Eight Important Differences Between Hospice Care and Palliative Care
Many people have at least heard of Hospice Care and have a general idea of how it works. But fewer people have heard of Palliative Care.
Perhaps this is because Hospice has been around as a medical concept and practice much longer than Palliative Care.
It is important to understand the differences between these two medical options if a loved one develops a serious illness and winds up under medical care. This will let you be able to discuss both options with family and their medical team, as well as with health insurance professionals.
Key differences between Hospice Care and Palliative Care
1. Location - Hospice Care is most often given by a team of doctors, nurses, and therapists at the patient’s home. Palliative Care is most often, given at the place where the person is receiving medical treatment. This may be a hospital, nursing home, or extended care facility.
2. Requirements - A person is enrolled in Hospice Care by their physician after he or she determines that the patient has a terminal illness. This means they are unlikely to live more than another six months. A decision for Palliative Care does not require that a person must be terminally ill. It only requires that a patient must have reached a point where they a suffering and in pain. The patient needs special care and medications to give them some relief.
3. Medicare Coverage - When a person is enrolled in Hospice Care and has Medicare, all treatment and support services are paid for by Medicare Part A. If the patient had Medicare Part B, they must give it up. When a person is enrolled in Palliative Care and has both Medicare Parts A & B they keep all benefits from both programs.
4. Amount of Care - In Hospice Care if a person needs 24/7 care, the Hospice team of doctors, nurses and therapists are on hand to provide it. In a Palliative Care setting although medical assistance is always on call, they are not necessarily by the person’s bedside 24/7.
5. Insurance Coverage - In Hospice Care everything a person needs is handled through a single program. This includes things like medications, daily care, medical equipment, counseling, symptom treatment, and counseling. In Palliative Care there may be multiple providers involved, each with their own eligibility, level of care, and billing procedures.
6. Co-pays - With Hospice Care, everything the patient needs is paid for by Medicare Part A. Sometimes there is a maximum co-pay of no more than $5 for very expensive medications, but that’s it. With Palliative Care, what things are covered, and the patient responsibility varies depending on their insurance.
7. Prescription Coverage - In Hospice Care under Medicare Part A most prescriptions are fully covered. With Palliative Care, prescriptions coverage and patient responsibility are determined by the patient’s insurance coverage.
**Important note for Veterans: If a Veteran is enrolled in "Tricare For Life” they will generally find that most of their prescriptions are paid for by the VA (even if they do not have Medicare Part D). However, to enroll in "Tricare For Life” at age 65 they must have also enrolled in BOTH Medicare Parts A & B when they became eligible at age 65.**
8. Use of Life-prolonging Therapies - In Hospice care, life-prolonging therapies are usually not part of the medical treatment program. This is because to be enrolled in Hospice in the first place, it must have determined that the person has a limited life expectancy. In Palliative Care no such limitations exist. Life-prolonging as well as health-recovery medical treatments can continue alongside Palliative Care. However, the cost and type of treatment available may be subject to the requirements of the person’s insurance coverage.
