How and Where Is Palliative Care Provided and How Is It Paid For?

Who provides palliative care?

Palliative care is most often offered and started by the cancer care team who is giving your treatment. The doctors and nurses you see during your treatment visits may provide some palliative care themselves, such as helping to manage symptoms and side effects like nausea or pain. And they will continue to help control those problems while you are getting treatment. But they will often refer patients to a team of palliative care specialists.

This palliative care "team" typically includes a palliative care doctor (who may be board-certified in Hospice and Palliative Medicine), a palliative care nurse, social worker, dietitian, patient navigator, and maybe a person with a spiritual role such as a pastoral counselor or chaplain.

Many hospitals and oncology clinics have these teams as part of the services they provide. With many types of professionals, the palliative care team can better help with symptoms and problems that are harder to manage, like severe pain, family distress, insurance issues, or complex medical problems.

Where palliative care is given

Palliative care is most often given to the patient in the home as an outpatient, or during a short-term hospital admission. Even though the palliative care team is often based in a hospital or clinic, it’s becoming more common for it to be based in the outpatient setting. 

The palliative care team also can see patients, family, and caregivers in intensive care units, emergency rooms, treatment centers, or hospital units.

Most actual palliative care happens at home. At home, you may take medicines and use other methods prescribed by the team, or your family members and loved ones might need support as they help care for your needs . The team provides support to the patient as well as to the home caregivers.

You can read more about caregiving in What a Cancer Caregiver Does.

How palliative care is paid for

Palliative care can be covered by both government and private insurance plans, but it may be part of chronic care or long-term care coverage. Sometimes it's included in the hospice care part of coverage depending on how the health plan describes what palliative care is.

It's important to check and see if your insurance coverage has certain limits on palliative care, such as a list of what types of serious illnesses are covered, or other situations that may or may not be eligible for palliative care services.

There can also be limits on where palliative care is provided. Coverage may differ if you are getting palliative care in the hospital, rehab, or a skilled nursing or hospice facility instead of getting it at home. Sometimes nursing visits, social work, and spiritual care are covered, in addition to the care and medicines that help control symptoms. It's best to check with your health insurance company for details about what is covered and what is not.