Hospice vs. Palliative Care in Michigan: What Is the Difference?

Written and reviewed by the Lily Hospice clinical team. Updated September 2026.

Palliative care is comfort-focused care that can be provided at any stage of a serious illness, alongside treatment. Hospice is palliative care for people whose illness is likely in its last six months, when the goal has shifted from treating the disease to comfort and time at home. Both are covered in Michigan; hospice through the Medicare hospice benefit, palliative care usually as regular medical visits under Part B.

The same goal, at different points

Both focus on pain, symptoms, and what matters to the person. The difference is timing and coverage. Palliative care can begin the day of a serious diagnosis and continue through chemotherapy, dialysis or heart-failure treatment. Hospice begins when two physicians certify that life expectancy is likely six months or less if the illness runs its course, and the person chooses comfort care rather than treatment aimed at cure. People are not required to stop living past six months; hospice continues as long as eligibility does.

Hospice brings a full team to the home: nurse, aide, social worker, chaplain, volunteers, medications and equipment related to the illness, and a 24-hour line. Palliative care is usually a physician or nurse practitioner visit, in a clinic or at home, with a smaller supporting team.

Which one is right, right now

If your loved one is still pursuing treatment and doing reasonably well, but struggling with symptoms or repeated hospital stays, palliative care is the fit. If treatment is no longer slowing the illness, the hospital trips are getting closer together, weight and function are dropping, and the person or family is starting to ask about comfort, it is time to talk about hospice. Many families use palliative care first and move to hospice later; the transition is easier when the same organization provides both.

Lily Hospice’s Pathways palliative program exists for the “not yet” patient: someone who is not ready for or eligible for hospice but needs symptom management and a plan. When the time comes, the move to hospice is a conversation, not a new referral.

How each is paid for in Michigan

Hospice is a defined Medicare benefit under Part A, with little or nothing out of pocket for most families; Medicaid, VA-authorized care and most commercial plans mirror it. Palliative care is billed like other physician services, usually under Medicare Part B or a commercial plan, with the usual copays. Read more in What does Medicare cover for hospice care?

Questions families ask

Can you have palliative care and still get treatment?

Yes. Palliative care is designed to run alongside treatment such as chemotherapy or dialysis.

Can you get hospice and chemotherapy at the same time?

Under the standard Medicare hospice benefit, treatment aimed at curing the terminal illness is not covered. Treatment that is purely for comfort can be.

Is palliative care only for cancer?

No. It is used for heart failure, COPD, kidney disease, dementia, Parkinson’s, ALS and any serious illness with heavy symptoms.

Does palliative care mean the doctor has given up?

No. It means symptoms and quality of life are being taken as seriously as the disease.

Does Lily Hospice offer palliative care?

Yes, through the Pathways palliative program, for people who are not yet ready for hospice. Call (248) 955-5100.

General education, not medical or benefits advice. Decisions about hospice are made with your loved one’s physician. Lily Hospice, 2125 Butterfield Dr, Suite 299, Troy, MI 48084. Medicare-certified since 2021. ACHC-accredited.

Hospice isn’t giving up. It’s showing up.