Getting palliative care starts with a conversation, either with your doctor or directly with a palliative care program. Unlike hospice, palliative care has no requirement that you be near the end of life. It’s available at any stage of a serious illness, from the day of diagnosis onward, and you can receive it while still pursuing treatment aimed at curing your condition.
Who Qualifies for Palliative Care
There is no strict checklist you need to pass. Palliative care is a resource for anyone living with a serious illness that causes significant symptoms, stress, or disability. Common conditions include heart failure, cancer, chronic obstructive pulmonary disease, dementia, Parkinson’s disease, kidney disease, and ALS, but the list is not limited to these. If your illness is making daily life harder, whether through pain, fatigue, nausea, anxiety, or difficulty functioning, you are a candidate.
Age doesn’t matter either. Palliative care serves children, working-age adults, and older people. For children covered by Medicaid or CHIP, a federal provision called Concurrent Care for Children (part of the Affordable Care Act) specifically allows kids to receive hospice-level palliative services without giving up curative treatments.
How to Request a Referral
The most common path is through your existing doctor. Tell your primary care physician or specialist that you’re interested in palliative care. Use direct language: “I’d like a referral to a palliative care team to help manage my symptoms and quality of life.” Many doctors welcome this conversation but won’t initiate it themselves, so being specific helps move things forward.
If your doctor isn’t familiar with palliative care or seems hesitant, you have other options. You can contact a hospital’s palliative care program directly. Most mid-size and large hospitals have one. You can also search the provider directory at GetPalliativeCare.org, which lets you look up programs by zip code and filter by setting: hospital, nursing home, outpatient clinic, or home-based care. If you’re already hospitalized, ask the nursing staff or a hospital social worker to request a palliative care consultation. In many hospitals this can happen within a day or two.
You do not need to wait until other treatments have failed. Research on patients with metastatic lung cancer found that those who started palliative care early alongside standard treatment had better quality of life, less aggressive treatment near the end of life, and improved survival compared to those who received oncology care alone. Similar benefits have been seen in other cancers and serious illnesses. Starting early gives the team more time to address symptoms before they become entrenched.
What the Palliative Care Team Looks Like
Palliative care is delivered by a group of specialists working together, not a single provider. A typical team includes physicians, nurse practitioners or physician assistants, social workers, and chaplains. Depending on your needs, it may also involve physical therapists, dietitians, or counselors. The team coordinates with your existing doctors rather than replacing them.
Their focus covers the full range of what serious illness does to a person: physical symptoms like pain and shortness of breath, emotional distress, help navigating difficult medical decisions, and support for family members or caregivers who are also affected. Social workers on the team often help with practical concerns like insurance paperwork, advance directives, and connecting you to community resources.
Where You Can Receive It
Palliative care is not limited to hospitals. You can receive it in several settings depending on what’s available in your area and what fits your situation.
- Hospital-based: The most widely available model. A palliative care team consults on your case while you’re admitted, or you visit an outpatient palliative care clinic for ongoing appointments.
- Home-based: A team visits you at home. Research from a Cochrane review found that home-based end-of-life care increased the likelihood of dying at home for those who preferred it, and in one study reduced average costs from about $20,000 to roughly $12,700 per patient compared to standard care.
- Nursing facility: If you live in a long-term care facility, palliative care teams can provide services there.
- Outpatient clinic: Regular office visits, similar to seeing any other specialist. This works well for people whose illness is being managed but who need better symptom control or help with care planning.
Home-based programs also showed slightly higher patient satisfaction in the short term, though the difference leveled out over six months. One practical consideration: home-based care places more responsibility on family caregivers between visits, so the team should assess whether adequate support is in place.
How Palliative Care Differs From Hospice
People often confuse these two, and the distinction matters because it affects what you’re eligible for and what you can still receive. Palliative care is available at any point during a serious illness, and you continue all your regular treatments. Hospice is a specific type of palliative care reserved for people whose doctor estimates they have six months or less to live, and it generally requires stopping curative treatment for the terminal illness.
Once you elect hospice under Medicare, the program covers nearly everything related to your terminal condition at no cost to you, but Medicare will no longer pay for treatments intended to cure that condition. You’ll pay nothing for the hospice care itself, up to $5 per prescription for symptom-related medications, and up to 5% of the approved amount for short-term inpatient respite care (temporary stays that give your caregiver a break). Medicare still covers treatment for health problems unrelated to the terminal diagnosis under its normal rules.
Palliative care that isn’t hospice doesn’t carry these trade-offs. You keep all your treatments and simply add palliative support on top of them.
What Insurance Covers
Most insurance plans cover palliative care services, though the details vary. Medicare Part B covers outpatient palliative care consultations as specialist visits, meaning you’ll pay your standard copay or coinsurance. If you’re admitted to a hospital and a palliative care team consults, that’s typically covered under Part A as part of your inpatient stay.
Medicaid coverage varies by state. Hospice is an optional benefit that states can include in their Medicaid plans, and most do. Palliative care services outside of hospice are generally billed as physician visits, social work consultations, or other covered services rather than under a single “palliative care” benefit. Private insurance plans increasingly cover palliative care, but it’s worth calling your insurer to confirm what’s included and whether you need a referral from your primary doctor first.
If cost is a concern, the palliative care team’s social worker can help you navigate coverage options and identify programs that reduce out-of-pocket expenses. Some community and nonprofit organizations also offer palliative support services at low or no cost.
What to Expect at the First Visit
Your initial palliative care appointment is typically longer than a standard doctor’s visit, often 60 to 90 minutes. The team will ask detailed questions about your symptoms, how your illness affects your daily life, what matters most to you, and what your goals are for treatment. They’ll review your medications and may suggest changes to better manage pain, nausea, sleep problems, or other symptoms.
You’ll also have a conversation about your broader wishes for care. This isn’t limited to end-of-life planning. It includes questions like how aggressive you want treatment to be, what side effects you’re willing to tolerate, and what activities or milestones matter to you. Bringing a family member or caregiver to this appointment is helpful, both because they can share observations about your symptoms and because the team’s support extends to them as well.
After the first visit, follow-up frequency depends on your needs. Some people see the palliative care team weekly, others monthly, and some check in only when symptoms change or a major treatment decision comes up. The relationship is ongoing and adjusts as your condition evolves.