Planning situation Learning the difference between palliative care and hospice Preparing for a serious-illness care visit Hospice has been mentioned by the care team Comparing hospice providers or care settings Already enrolled and reviewing the care plan
Current care setting Home Hospital Skilled nursing or rehab Assisted living or memory care Nursing home Not sure
Main family concern right now Comfort, symptoms, or care goals Medicare, plan, or out-of-pocket costs Whether care at home is realistic Choosing or changing a provider Family communication or decision roles
Coverage context Original Medicare Medicare Advantage plan Medicaid or dual coverage Private, VA, retiree, or other coverage Not sure
Care team conversation status Not started yet Some questions asked, but unclear Care plan discussed Urgent review or new symptoms need attention
Provider search status No provider search yet One provider suggested Comparing providers Current provider concerns or possible change
Family caregiver capacity Strong support available most days Limited support or work conflicts Long-distance or mostly remote support Not sure yet
Advance care documents status Not started Started but not shared with care team Shared with agent, family, or care team Not sure
Need respite or after-hours backup planning? Yes No Not sure
Use this as a conversation checklist, not a medical or coverage decision.
Do not enter diagnoses, Medicare numbers, Social Security numbers, claim numbers, account numbers, medication details, or private medical facts into this worksheet.
This planner is educational and organizational. It is not medical, legal, insurance, benefits, tax, or financial advice. Confirm personal care decisions, eligibility, coverage, costs, provider quality, and emergency concerns with qualified clinicians, the plan, Medicare, hospice or palliative care providers, and appropriate professionals.
Official references:
Medicare hospice care coverage ,
Medicare Care Compare hospice search ,
MedlinePlus palliative care ,
MedlinePlus hospice care ,
CMS hospice overview ,
Eldercare Locator .
