, provides excellent symptom management, and supports the whole person — body, mind, and spirit. Families throughout Vernon Hills, Lake Forest, and across Lake County have shared with us that their loved ones seemed more comfortable, more present, and more themselves after starting hospice than they had been in months.
Taking the Next Step: You're Not Alone
Understanding Medicare coverage for palliative care and hospice is just the beginning. The real journey is about recognizing when the time is right to shift your focus from fighting a disease to embracing the life that remains.
If you're in Chicago or the surrounding counties of Cook, Lake, McHenry, or DuPage, LifeChoice Hospice & Palliative Care is here to walk alongside you. We bring compassionate, expert care directly to your home — whether that's a house, an apartment, an assisted living community, or a nursing facility.
You don't have to figure this out alone. Our team is available 24/7 to answer your questions, provide guidance, and help you understand your options.
Ready to learn more about how hospice can support your family? Call us at 847-777-8888 or email info@mylifechoice.org. We offer free consultations with no obligation — just honest conversation about what's best for your loved one.
Contact LifeChoice to speak with a member of our care team today. Because the best time to start hospice is often sooner than you think — and every day of comfort, dignity, and connection matters.
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