Medicare can cover medically necessary services used in palliative care. There is not a single stand-alone Original Medicare benefit called palliative care for every person with a serious illness. Each service must meet the coverage rules for Part A, Part B, Part D, or the hospice benefit.
Palliative care outside hospice
Palliative care can be provided while a person continues treatment intended to cure or control an illness. Medicare may cover doctor and nurse practitioner visits, hospital care, home health services, therapy, mental health care, durable medical equipment, and prescription drugs when the normal requirements for those services are met. Part D coverage depends on the plan formulary.
Medicare does not pay for nonmedical custodial care, room and board in assisted living, or services that do not meet a covered benefit category. A palliative care program may include both covered and noncovered components. The provider should identify how each service will be billed.
Palliative care under hospice
Palliative care is a central part of hospice. To elect the Medicare hospice benefit, the person must have Part A, be certified as terminally ill with a life expectancy of six months or less if the illness follows its normal course, choose comfort care instead of curative treatment for the terminal illness, and use a Medicare-approved hospice. Hospice then arranges covered care related to the terminal illness and related conditions.
Costs and Medicare Advantage
Normal Part A, Part B, and Part D costs apply to covered palliative services outside hospice. Under hospice, covered care generally has no charge, although a drug copayment of up to $5 and 5 percent coinsurance for inpatient respite care can apply. Room and board is generally not covered.
Medicare Advantage plans may coordinate palliative services and use network or authorization rules. Once hospice is elected, Original Medicare generally pays for care related to the terminal illness, even if the person remains enrolled in Medicare Advantage.
What to do next
- Ask whether the program is palliative care, hospice, or both.
- Request an itemized explanation of covered and noncovered services.
- Ask which part of Medicare will be billed and whether plan authorization is required.
- Review Medicare’s hospice coverage and hospice benefit guide.
Sources
Coverage and costs can change each calendar year. Check current Medicare rules and current plan documents before receiving care. A provider’s estimate is not a Medicare coverage decision. Final payment depends on the claim and the applicable coverage requirements.
Last reviewed: August 2026. Medicare rules and plan benefits can change.