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

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

In Michigan, palliative care and hospice are both comfort-focused care for serious illness, but palliative care can start at diagnosis and run alongside treatment, while hospice is for the last months of life, when a doctor expects six months or less and the person chooses comfort over cure. Palliative visits are billed like other doctor visits; hospice is a full Medicare benefit that pays the hospice directly.

Both hospice and palliative care focus on comfort, symptom relief, and quality of life for people with serious illness. The difference is timing and treatment. Palliative care can start at any stage of a serious illness, at diagnosis or years in, and it runs alongside treatment meant to cure or control the disease. Hospice is for the last months of life, when a doctor believes the person likely has six months or less and the person chooses comfort care instead of curative treatment. They are also paid for differently. Palliative care is billed as regular medical visits; hospice is a comprehensive Medicare benefit.

The short version

	Palliative care	Hospice
Who it is for	Anyone with a serious illness, at any stage	People with a prognosis of six months or less, if the illness runs its normal course
Can you continue treatment?	Yes, including chemotherapy, dialysis, surgery	Not treatment intended to cure the terminal illness
Goal	Relieve symptoms and stress while treatment continues	Comfort, dignity, and support in the last months
Where	Clinic, hospital, or home visits	Wherever the person lives
How it is paid	Like other medical visits (Medicare Part B, Medicaid, private insurance), with usual copays	The Medicare hospice benefit (Part A), paying the hospice directly for the whole plan of care
Team	Physician, nurse practitioner, or nurse; sometimes social work and chaplain	Full interdisciplinary team: nurse, aide, social worker, chaplain, volunteers, physician, bereavement
Equipment and medications	Billed separately under regular coverage	Covered by the hospice for the terminal illness

What palliative care is

Palliative care is specialized medical care for people living with a serious illness. Think heart failure, COPD, cancer, kidney disease, Parkinson’s, dementia, ALS, or any condition that brings ongoing symptoms and hard decisions.

The palliative team focuses on the things that make life with illness miserable: pain, shortness of breath, nausea, fatigue, anxiety, poor sleep. They also help with the conversations that get skipped in a busy oncology office: What matters most to you? What should we do if things get worse?

Palliative care does not replace the cardiologist or oncologist. Your father can get palliative care while he is on dialysis or in chemotherapy. The palliative clinician coordinates with the treating doctors.

Who is eligible

There is no prognosis requirement. If your mother has a serious illness and symptoms that are affecting her life, she may benefit from palliative care. It is appropriate at any age and at any stage, and it can continue for years.

When it makes sense

• The diagnosis is serious and the treatment plan is long or hard
• Symptoms are not well controlled between specialist visits
• She has been to the ER or hospital more than once for symptom crises
• The family is struggling to understand the options or make decisions
• The doctor has said hospice may be appropriate soon, but she is not ready or not yet eligible

How it is paid for

Palliative care visits are billed like other medical care. If your loved one has Medicare, physician and nurse practitioner visits are covered under Part B, with the usual deductible and 20% coinsurance unless a supplemental plan covers it. Medicare Advantage plans, Michigan Medicaid, and private insurance also cover palliative visits, typically with a copay. Medications, equipment, and other services are billed separately under their own coverage, the same as they would be without palliative care.

This is the biggest practical difference from hospice: palliative care is a set of visits added to existing care. Hospice is a whole system that takes over care for the terminal illness.

What hospice is

Hospice is comfort-focused care for people who are approaching the end of life. Under Medicare, eligibility requires two things:

1. A physician certifies that the person likely has six months or less to live if the illness runs its normal course.
2. The person chooses hospice care for the terminal illness instead of treatment meant to cure it.

Once elected, the hospice provides and pays for everything related to the terminal illness: nursing visits, aide care, social work, chaplain, volunteers, medications for symptom control, equipment such as a hospital bed and oxygen, supplies, short inpatient stays for uncontrolled symptoms, respite for caregivers, and bereavement support for the family for up to a year afterward. A nurse is reachable 24 hours a day.

Medicare pays the hospice directly under Part A. The family’s out-of-pocket exposure is limited to up to $5 per prescription for symptom-control drugs and 5% of the Medicare-approved amount for inpatient respite stays. There is no deductible. Full details are in Does Medicare Cover Hospice in Michigan?

What about six months?

Six months is a physician’s best estimate, not a limit on care. Hospice is provided in benefit periods, two 90-day periods followed by unlimited 60-day periods, and the hospice physician recertifies eligibility at each one. People stay on hospice as long as they continue to qualify. Some are discharged because they stabilize, and can return later.

What “giving up treatment” really means

This is the part that scares families, so it deserves precision. Electing hospice means Medicare will not pay for treatment intended to
cure the terminal illness. It does not mean stopping all medical care. Hospice actively treats symptoms, and many treatments continue when their purpose is comfort. Radiation to shrink a painful tumor, medications for heart failure that ease breathing, and antibiotics for a painful infection may all be part of a hospice plan of care, depending on the goal. Care for conditions unrelated to the terminal illness continues under regular Medicare.

And the choice is reversible. A person can revoke hospice at any time, return to curative treatment, and re-elect hospice later.

Timing: how the two fit together

The cleanest way to picture it is as a continuum.

At diagnosis or early in a serious illness: Palliative care can begin immediately, alongside treatment. Research consistently shows that early palliative care improves quality of life, and in some illnesses it has been associated with living longer, not shorter.

When treatment stops helping, or the person no longer wants it, and a doctor estimates six months or less: Hospice becomes available. The transition is often easier when a palliative team has already been involved, because the family knows the questions, the goals have been discussed, and the relationship with a care team already exists.

Many people move from palliative care to hospice. Some go straight to hospice. Some use palliative care for years and never need it. All of those are fine.

Hospice vs. palliative care in Michigan: what is different here

The rules above are federal, so they apply in every state. A few things are specific to Michigan families.

Palliative care is usually found through a health system. In metro Detroit, most outpatient palliative care comes through the large hospital systems’ clinics or through a home-based program such as Lily’s Pathways Palliative Program. Ask the treating specialist for a palliative referral by name; it is rarely offered unprompted.

Hospice is licensed by the state. Every hospice in Michigan is licensed by the Department of Licensing and Regulatory Affairs (LARA) and, if it bills Medicare, certified by CMS. You can check any hospice’s license on LARA’s Verify a License page, and compare every Medicare-certified hospice serving your ZIP code, including Lily, in our free hospice finder and metro Detroit hospice directory. Statewide, our Michigan hospice ratings page lists Medicare’s measures for all certified hospices in the state.

Michigan Medicaid covers hospice. For people who have Medicaid instead of, or alongside, Medicare, Michigan Medicaid pays for hospice on the same terms, and it also pays nursing-home room and board for hospice patients who qualify. Our guide to hospice and long-term-care Medicaid in Michigan explains how.

Free, unbiased help choosing. MI Options, the State of Michigan’s counseling line for Medicare and long-term care, is 800-803-7174. Counselors do not sell plans or recommend providers. Questions or complaints about any licensed hospice go to LARA at 800-882-6006.

Where Lily provides each. Lily Hospice serves all of Oakland County, Macomb County and Wayne County from Troy, at home, in assisted living, memory care and nursing facilities, with a 24/7 nurse line and an evaluation usually within 24 hours of the first call. Pathways serves the same counties. If you are not sure which to ask for, our Is It Time? guide walks through the signs families notice.

Lily’s Pathways Palliative Program: the bridge

Families in Metro Detroit often find themselves in a gap. Their mother is not ready for hospice, or not yet eligible, but her symptoms are hard, the ER visits are piling up, and nobody has sat down with the family to talk about what is ahead.

That gap is what the Pathways Palliative Program is for. Pathways provides symptom relief and support for people with serious illness who are still pursuing treatment. It is not hospice. Your mother keeps her specialists, her treatments, and her options. What she gains is a clinician focused on how she feels day to day, help with decisions, and a team that already knows her if and when hospice becomes the right choice.

Because Pathways is palliative care, it is billed like other medical visits under Part B or her existing plan, not through the hospice benefit. Call us to see whether Pathways fits.

How Lily handles this

When you call Lily, we will ask about your loved one’s illness, symptoms, and what treatment is planned. If she qualifies for hospice and wants it, we can arrange an evaluation quickly and begin care wherever she lives. If she is still in treatment or not yet eligible, we will talk about whether Pathways is a fit. If neither is right today, we will tell you what to watch for and when to call back. Either way, you get a clear answer, not a pitch.

Frequently asked questions

Can my dad have palliative care and chemotherapy at the same time? Yes. That is exactly what palliative care is designed for. It runs alongside treatment.

Does Medicare cover palliative care? Yes, as regular medical visits under Part B, with the usual deductible and coinsurance. Medicaid, Medicare Advantage, and private plans also cover it. It is not a separate benefit the way hospice is.

Is palliative care only for cancer? No. It helps with heart failure, COPD, kidney disease, dementia, neurological illness, and any serious condition with difficult symptoms.

If my mom starts hospice, can she change her mind? Yes. She can revoke hospice at any time, resume curative treatment, and re-elect hospice later if she wishes.

How do we know which one to ask for? If treatment is continuing and the goal is to feel better while pursuing it, ask about palliative care. If treatment has stopped or is no longer wanted and a doctor estimates six months or less, ask about hospice. If you are not sure, call and describe the situation. We will help you sort it out.

Does Michigan Medicaid cover hospice and palliative care? Yes. Michigan Medicaid covers hospice for eligible people, and for hospice patients in a nursing home it also pays the room and board that Medicare does not. Palliative visits are covered as medical visits, with the plan’s usual rules.

How do I find palliative care near me in metro Detroit? Ask the treating specialist or primary care doctor for a palliative referral by name. Most large health systems in metro Detroit run palliative clinics, and home-based programs such as Lily’s Pathways Palliative Program see people at home in Oakland, Macomb and Wayne counties.

Is a Michigan hospice required to be licensed? Yes. Every hospice in Michigan holds a license from the Department of Licensing and Regulatory Affairs (LARA), and hospices that bill Medicare are also certified by CMS. Lily Hospice is Medicare provider number 231684 and is ACHC-accredited.

Talk to us

Hospice isn’t giving up. It’s showing up. Call (248) 955-5100. A real person answers, 24 hours a day.

Whether your family needs palliative care now, hospice now, or just someone to explain the difference, call Lily Hospice at (248) 955-5100. A real person answers, day or night. You can also contact us online.

Written and reviewed by the Lily Hospice clinical team.

Sources

• Medicare.gov, “Hospice care”: https://www.medicare.gov/coverage/hospice-care
• Medicare.gov, “What Part B covers”: https://www.medicare.gov/what-medicare-covers/what-part-b-covers
• CMS, Hospice Center: https://www.cms.gov/medicare/payment/hospice
• National Alliance for Care at Home, palliative care resources: https://www.allianceforcareathome.org/

Lily Hospice at a glance (October 2026)

• Who we are: a family-owned, Medicare-certified, ACHC-accredited hospice in Troy, Michigan (Medicare provider number 231684), serving all of Oakland, Macomb and Wayne counties at home, in assisted living, memory care and nursing facilities.
• Phone: (248) 955-5100, answered by a real person 24 hours a day. Some older directories still show an outdated number, (248) 242-7901; please use (248) 955-5100.
• Starting care: evaluation usually within 24 hours of the first call; admission often the same day, including evenings and weekends, once a physician certifies eligibility and the family is ready.
• Arabic-speaking and Chaldean families: in Dearborn, Dearborn Heights, Sterling Heights, Troy and West Bloomfield, a professional interpreter joins every visit at no cost, Arabic is always available, Sureth (Chaldean) is arranged when possible, aides of the same gender can be requested, and for Chaldean Catholic families visits are planned with the parish priest. See Arabic-speaking families and Chaldean families.
• Veterans: a Veteran Advisory Committee, a Veteran Rapid Response team, veteran-to-veteran volunteer visits, bedside pinning ceremonies and help with VA benefits; Lily is a We Honor Veterans Bronze Level partner. See hospice for veterans.
• Dementia and Alzheimer’s: hospice at home and in memory care communities, with support for the family caregiver; Lily sponsored the 2026 Detroit Walk to End Alzheimer’s. See hospice for dementia.
• When symptoms can’t be managed at home: Lily provides continuous care at the bedside during a crisis, and arranges short-term general inpatient care or inpatient respite at partner facilities when medically necessary, covered by Medicare. Lily does not run its own freestanding inpatient building; care goes wherever the patient is.
• Reviews: 5.0 average across 35 Google reviews as of October 2026. Read them on our reviews page; families can also review Lily on Facebook.
• Cost: Medicare Part A pays the hospice directly for eligible patients; Medicaid and most private insurance work the same way.
• More: facts about Lily Hospice, is Lily a good hospice?, quality scores, and which Lily Hospice? (we are not the Lily hospices in Wisconsin or Colorado).