Does Medicare Cover Palliative Care?

Health Line

a day ago

Key takeaways
Medicare covers palliative care for people with long-term and terminal illnesses. Coverage includes inpatient and outpatient services and mental health care.
Original Medicare and Medicare Advantage both cover palliative care — with and without hospice care — when it's deemed medically necessary.
Palliative care is an important part of both treatment-related and end-of-life care that Medicare beneficiaries may wish to take advantage of.
Palliative care is a type of service that many Medicare beneficiaries may need in their lifetime. Medicare beneficiaries who choose palliative care are covered under Original Medicare or Medicare Advantage.
What qualifies as palliative care, and is it the same as hospice care?
Palliative care helps improve the overall quality of life for those with serious illnesses. It offers support to patients and their families and continued curative or life-prolonging treatments.
When you're diagnosed with a serious illness, your doctor can help you get in touch with a palliative care specialist and their team. This may include a palliative care doctor, counselor, pharmacist, or dietitian, for example.
Together, they will create a customized plan involving therapy sessions, medications, and other specialized care tailored to your needs. This plan can help increase your quality of life during your illness or at the end of your life.
Note, however, that palliative care is slightly different from hospice care, which is reserved specifically for those with a terminal illness with less than 6 months to live. Hospice care can include palliative care, but you can also get palliative care separately without hospice care if your illness isn't end stage.
Original Medicare and Medicare Advantage both cover palliative care, both with and without hospice care, when it's deemed medically necessary. Here's what each part of Medicare covers:
What does Part A cover for palliative care?
Medicare Part A is hospital insurance. It covers many of the inpatient and skilled care needed with palliative care. Under Part A, you are covered for:
What does Part B cover for palliative care?
Medicare Part B is medical insurance. It covers most of the outpatient services that are needed during palliative care. With Part B, you're covered for:
Doctor's appointments: These may be needed to diagnose, treat, and prevent your illness or other related conditions.
Durable medical equipment: This includes any equipment that may be needed for treatment or to make you more comfortable.
Mental health counseling: Emotional support and counseling may be needed for yourself or your loved ones during your care.
Rehabilitation therapy (as an outpatient): This includes speech therapy, physical therapy, or occupational therapy as needed.
What does Part C cover for palliative care?
Medicare Part C is also known as Medicare Advantage. This is a Medicare option sold by private insurance companies. With Medicare Advantage, you're automatically covered for the same services as Medicare Part A and Part B, including those for palliative care.
Under Medicare Advantage, you might also be covered for additional services, such as prescription drugs for treatment or to help ease any symptoms or long-term care, which may include skilled healthcare services or help with everyday personal needs, such as bathing, dressing, or eating.
Companies that sell Medicare Advantage plans may also offer different plan options to fit individual needs. For people with serious illnesses, Special Needs Plans (SNPs) offer additional medical services and flexibility that may be better for long-term or serious conditions.
What does Part D cover for palliative care?
Medicare Part D is prescription drug coverage. Part D may cover medications needed during palliative care.
According to the International Association for Hospice and Palliative Care (IAHPC), medications that might be prescribed during palliative care include antidepressants, anxiolytics, antipsychotics, stool softeners, antidiarrheals, and opioid and nonopioid analgesics.
If you are receiving hospice care, most medications are covered under the hospice benefit with a copayment of up to $5 per prescription drug. Medications that aren't covered under the hospice benefit may still be covered under a Medicare Part D plan.
How much does palliative care cost with Medicare?
If you are receiving palliative care without hospice care, you'll owe standard Medicare out-of-pocket costs. These costs generally include:
Premiums: In 2025, these are usually free for Part A and $185 per month for Part B. However, if you have a higher income or need to buy into Part A, you may pay more.
Deductibles: In 2025, you'll pay $1,676 per benefit period for Part A and $257 per year for Part B.
Copayments: These may include out-of-pocket costs for prescription drugs and Medicare Advantage doctors and specialist visits.
Coinsurance: Depending on the length of your inpatient care, you may pay some coinsurance costs each day under Part A, 20% of the costs for services under Part B, and any costs related to prescription drugs.
If you're enrolled in a Medicare Advantage plan, you may also owe additional premium, deductible, copayment, and coinsurance costs. These vary by plan, and you can contact your insurer or check your plan documents for specific cost information.
Takeaway
Palliative care is an important part of both treatment-related and end-of-life care that Medicare beneficiaries can and should take advantage of. It can be used along with the treatment of serious illnesses or as a part of hospice care for those at the end of life.
If you are interested in having a palliative care plan created for yourself or a loved one, your doctor can connect you with a specialist in your area.