Extra support while treatment continues
Palliative care at home in San Bernardino and Riverside
Palliative care in San Bernardino and across the Inland Empire is medical care focused on relief from the symptoms and stress of a serious illness, at any stage and alongside treatment. At home in San Bernardino and Riverside counties it is paid for visit by visit through Medicare Part B, through a Medi-Cal managed care benefit under SB 1004, or through your health plan's own program. You keep your doctors, and you do not need a six-month prognosis.
Medically reviewed by Oscar Chien, MD, Medical Director, October 13, 2026
On this page (8 sections)
- What is palliative care?
- Who qualifies for palliative care?
- How is palliative care different from hospice?
- Who pays for palliative care in California?
- How does a palliative care referral start?
- What do palliative care visits look like?
- When does palliative care become hospice?
- Common questions about palliative care
What is palliative care?
A serious illness brings more than the disease itself. There is pain, breathlessness, nausea, poor sleep, worry, and a calendar full of appointments with specialists who each look at one organ. Palliative care looks at the whole person. A palliative clinician takes time to manage symptoms, explain what the illness is likely to do, and help you decide which treatments fit what matters to you.
Palliative care is an added layer. Your oncologist, cardiologist, lung doctor or primary care doctor stays in charge of treating the illness. The palliative team shares its notes and recommendations with them.
Who qualifies for palliative care?
It is based on need, not on how long someone is expected to live. It may help at any stage of cancer, heart failure, COPD, kidney or liver disease, dementia, stroke, ALS or Parkinson's disease, when there is:
- Pain, shortness of breath, nausea, fatigue, anxiety or other symptoms that are not well controlled
- Two or more hospital stays or emergency room visits in recent months
- Side effects from treatment that make it hard to keep going
- Hard decisions ahead about treatment, and a wish to understand the options
- A family caregiver who is stretched thin and unsure what to expect
How is palliative care different from hospice?
| Palliative care | Hospice | |
|---|---|---|
| Who it is for | Anyone with a serious illness and symptoms or stress that need attention | People with a serious illness when a doctor certifies that life expectancy is six months or less if the illness runs its usual course |
| When it starts | Any stage, including at diagnosis | When the person chooses comfort-focused care and is certified eligible |
| Treatment for the illness | Continues | Stops. Care focuses on comfort |
| Where | Home, clinic, hospital or facility, by program | Wherever the person lives, including nursing facilities, RCFEs and board-and-care homes |
Who pays for palliative care in California?
Palliative care is not one bundled benefit. It is paid for through the regular parts of your coverage.
| Coverage | How palliative care is covered | What you may pay |
|---|---|---|
| Original Medicare | Visits with a palliative doctor or nurse practitioner, including at home, are covered under Part B like other medical visits | The Part B deductible and usually 20% coinsurance, unless Medigap or Medi-Cal is secondary |
| Medi-Cal managed care | Under SB 1004, every Medi-Cal managed care plan must offer palliative care to members with certain advanced illnesses, including cancer, heart failure, COPD and liver disease, who meet the plan's criteria: in general, an advanced illness with recent or likely hospital use. In San Bernardino and Riverside counties the Medi-Cal plans are IEHP and Molina. Each runs its own program, so ask your plan how to be referred | Usually nothing beyond any Medi-Cal share of cost. The plan must authorize the service |
| Medicare and Medi-Cal together (D-SNP) | Since 2024, DHCS also requires Medicare D-SNP plans for people with both Medicare and Medi-Cal to have palliative care programs | Ask the plan |
| Medicare Advantage and private insurance | Most plans cover palliative visits as specialist care. Some run their own home-based programs | Your plan's copays and network rules apply |
See paying for care for hospice and palliative coverage side by side.
How does a palliative care referral start?
- Step 1
Ask
You, a family member or any of your doctors can ask. Families can contact us. Clinicians and plan care managers can use the palliative referral page, which summarizes the SB 1004 criteria.
- Step 2
Coverage is checked with your plan
Original Medicare needs a doctor's order for visits. Medi-Cal managed care and most other plans must authorize palliative care before visits start.
- Step 3
First visit
A palliative clinician reviews your history, medicines and symptoms and asks what matters most to you. Family is welcome.
- Step 4
A plan, shared with your doctors
You get a plan for symptoms and next steps. Your doctors get the notes. Follow-up depends on how you are doing.
What do palliative care visits look like?
A palliative visit at home is a scheduled visit from a doctor, nurse practitioner or nurse, with social work and spiritual support when the program offers them and you want them. The clinician reviews symptoms and medicines, adjusts doses for pain, breathlessness, nausea or sleep, and helps complete an advance directive or POLST. Caregivers get a written plan for flare-ups and a number to call between visits.
Visits are periodic, not daily. Palliative care does not place a caregiver in the home, does not replace your specialists, and is not an emergency service. For an emergency, call 911.
When does palliative care become hospice?
Palliative care can start at diagnosis and continues alongside treatment. Hospice is for people with a serious illness when a doctor certifies that life expectancy is six months or less if the illness runs its usual course, and treatment to cure the illness stops. Many people use palliative care first and move to hospice later with less disruption, because the goals are already clear.
Signs that it is time to talk with your doctor are on is it time for hospice; the full comparison is at hospice vs palliative care. Choosing hospice is your decision. You can stop hospice at any time and return to regular Medicare coverage. You have the right to choose your hospice.
Common questions about palliative care
Does Medi-Cal cover palliative care in California?
Yes, for Medi-Cal managed care members who meet the plan's criteria under SB 1004 and DHCS All Plan Letter 18-020: advanced cancer, heart failure, COPD or liver disease, plus general criteria. In San Bernardino and Riverside counties, ask IEHP or Molina how to be referred.
Can you have palliative care and keep treatment?
Yes. That is the main difference from hospice. Chemotherapy, dialysis, heart procedures and other treatment for the illness continue, and your specialists stay in charge. Medi-Cal palliative care under SB 1004 is designed to run alongside treatment.
Does palliative care mean dying?
No. It is based on need, not life expectancy. Many people receive it for years with a long-term illness; some stop needing it when a hard stretch of treatment ends. Hospice is the form of palliative care for the last months of life, and a separate decision.
How long can you be on palliative care?
There is no time limit. It continues as long as it helps and your coverage allows. Medicare Part B pays visit by visit; Medi-Cal plans reassess periodically.
Palliative care at home or in the hospital: which is better?
They do different jobs. Hospital teams see patients during an admission and plan the return home. Home-based care follows the person between hospital stays, where most symptom problems and decisions happen, and suits people who find travel hard.
About this page
- Written by
- Beta Hospice care team
- Medically reviewed by
- Oscar Chien, MD, Medical Director
- Last reviewed
- October 13, 2026
- Next review
- April 13, 2027
How we write and review this site
Sources
- National Institute on Aging: What are palliative care and hospice care? (opens in a new tab)
- California DHCS: Palliative care policies (SB 1004 and APL 18-020) (opens in a new tab)
- Medicare.gov: Doctor and other health care provider services (Part B) (opens in a new tab)
- Medicare.gov: Hospice care coverage (opens in a new tab)
These sources support the general information on this page. For one person鈥檚 care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (877) 258-7129 any time, or leave your number and someone from Beta's hospice team will call you. No decision is needed to call. Most families start with a question.
Only a hospice doctor, together with the person鈥檚 own doctor, can confirm hospice eligibility. A website cannot.
- A nurse answers 24 hours a day, 7 days a week
- You can stop hospice at any time
- You have the right to choose your hospice