Two services that get confused constantly — what each one covers, who pays, and how they work in Orange, Seminole, Osceola, Lake, and Sumter counties.
By Orlando Senior Advisor Care Team · August 27, 2026
Palliative care is comfort-focused medical care that treats pain, breathlessness, nausea, anxiety, and the exhaustion that comes with serious illness. It can start at diagnosis, it runs alongside curative treatment, and there is no requirement that anyone be dying. Hospice is a specific Medicare benefit for someone whose physician expects a life expectancy of six months or less if the illness follows its usual course, and it replaces curative treatment for that terminal condition with full comfort care.
In plain terms: every hospice patient is receiving palliative care, but most palliative-care patients are not on hospice. Families in Central Florida are routinely told “it's time to think about hospice” when what a parent actually needs is a palliative-care consult — and the two decisions carry very different consequences.
The Medicare Hospice Benefit is unusually generous. Once a patient elects it, Medicare covers the hospice team's nursing visits, the hospice physician, medications related to the terminal diagnosis, medical equipment such as a hospital bed or oxygen concentrator, supplies, home health aide and homemaker visits, social work, chaplain support, and bereavement support for the family for up to 13 months after a death. Out-of-pocket costs are minimal: up to $5 per prescription for symptom-control drugs and 5% of the Medicare-approved amount for inpatient respite care.
The gap that surprises Central Florida families most: hospice does not pay room and board. If a parent lives in an Orlando-area assisted living community or a nursing home, the hospice team comes to them, but the monthly rent or the nursing-home daily rate is still owed — paid privately, or through Florida's Medicaid long-term care program for those who qualify. Budget for hospice as an added layer of care, not as a replacement for the housing bill.
Palliative care works differently. It is billed like other physician and outpatient services under Medicare Part B, which means normal deductibles and coinsurance apply, and it does not require giving up any treatment.
A common misconception is that hospice is a building you move into. In Central Florida, the overwhelming majority of hospice care is delivered wherever the patient already lives — a house in Winter Park, an assisted living community in Kissimmee, a nursing home in Sanford, a villa in The Villages. A nurse typically visits once or twice a week at first, with an aide coming more often for bathing and personal care, and a 24-hour on-call line for nights and weekends. Families still provide most of the hands-on caregiving between visits, which is the part that catches people off guard.
Hospice also includes short inpatient stays when symptoms can't be controlled at home, and up to five consecutive days of inpatient respite care so a family caregiver can rest. Enrollment is not permanent: a patient can revoke hospice at any time to pursue treatment again, and can re-elect it later. Certification runs in two 90-day periods followed by unlimited 60-day periods, each requiring a physician to re-certify that the prognosis still holds. People do get discharged from hospice for stabilizing — that is a normal outcome, not a mistake.
Every hospice operating in Florida must hold a license from the Agency for Health Care Administration, and you can confirm any provider's license and inspection history yourself at FloridaHealthFinder.gov before you sign anything. Hospice is one of the few care decisions where families are almost always free to choose the provider — a hospital case manager may hand you one name, but you are not obligated to take it, and switching providers later is allowed.
Questions worth asking every agency: How quickly can you admit, including on a weekend? Who answers the after-hours line — your own nurse or an answering service? How often will a nurse and an aide actually visit at this stage? Do you serve my parent's specific assisted living community or nursing home? What is your inpatient unit, and where is it? Response time and visit frequency vary widely between providers serving the same ZIP code, and those two answers matter more than any brochure.
For help sorting out benefits, the Senior Resource Alliance is the Area Agency on Aging for Orange, Osceola, Seminole, and Brevard counties; Lake and Sumter counties, including The Villages, are served by Elder Options. Florida's statewide Elder Helpline at 1-800-963-5337 will route you to the right one.
If a parent is living with advanced heart failure, COPD, kidney disease, Parkinson's, or early-to-moderate dementia and is still pursuing treatment, a palliative-care consult is usually the right first call. Ask the treating specialist for a referral — AdventHealth and Orlando Health both run palliative programs, and several Central Florida hospice organizations offer community-based palliative care as a separate service line from their hospice program.
The practical benefit is fewer emergency-room trips. Palliative teams manage symptoms proactively, coordinate between specialists who often aren't talking to each other, and help families put an advance directive and a Florida DNRO in place while the person can still say clearly what they want. Starting that conversation early tends to make the eventual hospice decision, if it comes, far less frightening.
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