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Hospice vs Palliative Care: What's the Difference?

A plain-language guide for Texas families comparing eligibility, treatment, cost and where care happens, from the hospice and palliative care team at Prime Choice in Houston.

Reviewed by the Prime Choice Hospice clinical team · Updated September 2026

The short answer

Palliative care relieves the symptoms and stress of a serious illness at any stage, and you can keep receiving treatment to cure or control the disease. Hospice care is palliative care for the final stage: a doctor certifies a life expectancy of six months or less, and the patient chooses comfort care instead of curative treatment. In Texas, Medicare covers hospice almost completely, while palliative care is billed like other specialist visits.

Side by Side

How Do Hospice and Palliative Care Compare?

	Palliative Care	Hospice Care
Who it's for	Anyone with a serious illness, at any age or stage	People with a terminal illness and a prognosis of 6 months or less
When it starts	As early as the day of diagnosis	When curative treatment stops helping or the patient chooses to stop it
Curative treatment	Continues: chemo, dialysis, surgery and so on	Stopped for the terminal illness; unrelated conditions are still treated
Prognosis required	No	Yes, certified by two physicians
Medicare coverage	Part B specialist visits (deductible and 20% coinsurance may apply)	Medicare Part A hospice benefit: care, equipment, supplies and related medications, at little or no cost
Texas Medicaid	Covered as regular physician and home health services	Covered through the Texas Medicaid Hospice Program
Where care happens	Clinic, hospital, or at home	Mostly at home; also nursing homes, assisted living and inpatient units
Care team	Palliative physician or NP, nurse, social worker	Physician, RN case manager, aide, social worker, chaplain, volunteers, bereavement counselor
24/7 on-call nurse	Varies by program	Required: always available by phone, with home visits when needed
Family grief support	Varies by program	Included for up to a year after the death

What Is Palliative Care?

Palliative care is specialized medical care for people living with a serious illness such as cancer, heart failure, COPD, kidney disease, Parkinson's or dementia. The team treats the pain, nausea, fatigue, shortness of breath, anxiety and depression that come with the disease and with its treatment.

It works alongside your other doctors. You keep your oncologist, cardiologist or nephrologist, and the palliative team adds a layer of support focused on how you feel day to day. It also helps you understand your options and plan ahead.

In Texas law this is called supportive palliative care. Texas Health and Safety Code Chapter 142A defines it as physician-directed, team-based care for a serious illness at any age or stage, which can be given at the same time as curative treatment.

Our palliative care services in Houston →

What Is Hospice Care?

Hospice care is comfort-focused care for the last months of life. It begins when a physician certifies that the illness will likely lead to death within six months if it follows its usual course, and the patient decides to stop treatments aimed at curing it.

Hospice is not a place. Most hospice care in Texas happens at home: a private home, a relative's home, an assisted living community or a nursing home. A full team visits on a schedule, and a nurse is on call 24/7. The hospice also provides medications, equipment and supplies related to the illness.

Texas hospices are licensed by Texas Health and Human Services (HHSC) as Home and Community Support Services Agencies and follow the federal Medicare hospice rules (42 CFR Part 418).

In-home hospice care in Houston →

How Are Hospice and Palliative Care Alike?

Both focus on the whole person rather than only the disease. Both use an interdisciplinary team that treats physical symptoms, emotional distress and spiritual concerns, and both support the family as well as the patient. Most of all, both put the patient's own goals at the center of every care decision.

The simplest way to remember it: all hospice care is palliative care, but not all palliative care is hospice.

What Are the 4 Key Differences Between Hospice and Palliative Care?

Timing and prognosis

Palliative care has no prognosis requirement and can begin on the day of diagnosis. Hospice requires a physician to certify a life expectancy of six months or less. That is a clinical estimate, not a deadline: patients who live longer can stay on hospice as long as they continue to qualify.

Curative treatment

With palliative care, treatment to cure or slow the disease continues. With hospice, the patient chooses comfort care in place of curative treatment for the terminal illness. Medications for unrelated conditions, such as blood pressure or thyroid, can usually continue.

How it's paid for

Hospice is a dedicated Medicare Part A benefit that pays for the team, medications, equipment and supplies for the terminal illness. The only costs are up to a $5 copay per prescription and 5% of the cost of inpatient respite care. Palliative care has no separate benefit, so visits are billed like other specialist care under Part B or your private plan.

How much support comes home

Hospice brings the most support into the home. Nurse and aide visits, a chaplain, a social worker, volunteers, a 24/7 on-call nurse, a hospital bed, oxygen and comfort medications are all part of the benefit. Palliative programs vary more; many are consult-based, with visits every few weeks.

Who Qualifies for Hospice in Texas?

Hospice eligibility follows federal Medicare rules, so it is the same in Houston as anywhere in Texas. A patient qualifies when:

Their attending physician (if they have one) and the hospice medical director both certify a life expectancy of six months or less if the illness runs its normal course.
They, or their medical power of attorney, sign an election statement choosing hospice care.
They have Medicare Part A, Texas Medicaid, VA benefits, or private insurance with a hospice benefit.

Care is provided in benefit periods: two 90-day periods, then an unlimited number of 60-day periods, as long as the physician recertifies eligibility. Before the third period, a hospice physician or nurse practitioner makes a face-to-face visit.

Signs it may be time to ask about hospice: repeated ER visits or hospital stays, losing weight without trying, sleeping most of the day, needing help with bathing, dressing or eating, or a doctor saying "there's not much more we can do."

How Do You Pay for Hospice vs Palliative Care in Texas?

Medicare. Original Medicare pays for hospice even if the patient is enrolled in a Medicare Advantage plan. Palliative care visits fall under Medicare Part B.

Texas Medicaid. HHSC runs the Texas Medicaid Hospice Program for people who qualify for Medicaid. For people with both Medicare and Medicaid ("dual eligible"), Medicaid may also help with nursing facility room and board, which the hospice benefit itself does not cover.

Private insurance and VA. Most employer and marketplace plans, and VA health benefits, include a hospice benefit modeled on Medicare's. Our intake team verifies your benefits before care starts, free of charge.

What Texas Paperwork Should You Complete?

Whichever care you choose, these Texas advance directives, created under the Texas Advance Directives Act (Health and Safety Code Chapter 166), keep your wishes in charge:

Medical Power of Attorney names who makes medical decisions if you can't.
Directive to Physicians and Family or Surrogates (Texas living will) records your wishes about life-sustaining treatment.
Out-of-Hospital DNR Order tells EMS not to attempt CPR at home. Without it, paramedics called to the home are required to try resuscitation.

Our social workers help families complete these state forms at no charge. Learn about family support and guidance.

Not Sure Which Is Right? Talk to a Hospice Nurse.

Prime Choice provides both hospice and palliative care in Houston and surrounding Texas communities. A nurse can walk you through your options at no cost, 24 hours a day.

Call 832-622-6418 Request a Free Consultation

Questions Families Ask

Hospice vs Palliative Care: FAQs

Timing and treatment. Palliative care can start at diagnosis and continues alongside treatment meant to cure or control the illness. Hospice is for the final phase of a terminal illness — a physician certifies a life expectancy of six months or less — and the patient chooses comfort care instead of curative treatment for that illness.

No. All hospice care is palliative, but not all palliative care is hospice. Palliative care is the broader approach of relieving symptoms and stress; hospice is a specific Medicare benefit that delivers palliative care at the end of life.

Yes. That is the defining feature of palliative care. A palliative team manages pain, nausea, breathlessness and stress while your oncologist, nephrologist or surgeon continues treating the disease.

No. Hospice is its own Medicare Part A benefit that covers almost everything related to the terminal illness, with at most a $5 copay per prescription and 5% of the cost of inpatient respite care. Palliative care has no separate benefit; visits are usually billed under Medicare Part B like other specialist visits, so the normal Part B deductible and 20% coinsurance can apply.

Yes, and it is common. When treatment stops working or becomes more burdensome than helpful, and a physician certifies a prognosis of six months or less, the patient can elect hospice. Starting with palliative care often makes that transition smoother because the family already knows what comfort-focused care looks like.

Yes. A patient can revoke the hospice benefit at any time, for any reason, and regular Medicare coverage resumes. They can elect hospice again later if they still qualify.

It is the legal term Texas uses for palliative care. Texas Health and Safety Code Chapter 142A defines supportive palliative care as physician-directed, team-based care for a person with a serious illness, at any age or stage, that can be provided alongside curative treatment.

Ask two questions: Is the goal still to cure or control the illness? Has a doctor said the illness is likely in its last six months? If treatment is still the goal, palliative care fits. If the focus has turned to comfort and time left, hospice is usually the better fit and covers more. Call us at 832-622-6418 and a nurse will help you work through it at no cost.