Medicare covers palliative care, but only through specific programs and settings — and the coverage rules differ sharply depending on whether you are in Original Medicare or a Medicare Advantage plan.

Palliative care is medical care focused on relieving pain and managing symptoms, rather than curing disease. It can happen at home, in a hospital, in a nursing facility, or in a dedicated palliative care clinic. Medicare will pay for it in some of these settings but not others, and you may face out-of-pocket costs even when it is covered.

The key distinction is this: Medicare covers palliative care services when they are delivered as part of a covered setting — such as a hospital stay, a skilled nursing facility stay, or a hospice program. Medicare does not cover standalone palliative care clinics or office visits to a palliative care specialist unless those visits happen during a hospital stay or as part of another covered service.

Key Takeaways

  • Medicare covers palliative care when it is delivered inside a hospital, skilled nursing facility, or hospice program, but not when you visit a palliative care clinic as an outpatient.
  • If you have Original Medicare, you pay a copay for each hospital or office visit where palliative care is part of your treatment, but hospice palliative care is covered with no copay once you are enrolled.
  • Medicare Advantage plans vary widely in their palliative care coverage, and some plans cover outpatient palliative care visits that Original Medicare does not.
  • Palliative care can happen at the same time as curative treatment, so you do not have to choose between them — but Medicare's payment rules treat them differently depending on the setting.
  • If you are considering palliative care, ask your doctor whether it will be delivered in a covered setting, because that determines what you will owe out of pocket.

How Original Medicare Covers Palliative Care in Hospitals

When you receive palliative care during a hospital stay, Original Medicare covers it as part of your inpatient hospital benefit. You pay your hospital deductible (currently $1,676 per benefit period, though this amount changes yearly) and then coinsurance of $419 per day for days 9 through 60, and higher amounts for longer stays. The palliative care itself — the symptom management, the pain control, the specialist consultation — is bundled into that hospital bill and does not trigger a separate charge.

This is true whether the palliative care is delivered by your primary hospital team or by a palliative care specialist brought in as a consultant. The hospital bills Medicare for the entire stay, and palliative care is part of what that payment covers.

Palliative Care in Skilled Nursing Facilities

If you move to a skilled nursing facility after a hospital stay, and palliative care is part of your care plan there, Medicare Part A covers it. You pay coinsurance of $209.50 per day for days 21 through 100 of your stay (days 1 through 20 are fully covered after you meet your deductible). Again, palliative care services are included in the facility's daily rate — there is no separate bill for the palliative care itself.

The palliative care team at the facility might include nurses, social workers, and doctors, and they coordinate with your other care. Medicare covers this as long as you are a covered resident of the facility and the care is medically necessary.

Hospice and Palliative Care Coverage

Hospice is the setting where Medicare's palliative care coverage is most generous. When you are enrolled in a Medicare-covered hospice program, palliative care is the entire point of the service. Medicare covers all hospice-related care with no copay or coinsurance — including medications, equipment, visits from nurses and doctors, counseling, and bereavement support.

Hospice is typically for people with a terminal illness and a life expectancy of six months or less, as certified by a doctor. Once you enroll, you are choosing comfort-focused care over curative treatment for your terminal condition, though you can still receive treatment for other unrelated conditions. The hospice benefit is one of Medicare's most comprehensive, because the entire service model is palliative.

Outpatient Palliative Care and the Coverage Gap

This is where the coverage becomes limited. If your doctor refers you to a palliative care clinic or specialist for an office visit — not connected to a hospital stay, nursing facility stay, or hospice enrollment — Original Medicare does not cover it. You would pay the full cost out of pocket, or you would need supplemental insurance to cover it.

Some palliative care clinics are embedded in hospitals and bill as part of a hospital outpatient department. In that case, Original Medicare covers the visit under your Part B outpatient benefit, and you pay your Part B copay (usually 20% of the approved amount after your deductible). But a standalone palliative care clinic with no hospital affiliation will not be covered by Original Medicare.

This gap matters because many people benefit from palliative care while still pursuing curative treatment — managing side effects from chemotherapy, controlling pain from advanced arthritis, or handling the emotional toll of a serious diagnosis. Original Medicare does not fund this kind of outpatient palliative support unless it happens within a covered setting.

Medicare Advantage Plans and Palliative Care

Medicare Advantage plans (Part C) have flexibility that Original Medicare does not. Some Advantage plans cover outpatient palliative care visits, specialist consultations, or even dedicated palliative care programs. Coverage varies plan to plan and year to year, so you need to check your specific plan's formulary and coverage documents.

If palliative care is important to you, ask your plan directly: "Does this plan cover outpatient palliative care visits?" and "Are there palliative care specialists in the network?" Some plans market palliative care as a covered benefit; others do not mention it. The answer determines whether you can access this care without paying out of pocket.

Advantage plans also cover palliative care in hospitals, nursing facilities, and hospice the same way Original Medicare does — as part of those settings' benefits.

Medications and Equipment in Palliative Care

Medications used for symptom management — pain relievers, anti-nausea drugs, anxiety medications — are covered under Medicare Part D (prescription drug coverage) if you have it, or under Part B if they are administered in a covered setting like a hospital or hospice. You pay your normal Part D copay or coinsurance for the drugs themselves.

Equipment like oxygen, hospital beds, or wheelchairs used in palliative care is covered under Medicare Part B's Durable Medical Equipment benefit if it is medically necessary and prescribed by a doctor. You typically pay 20% coinsurance after your Part B deductible.

What to Do Before Starting Palliative Care

Before you begin palliative care, ask your doctor or the palliative care team three questions: Where will the care take place? Will it be billed as part of a hospital stay, nursing facility, hospice, or as outpatient visits? And if it is outpatient, does your insurance cover it?

If you have Original Medicare and the answer is "outpatient palliative care clinic," ask whether the clinic is hospital-affiliated. If it is not, you will pay out of pocket unless you have a Medigap or other supplemental plan that covers it. If you have a Medicare Advantage plan, call your plan's customer service line and ask directly whether outpatient palliative care is covered.

Getting this answer before you start prevents surprise bills and helps you understand what your actual costs will be.

Frequently Asked Questions

Can I get palliative care and curative treatment at the same time?

Yes. Palliative care manages symptoms and pain while you continue cancer treatment, dialysis, or other curative therapies. Medicare covers both when they happen in a covered setting like a hospital. If you want outpatient palliative care alongside outpatient curative treatment, Original Medicare covers the curative care but not the palliative care unless it is hospital-affiliated.

Do I have to be dying to get palliative care covered?

No. Palliative care is covered in hospitals and nursing facilities for anyone with a serious illness or injury, regardless of prognosis. Hospice requires a terminal diagnosis and six-month life expectancy, but hospital-based palliative care does not. The coverage depends on the setting, not on how sick you are.

What if my palliative care doctor is not in my Medicare Advantage plan's network?

Out-of-network providers in an Advantage plan usually cost more — you may pay higher copays or coinsurance, or the visit may not be covered at all. Check your plan documents or call customer service before seeing an out-of-network palliative care doctor. Some plans cover emergency or specialist care out of network; others do not.

Does Medicare cover palliative care at home?

Only if it is part of a covered service. Home health care (nursing, therapy, aide services) is covered by Medicare Part A when ordered by a doctor after a hospital stay. If palliative care is part of your home health plan, it is covered. Standalone palliative care visits to your home by a specialist are not covered by Original Medicare unless the specialist is part of a hospice program.

Will I owe anything if I am in hospice?

No copay or coinsurance for hospice-related care. You may still owe your Part B premium and Part D premium if you have those. You are responsible for any care related to conditions other than your terminal diagnosis — for example, if you break your arm while in hospice, that treatment is not covered by the hospice benefit.