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The one-sentence answer
All hospice care is palliative, but not all palliative care is hospice. Palliative care is comfort care that can run alongside treatment meant to cure, at any stage, with no prognosis required. Hospice is a complete Medicare benefit for a prognosis of about six months or less, for when the goal of care has shifted from curing the illness to living as well as possible.
Neither one means giving up. Palliative care is often given during chemotherapy. Hospice is not a countdown — it is a different set of goals, and people frequently feel better on it than they did before.
Side by side
| Palliative care | Hospice care | |
|---|---|---|
| When you can start | Any stage of a serious illness, from the day of diagnosis | When a physician believes the prognosis is about six months or less |
| Treatment meant to cure | Continues — chemotherapy, dialysis, surgery all carry on | Stops for the hospice illness; the goal becomes comfort |
| Who pays | Billed like other specialist care — Medicare Part B, Medicaid or private insurance, usually with copays | The Medicare Hospice Benefit covers the team, medications, equipment and supplies for the illness — for most families, close to nothing out of pocket |
| Where it happens | Usually a clinic or hospital, sometimes at home | Wherever the person lives — house, apartment, assisted living, nursing home |
| Who comes | A physician or nurse practitioner, often a nurse and social worker | A full team: physician oversight, nurses, aides, social work, chaplaincy, volunteers |
| After hours | Generally clinic hours | A nurse on call 24 hours a day, every day |
| Support for the family | Varies by programme | Included, and it continues for up to 13 months after a death |
What palliative care actually is
Palliative care is specialist attention to the parts of illness that treatment tends to leave for later: pain, breathlessness, nausea, appetite, exhaustion, anxiety, and the question of what you actually want out of the next year. It exists alongside whatever your oncologist or cardiologist is doing, not instead of it.
Access is usually through the hospital or specialist practice already treating the illness — ask the treating physician for a palliative care referral. It is a normal request and a common one.
To be straight with you: we are a home health and hospice agency, and hospice is what we provide. If palliative care alongside ongoing treatment is what fits today, we will tell you that and help you find it rather than sign you up for something you don’t need yet. Call and ask — there is no cost to a conversation.
Which one fits right now
Rough guide, and not a substitute for a conversation with the treating physician:
- Still pursuing treatment meant to cure or control the illness? Palliative care is the fit. Ask the specialist for a referral.
- Treatment is no longer working, or the burden of it now outweighs the benefit? That is the conversation hospice exists for.
- Repeat hospital trips, rapid weight loss, more time in bed than out of it? Worth a hospice conversation even if nobody has raised it yet — you do not need a doctor’s permission to ask.
- Genuinely unsure? Ask us. If the honest answer is “not yet,” you will hear that from us, and we will tell you what to watch for.
If you want the longer version of that question, we wrote a whole page on it: how do I know when it’s time for hospice?
Getting either one in southern Utah
For hospice, you can call us directly on 435-635-1001 — a family can start the conversation without a physician referral, and we handle the medical side from there with your doctor. We serve St. George, Cedar City, Hurricane, Washington, Ivins, Santa Clara and the surrounding communities.
For palliative care, start with the specialist treating the illness, or with Intermountain and the other hospital systems in the region. If you are not sure who to ask, call us and we will point you in the right direction — we would rather you get the right care than our care.
If you are a physician, hospital case manager or facility nurse, send a referral and we will call you back, usually within the hour during the day.
Common questions
Can you have palliative care and hospice at the same time?
Not as two separate programmes for the same illness, because hospice care is itself palliative — the hospice team takes over comfort care completely. What you can do is move from palliative care to hospice when the goals change, and that transition is common and straightforward.
Is palliative care only for people who are dying?
No. Palliative care is for anyone living with a serious illness, at any stage, and plenty of people receive it for years while being actively treated. Studies have found that people who get palliative care early alongside treatment often report better quality of life.
Does Medicare pay for palliative care the way it pays for hospice?
Not in the same way. Hospice has its own dedicated Medicare benefit that bundles the team, medications, equipment and supplies related to the illness, which is why most families pay close to nothing. Palliative care is billed like other specialist visits under Medicare Part B or your insurance, so ordinary copays and deductibles apply.
If we choose hospice, can we change our minds?
Yes. You can revoke the hospice benefit at any time, for any reason, and return to treatment intended to cure. You can also elect hospice again later. It is not a one-way door.
Who decides that someone qualifies for hospice?
A physician certifies the prognosis — usually the person’s own doctor together with our medical director. Anyone can ask for the conversation, though: a spouse, an adult child, a facility nurse, or the person themselves.