Palliative Care vs. Hospice in Florida: What's the Difference?

Palliative care treats the symptoms and stress of a serious illness: pain, shortness of breath, nausea, anxiety and the strain on the family. Florida's statute describes it as the "comprehensive management of the physical, psychological, social, spiritual, and existential needs of patients," especially suited to people with "incurable, progressive illnesses" (Fla. Stat. 765.102(6)). The same section says palliative care must include a chance to plan for end-of-life care and respect for advance directives wherever care is given.

Hospice is a specific, organized form of palliative care for people near the end of life. Federal rules describe it as a set of services coordinated by an interdisciplinary team for a terminally ill patient and the family (42 CFR 418.3).

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

Palliative care has no prognosis requirement. A person with heart failure, cancer or dementia may receive it for years while still treating the illness. It's usually arranged by a referral from the treating doctor to a palliative care team. The team may include doctors, nurses, social workers and chaplains (NIA).

Hospice under Medicare requires a certification that the patient's life expectancy is six months or less "if the illness runs its normal course" (42 CFR 418.3). Our hospice, Medicare and Medicaid guide explains the certification, the election, the benefit periods and Medicaid's role in nursing home room and board. This page doesn't repeat those rules.

Original Medicare has no separate "palliative care benefit." Palliative visits are usually billed like other medical care. Coverage depends on the person's benefits and treatment plan (NIA). In practice:

Part B generally pays for office, clinic and home visits by doctors and nurse practitioners. In 2026, the Part B deductible is $283 (CMS), and after the deductible the patient usually pays 20% of the Medicare-approved amount (Medicare.gov). Part A applies to a hospital stay, where palliative consults often begin. The 2026 inpatient deductible is $1,736 (CMS). Part D, or the drug coverage in a Medicare Advantage plan, generally covers prescriptions for symptoms, under that plan's rules. Medigap may pick up some of the Part A and Part B cost sharing, depending on the plan. Medicare Advantage plans set their own copays and networks, so ask whether the palliative team is in network. Medicaid may cover palliative services for people who qualify, and private insurance depends on the plan (NIA).

Palliative care alone usually doesn't pay for an aide to help with bathing and dressing, or for a nursing home bed. Medicare doesn't pay for that kind of long-term custodial care (Medicare.gov). For that cost, see our Medicaid planning page.

Florida gives patients two specific protections (Fla. Stat. 765.1103):

A right to information. When a doctor discusses the diagnosis, the treatment plan, alternatives, risks or prognosis, the patient must be told about pain management and palliative care. If the patient is incapacitated, the information goes to the health care surrogate or proxy, a guardian, or an agent under a durable power of attorney who has health care authority. A right to have a request honored. Physicians, osteopathic physicians and nurses must, as appropriate, comply with a request for pain management or palliative care from the patient or the patient's authorized decision-maker. Hospitals, nursing homes and assisted living facilities must comply with the palliative care measures the patient's physician orders.

This is one reason a signed health care surrogate designation matters. Without one, Florida's proxy statute sets the order of who decides (Fla. Stat. 765.401), and adult children may need a majority to agree.

Many people start with palliative care and move to hospice when the illness advances and treatment aimed at a cure no longer helps. The move happens when a doctor certifies the six-month prognosis and the patient, or a representative, signs the hospice election.

The move can go the other way, too:

Revoking hospice. The patient or representative can revoke hospice with a signed, dated statement. The revocation can't be backdated. Medicare's standard coverage resumes, and the patient can elect hospice again later if still eligible (42 CFR 418.28). Discharge after improvement. A hospice may discharge a patient who is no longer terminally ill. The hospice must plan for that possibility and prepare the family (42 CFR 418.26). Palliative care can then continue under the ordinary Medicare rules.

People in a Medicare Advantage plan can stay in their plan during hospice. Original Medicare pays for care related to the terminal illness, and the plan still covers unrelated care and extra benefits as long as the premiums are paid (Medicare.gov).

Comfort care decisions often come up when the patient can no longer speak for themselves. In Florida, these documents do the work:

Health care surrogate designation. It names the person who can request palliative care, sign a hospice election or revoke one (Fla. Stat. 765.202). Living will. It records wishes about life-prolonging procedures if the person has a terminal condition, an end-stage condition or a persistent vegetative state (Fla. Stat. 765.302). See living will vs. last will. Do Not Resuscitate Order (DNRO). A DNRO is a Department of Health form that tells paramedics not to perform CPR. It's valid only on the state form (Fla. Stat. 401.45(3)), printed on yellow paper (Florida Department of Health). The clinician signs it, along with the patient or the patient's surrogate, proxy, guardian or authorized agent. Durable power of attorney. It handles the money side, such as paying for care or applying for benefits. See our five documents guide.

Medicare Part B covers voluntary advance care planning conversations. There's no cost when the planning is part of the yearly Wellness visit and the provider accepts assignment (Medicare.gov).