Health Care at End of Life

What are Palliative Care and Hospice Care?

Palliative care and hospice care are often misunderstood, but they share the same common goal: to relieve the physical, emotional and spiritual pain of individuals living with a serious illness, while optimizing their overall quality of life.

Palliative care is probably best defined as what it is not: It is not hospice care, which focuses on the terminal phase of a serious illness.

According to the National Hospice and Palliative Care Organization (NHPCO), palliative care focuses on the pain, symptoms and stress of a serious illness while working in conjunction with the primary, curative treatment. Any individual with a serious illness, regardless of life expectancy or prognosis, is able to receive palliative care. Many individuals receive palliative care on an intermittent basis that increases as their disease progresses.

The NHPCO notes that services provided in palliative care often include pain and symptom management, in addition to help with navigating treatment options, advance care planning and referrals to community resources.

Most private insurance plans include palliative care, although some treatments and medications may not be covered or may be subject to a co-pay. Medicaid, the state-federal health insurance for the poor and disabled, offers coverage of palliative care, as does Medicare Part B for individuals 65 and older. However, some services or drugs may not be covered or may be subject to a co-pay.

Hospice care focuses on the pain, symptoms and stress of a serious illness during its terminal phase, according to the NHPCO. This terminal phase is defined by Medicare as an individual with a life expectancy of six months or less if the disease runs it natural course. Hospice care is usually considered when the burden of curative treatment outweighs any benefit.

The NHPCO notes that an interdisciplinary hospice care team offers services such as pain and symptom management, 24-hour on-call service, medical equipment, medications, inpatient care, continuous care in the home, respite care, spiritual care, and bereavement and counseling services.

Most private insurers offer a hospice benefit, but some drugs, services or equipment may not be covered or may require a co-pay. Medicare also covers hospice care, but again, may not cover all services or may require a co-pay. In most states, including Illinois, Medicaid pays for hospice care, although some services and drugs may not be covered or require a co-pay.

See this two-page fact sheet produced by NHPCO in 2019 for more details.