Medicare, Medi-Cal, health plans and what families pay
Paying for hospice and palliative care
Medicare covers hospice care related to the terminal illness. Under Medicare, most people pay nothing for hospice care itself. There can be a copay of up to $5 per prescription for symptom medicines and 5% of the Medicare amount for inpatient respite care. Medicare does not pay room and board where you live. Medi-Cal covers hospice, and most private plans include a hospice benefit. We check your benefits and tell you your costs before care starts.
Reviewed by our medical director, September 24, 2026
On this page (8 sections)
How is hospice paid for?
Hospice is a bundled benefit. The payer, usually Medicare, pays the hospice a set daily rate for each day a person is on hospice. From that daily rate the hospice provides the team's visits, medicines for the terminal illness, medical equipment and supplies that are part of the plan of care. Families are not billed that daily rate.
This is why hospice is different from most health care. There is no bill per visit, no deductible for hospice care under Medicare, and no separate charge for the hospital bed or oxygen when they are part of the plan of care. See what hospice provides.
Who pays for hospice in California?
| Coverage | What is covered | What you may pay | What to know |
|---|---|---|---|
| Medicare (Original Medicare, Part A) | Hospice care related to the terminal illness: nursing, doctor oversight, aide visits, social work, spiritual care, medicines for symptoms, equipment, supplies, short inpatient and respite stays, and grief support for family | Up to $5 per prescription for symptom medicines and 5% of the Medicare amount for inpatient respite care. Room and board where you live | The hospice must be Medicare certified. Medicare keeps covering conditions unrelated to the terminal illness, with the usual deductibles and coinsurance |
| Medi-Cal fee-for-service | Medi-Cal covers hospice. The benefit follows the same four levels of care as Medicare | Usually nothing for hospice care itself. If you have a Medi-Cal share of cost, it still applies | For people with both Medicare and Medi-Cal, Medicare pays for hospice first. Medi-Cal may cover nursing facility room and board for eligible residents |
| Medi-Cal managed care plan | Hospice is a covered benefit of Medi-Cal managed care plans. The plan pays the hospice | Usually nothing for hospice care itself, beyond any share of cost | The plan may need to be told about the hospice election, and some services such as inpatient care may need plan approval. We handle that with the plan. We check your plan's contract status before care starts |
| Medicare Advantage | Once hospice is elected it is paid by Original Medicare, not by the plan. This is true even if you stay in the plan | The same as Original Medicare for hospice care. Plan premiums continue if you stay in the plan | You can keep the plan for its extra benefits, such as dental or vision, and for care unrelated to the terminal illness. You do not need the plan's permission to choose a Medicare-certified hospice |
| Veterans (VA) | Hospice is part of the VA standard medical benefits package for veterans enrolled in VA health care. The VA can pay for hospice from a community hospice | The VA does not charge a copay for hospice care | Care from a community hospice needs a VA referral or authorization. Veterans who also have Medicare can use Medicare instead. Ask us and your VA team to verify current Community Care participation and the authorization needed before care is arranged |
| Private insurance | Most plans include a hospice benefit. Costs and approvals vary | Depends on the plan. Deductibles, copays or day limits can apply | We check your benefits and tell you your costs before care starts. We check your plan's contract status before care starts |
| No insurance | Hospice care is billed to the person unless coverage is found | Before any agreement you receive a written estimate that lists the included services, any excluded charges and the payment terms. We look for coverage options first | Many people with a terminal illness and limited income can get Medi-Cal. Our social worker can help you start a Medi-Cal application and look for other coverage. Call before you decide that care is out of reach |
This table is general information, not a benefits determination. Your own costs depend on your coverage. We verify your benefits with your payer and explain them to you before care starts.
What does hospice coverage not pay for?
Hospice coverage is for comfort care related to the terminal illness. It does not pay for treatment meant to cure that illness, for care from providers the hospice team did not arrange, or for emergency room visits and hospital stays the hospice did not arrange, unless they are for an unrelated condition.
It also does not pay for a caregiver in the home all day, or for room and board. Those two costs surprise families most often, so ask about them early.
Who pays room and board while someone is on hospice?
| Where the person lives | Who pays for room and board | What to know |
|---|---|---|
| A private home | The household, as before. Rent, food, utilities and hired caregivers are not part of the hospice benefit | Hospice brings the team, medicines, equipment and supplies to the home. See where care happens |
| Assisted living or a board-and-care home, licensed in California as a residential care facility for the elderly (RCFE) | The resident or family, under the facility's admission agreement | Hospice does not change the monthly fee. Some facilities charge more as care needs rise. Long-term care insurance may help, depending on the policy |
| A nursing facility | The resident or family, long-term care insurance, or Medi-Cal. Medi-Cal may cover nursing facility room and board for eligible residents | Medicare does not pay nursing facility room and board for a person on hospice. When Medi-Cal covers it, the payment is coordinated between the hospice and the facility |
| Short inpatient stays arranged by hospice | Included in the hospice benefit. Respite care has a 5% coinsurance under Medicare | General inpatient care is provided only when medically necessary during a symptom crisis. Respite care is up to 5 days at a time. See levels of care |
How is palliative care covered?
Palliative care is paid for differently from hospice. There is no single bundled benefit. Visits are billed to your regular coverage, like other specialist care.
Medicare Part B covers medically necessary visits with a palliative doctor or nurse practitioner. The Part B deductible and usually 20% coinsurance apply, unless you have Medigap or Medi-Cal as secondary coverage.
Medi-Cal managed care plans must offer a palliative care benefit to members who meet the plan's criteria, under California's SB 1004. It can include a care team, symptom management, advance care planning and care coordination while treatment continues. The plan usually has to authorize it.
Private plans vary. Some have a home-based palliative program, and others cover only the medical visits. Palliative care coverage is verified for each patient with the plan before scheduling. See palliative care and hospice vs palliative care.
How we check your benefits
- Step 1
You tell us the coverage
When a nurse or admissions coordinator talks with you in person or by phone, we ask what coverage the person has: Medicare, Medi-Cal, a health plan, VA or none. We do not collect Medicare numbers through this website.
- Step 2
We verify with the payer
We confirm eligibility, whether authorization is needed, and whether any copay, share of cost or plan limit applies.
- Step 3
We explain it before care starts
You hear what is covered, what is not, and what you may owe, including room and board if the person lives in a facility. Then you decide.
Your choice is protected
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. If you are not sure whether hospice fits yet, read is it time for hospice.
Common questions
Does Medicare pay 100% of hospice?
Nearly, for the hospice care itself. Medicare covers hospice care related to the terminal illness, and most people pay nothing for it. There can be a copay of up to $5 per prescription for symptom medicines and 5% of the Medicare amount for inpatient respite care. Medicare does not pay room and board where you live, and it does not pay for treatment meant to cure the terminal illness.
What if my family cannot afford hospice care?
Start by calling. Most people who need hospice have Medicare or Medi-Cal, and under both the family usually owes little or nothing for hospice care itself. If the person has no coverage, our social worker can help with a Medi-Cal application and other options. Questions about paying without coverage go to our finance contact, who reviews coverage options and any assistance that applies and documents the decision. The larger costs are often daily caregiving and room and board, and the social worker can help you plan for those too.
Does the state of California pay for hospice care?
Yes, through Medi-Cal, California's Medicaid program. Medi-Cal covers hospice for eligible members, either directly or through a Medi-Cal managed care plan. For people who have both Medicare and Medi-Cal, Medicare pays for hospice first, and Medi-Cal may cover nursing facility room and board for eligible residents. See Medi-Cal and hospice.
What is the average cost of hospice care in California?
For most families the honest answer is little or nothing for hospice care itself, because Medicare or Medi-Cal pays. Medicare pays the hospice a daily rate that is set each year and adjusted by area and by level of care. Families are not billed that rate. What families do pay for is room and board and any hired caregivers, and those costs vary widely. We tell you your own costs before care starts.
How much is hospice care per month in California?
With Medicare or Medi-Cal, most people have no monthly bill for hospice care itself. There may be small medicine copays under Medicare. A monthly cost usually comes from where the person lives, such as an assisted living fee or nursing facility room and board, or from hired caregivers. With private insurance, the amount depends on the plan's deductible and copays.
Is hospice covered by Medi-Cal?
Yes. Medi-Cal covers hospice, whether you have fee-for-service Medi-Cal or a Medi-Cal managed care plan. A doctor must certify eligibility and the person must choose hospice. Adults who elect hospice agree to comfort care instead of treatment to cure the terminal illness. Children on Medi-Cal can receive hospice and curative treatment at the same time.
Do I lose my Medicare Advantage plan if I choose hospice?
No. You can stay in the plan as long as you keep paying its premiums. Once you elect hospice, Original Medicare pays for hospice care and for other Medicare-covered services. The plan keeps covering its extra benefits, such as dental or vision. If you leave hospice, the plan takes over all of your coverage again, usually from the start of the next month.
About this page
- Written by
- Beta Hospice care team
- Clinically reviewed by
- our medical director
- Last reviewed
- September 24, 2026
- Next review
- March 24, 2027
How we write and review this site
Sources
- Medicare.gov: Hospice care coverage (opens in a new tab)
- 42 CFR 418.400: Individual liability for coinsurance for hospice care (opens in a new tab)
- California DHCS: Hospice care (opens in a new tab)
- California DHCS: Palliative care policies (SB 1004) (opens in a new tab)
- U.S. Department of Veterans Affairs: Hospice care (opens in a new tab)
These sources support the general information on this page. For one personās care and coverage, talk with the hospice team.
You do not have to decide alone.
Call (909) 347-7000 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 personās 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