Yes, Medicare covers palliative care, but the extent of coverage depends on whether you’re receiving palliative care alongside curative treatment or as part of the formal hospice benefit. These are two very different situations under Medicare, and the distinction matters for what you’ll pay out of pocket.
Palliative Care and Hospice Are Not the Same Thing
This is the single most important distinction for understanding your Medicare coverage. Palliative care focuses on relieving symptoms and improving quality of life for anyone with a serious illness, regardless of prognosis. You can receive palliative care while still pursuing treatments to cure your condition. It can begin at the time of diagnosis.
Hospice care is a specific type of palliative care reserved for people whose doctors certify they have a life expectancy of six months or less. When you elect hospice, you agree to stop curative treatments for your terminal illness and focus entirely on comfort care. You also sign a statement choosing hospice over other Medicare-covered treatments for your terminal condition.
Medicare treats these two situations very differently. Hospice has its own dedicated benefit with broad coverage and minimal out-of-pocket costs. Palliative care outside of hospice is covered, but it runs through your regular Medicare benefits, with the usual deductibles and coinsurance.
How Medicare Covers Palliative Care Outside Hospice
If you have a serious illness but aren’t terminally ill, or you’re choosing to continue curative treatment, Medicare can still cover many palliative services. These are billed through your standard Medicare Part A and Part B benefits. Doctor visits, outpatient consultations with palliative care specialists, mental health counseling, rehabilitation therapy, and durable medical equipment all fall under regular Medicare coverage.
The catch is that you’ll pay the same cost-sharing you would for any other medical service. In 2025, Medicare Part A has a deductible of $1,676 per benefit period for inpatient stays, while Part B has a yearly deductible of $257 for outpatient services. After meeting those deductibles, you’ll typically owe coinsurance or copayments for each service. There is no special billing category or reduced cost-sharing for palliative care delivered outside the hospice benefit.
Coverage also depends on medical necessity. Medicare will pay for palliative consultations and symptom management when they’re tied to a documented diagnosis and treatment plan, just like any other covered service. The National Institute on Aging notes that what Medicare pays for palliative care “depends on your benefits and treatment plan,” which is a polite way of saying there’s no blanket guarantee.
What the Medicare Hospice Benefit Covers
The hospice benefit is far more comprehensive. Once you qualify, Medicare covers virtually everything related to your terminal illness and related conditions: doctor services, nursing care, medical equipment, medications for symptom management and pain relief, counseling, and short-term inpatient care when needed. Most of these services come with little to no cost to you.
To qualify, two conditions must be met. Your hospice doctor and your regular doctor (if you have one) must certify that you’re terminally ill with a life expectancy of six months or less. And you must formally elect hospice care, which means agreeing to receive comfort-focused care instead of curative treatment for your terminal illness. After the initial six months, you can continue receiving hospice care as long as a hospice doctor or medical director recertifies your terminal status after a face-to-face meeting.
If your condition stabilizes or improves to the point where a six-month prognosis no longer applies, you may be discharged from the hospice benefit. You can always re-enroll later if your condition worsens again.
How Prescription Drugs Work Under Each Scenario
Medication coverage is one area where the hospice election creates real complexity. Once you choose hospice, the hospice program becomes responsible for covering all medications related to your terminal illness and related conditions. These drugs are included in Medicare’s per-diem payment to the hospice provider and are excluded from Part D coverage.
Part D will still cover medications for conditions completely unrelated to your terminal illness. But any drug that was previously used to treat or slow the terminal disease and is discontinued upon hospice election becomes your financial responsibility if you choose to keep filling it. Part D won’t pay for it, and the hospice won’t cover it if it’s deemed unnecessary for comfort care.
There’s also a formulary issue. If you request a specific drug for symptom management that isn’t on the hospice’s formulary and you refuse to try a formulary equivalent, you may have to pay for that drug yourself. Neither the hospice benefit nor Part D will cover it in that situation.
Outside of hospice, your palliative medications are covered through Part D like any other prescriptions, subject to your plan’s formulary, copays, and coverage rules.
Medicare Advantage Plans and Supplemental Benefits
If you’re enrolled in a Medicare Advantage (Part C) plan, your palliative care coverage depends on your specific plan’s benefit structure. All Medicare Advantage plans must cover at least what Original Medicare covers, but many offer additional benefits that can be particularly useful for palliative care patients.
Some Medicare Advantage plans offer supplemental benefits specifically designed for people with chronic illnesses, known as Special Supplemental Benefits for the Chronically Ill (SSBCI). These can include transportation to medical appointments, healthy food assistance, and other support services that address the practical challenges of living with a serious illness. CMS has expanded the flexibility for plans to target these benefits to enrollees who need them most, so it’s worth checking what your specific plan offers.
What You’ll Pay Out of Pocket
For palliative care outside hospice, expect the same cost-sharing structure as any Medicare-covered service: deductibles, coinsurance (typically 20% of the Medicare-approved amount for Part B services), and copays for prescriptions. If your palliative care specialist is a nurse practitioner or clinical nurse specialist rather than a physician, Medicare pays at 85% of the physician rate, which can slightly affect your costs.
For hospice, out-of-pocket costs are minimal. You may pay small copayments for prescription drugs and a percentage of the Medicare-approved amount for inpatient respite care, but most services are fully covered.
A Medigap (Medicare Supplement) policy can help cover the deductibles and coinsurance for palliative care received under Parts A and B. If you’re receiving palliative care for a serious illness and don’t yet qualify for hospice, a supplemental policy can significantly reduce your financial exposure.