Serious Illness Care · Buncombe County

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

By Asheville Senior Care Guide · Updated July 2026

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These two terms get used as if they mean the same thing, and the confusion causes real harm, because families often wait too long to ask for help they could have had much earlier. Both focus on comfort and quality of life for someone with a serious illness. The difference comes down to timing, whether you can keep pursuing treatment, and who pays.

The overlap that confuses everyone

Here is the key insight: hospice is a form of palliative care, but palliative care is much broader than hospice. All hospice care is palliative (comfort-focused), but palliative care can start years before hospice would ever be appropriate, and while a person is still fighting their illness. Think of palliative care as an extra layer of support you can add at any point, and hospice as the specific, intensive comfort care for the final chapter.

What each costs

This is a real practical difference. Hospice is one of the most complete benefits in American healthcare: the Medicare hospice benefit covers essentially all hospice-related costs, including nurses, aides, medications for the terminal illness, equipment, and counseling, at little to no out-of-pocket cost. Palliative care is billed like ordinary medical care, so you may have the usual copays for doctor visits and prescriptions, though it is widely covered by Medicare and private insurance.

Providers serving Buncombe County

Two established organizations provide both palliative care and hospice across the Asheville area:

For a fuller picture of end-of-life care, including how the hospice benefit works and what to expect, see our Hospice guide.