Serious illnesses affect more than just your health, and oftentimes, day-to-day tasks feel overwhelming. Making breakfast depletes your energy. Pain disrupts your sleep. Multiple doctor appointments fill your calendar. While your medical treatments target the illness itself, you need support managing these daily challenges.
Medicare benefits for serious illness recognize this reality.
Medicare includes palliative care coverage because comfort matters during treatment. This support helps with immediate concerns like pain, shortness of breath, or fatigue while you continue to receive care from your regular doctors. Your cardiologist still manages your heart condition, and your oncologist oversees your cancer treatment — palliative care simply adds specialists focused on helping you feel better today.
Many people wait too long to use this benefit because they confuse it with hospice care, but palliative care works differently. Here’s what you need to know about Medicare benefits for serious illness and how you can get palliative care with Medicare.
How palliative care works with your current medical team
Medicare covers palliative care because managing a serious illness takes more than just treating the disease. Your palliative care team works directly with your other doctors to create a complete care plan.
For example, if you are going through cancer treatment, between chemotherapy sessions, palliative care doctors can adjust your pain medications, teach you breathing techniques to manage shortness of breath, or help you find ways to keep your energy up throughout the day. Social workers on the team can connect you with transportation services for appointments, and counselors help you work through the emotional weight of your diagnosis.
This coordinated approach keeps your entire medical team on the same page. Your palliative care specialists share notes with your oncologist about which symptoms need attention, discuss medication adjustments with your cardiologist, and keep your primary care doctor updated on your overall well-being.
Lots of people mix up palliative care with hospice. Here’s the key difference: Hospice care starts in life’s final months, after treatment ends, while palliative care begins whenever you need support, especially during active treatment. It allows you to keep seeing your regular doctors and fighting your illness, but also adds specialists who help with today’s challenges.
The main goal? Improving your quality of life during treatment. Simple things make a big difference — like managing pain so you can garden again, easing nausea so you can enjoy meals, and reducing anxiety so you sleep better. Your palliative care team tackles these daily challenges, so you can feel your best while you focus on recovery.
| Palliative Care | Hospice Care |
| Available at any time during illness | Begins in final months of life |
| Supports ongoing medical treatment | Starts after stopping curative treatment |
| Works alongside your current doctors | Takes over as primary care team |
| Focuses on quality of life during treatment | Focuses on comfort at end of life |
| Medicare covers while treatment continues | Medicare hospice benefit is separate |
Getting started with palliative care doesn’t mean your condition has worsened or that you’re giving up on treatment. Many people find that adding palliative care early helps them stick with their treatment plan because they feel better day-to-day.
Talking to your medical team about palliative care
Most doctors bring up palliative care when they see you struggling with symptoms, but you don’t need to wait. Learning how to get palliative care with Medicare starts with a simple conversation.
Step 1: Talk to your doctor or specialist
Your primary care doctor can refer you to palliative care, but so can any of your specialists. Your oncologist, cardiologist, pulmonologist, or neurologist can all make referrals based on what they’re seeing in your treatment. If you’re working with multiple specialists, start with the doctor you see most often or feel most comfortable talking to about your symptoms.
Step 2: How to ask about palliative care
You don’t need a formal request. Here’s how you can bring it up at your next appointment:
- “These symptoms make daily life tough. Could palliative care help?”
- “I heard palliative care might help me manage pain better. What do you think?”
- “Would working with a palliative care team make sense for me?”
Your doctor will assess whether palliative care fits your situation and can connect you with local specialists who take Medicare.
Step 3: What to expect when starting palliative care
Once your doctor makes a referral, you’ll meet with a palliative care specialist for an initial consultation. During this visit, the specialist will review your medical history, current symptoms, and treatment plan. Together, you’ll identify which symptoms need the most attention and create a plan for managing them.
The palliative care team will coordinate with your other doctors throughout your treatment, adjusting your care plan as your needs change. Medicare covers these consultations under your regular benefits, with your standard Part B copay.
Medicare benefits for palliative care
Wondering how to get palliative care with Medicare? Different parts of Medicare can work together so you have as much coverage as possible.
Original Medicare coverage for palliative care
Medicare Part B handles most costs when you see palliative care specialists. Medicare benefits for serious illness include your standard Part B copay, just like visiting any specialist. These appointments work exactly like your regular doctor visits.
Palliative care and Medicare Part D prescription coverage
Your Part D plan covers many prescriptions your palliative care team recommends for symptom relief, though coverage varies by plan. You can check your plan’s formulary online through Medicare.gov or by calling the number on your insurance card to confirm a medication is covered before you fill it. Your palliative care team can work with you to find covered alternatives if your first-choice medication isn’t on your plan’s list. You’ll use the same pharmacy and pay your usual copays for covered drugs.
Medicare Advantage benefits for palliative care
Your Medicare Advantage plan might offer benefits that help with palliative care. Some include care coordinators who help arrange palliative care services. Others have special networks of palliative care providers. Call your plan to learn about additional coverage — you might discover helpful benefits you didn’t know about.
Starting palliative care shouldn’t mean stressing about costs, and your doctors, prescriptions, and specialists all coordinate under your existing coverage. Take that first step, and talk to your doctor about adding palliative care to your treatment plan — your Medicare benefits are ready to support you.
