IEHP and hospice: how it works for each IEHP plan

Which IEHP plan do you have?

Look at your IEHP card. IEHP Medi-Cal is for people with Medi-Cal only. IEHP DualChoice is for people with both Medicare and Medi-Cal, and one IEHP card covers both. The rules for hospice are different for each.

This table is general information, not a benefits determination. Your IEHP Member Handbook is the final word on IEHP's own benefits.

Does IEHP Medi-Cal cover hospice?

Yes. IEHP's 2026 Medi-Cal Member Handbook lists hospice as a covered benefit for members with a life expectancy of six months or less. It covers nursing, aide visits, social work, counseling, supplies, symptom medicines, respite care for up to 5 days at a time, and short-term inpatient care for pain or symptoms.

The handbook also says IEHP may require you to get hospice from an in-network provider unless the services you need are not available in network. State rules allow this (DHCS All Plan Letter 25-008). If you want a hospice outside IEHP's network, IEHP can make a one-time agreement with that hospice or refer you to one in its network.

The hospice sends IEHP the hospice election form and handles any approval the plan needs. Under DHCS rules, only general inpatient care can need prior authorization. Routine home care, continuous home care and respite care cannot. You stay an IEHP member, and IEHP keeps covering care unrelated to the terminal illness, including visits with your primary care doctor.

Who pays for hospice with IEHP DualChoice?

For IEHP DualChoice members, Original Medicare pays the hospice. IEHP's own 2026 DualChoice Member Handbook says that once you are in a hospice program, the hospice bills Original Medicare for your hospice care and for Part A and Part B services related to the terminal illness.

This is a federal rule for every Medicare Advantage plan. IEHP DualChoice is one: a Dual Special Needs Plan, or D-SNP. Under 42 CFR 422.320, once a member elects hospice, Medicare stops paying the plan for that care and Original Medicare pays the hospice. CMS says the same in its Medicare Managed Care Manual, chapter 4. So IEHP DualChoice does not approve or deny hospice, and you do not need a hospice in IEHP's network. The handbook says you can get care from any hospice program certified by Medicare.

IEHP DualChoice still covers services that Medicare Part A and Part B do not, whether or not they relate to the terminal illness, and the handbook says you pay nothing for them. Medicines for other conditions stay with the plan's Part D drug coverage. The plan needs a note from the hospice or the prescriber that a drug is unrelated before it pays for it, so ask the hospice to send that note early.

How do you find IEHP hospice providers?

Call IEHP Member Services and ask for the list of hospices near you. The number is also on the back of your IEHP card. If you have IEHP DualChoice, the handbook says the plan must help you find Medicare-certified hospices in its area, including any it owns or has a financial interest in. That list helps you choose. It does not limit you.

IEHP Medi-Cal Member Services: 1-800-440-4347 (TTY 1-800-718-4347), 7 a.m. to 7 p.m. Monday to Friday and 8 a.m. to 5 p.m. Saturday and Sunday. IEHP DualChoice Member Services: 1-877-273-4347 (TTY 711), 8 a.m. to 8 p.m., 7 days a week, including holidays.

If you have IEHP Medi-Cal only, ask which hospices are in IEHP's network for where you live. Before you choose, you can check any hospice's state license and Medicare record. See how to check a hospice's record and how to choose a hospice.

What is the IEHP palliative care program?

IEHP's palliative care program is called My Path. It is home- and community-based care for members with an advanced illness who are not eligible for hospice or do not want it yet. IEHP's guideline says it serves Medi-Cal members and some Medicare members, and the DualChoice handbook lists palliative care as a covered benefit.

My Path care includes a palliative assessment, advance care planning, a written plan of care, help with pain and symptoms, social work and mental health support, and care coordination from a palliative team. You can keep treatment for your illness at the same time.

To qualify, an adult generally needs an advanced illness such as heart failure, lung disease on oxygen, advanced cancer, liver or kidney failure, advanced dementia or a neurological disease, and a doctor who would not be surprised by death within two years. Using the hospital or emergency room for the illness, or being likely to, is also part of the criteria. IEHP must approve both the first consultation and enrollment, so ask your doctor to request a My Path referral. Adults 21 and older cannot have My Path and hospice at the same time, but you can ask to move to hospice at any time.

For questions about My Path, ask your doctor or IEHP Member Services.

For how palliative care and hospice differ, see palliative care and hospice and palliative care compared.

How do you start hospice with IEHP?

To start hospice with IEHP, talk with the doctor, choose a hospice, tell IEHP, and have your cards ready. The steps are the same for both IEHP plans.

1. Step 1

   Talk with the doctor

   Tell your IEHP doctor, or the hospital case manager, that you want to talk about hospice. 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. The hospice medical director and your doctor make that decision. A website cannot.

2. Step 2

   Choose a hospice

   With IEHP Medi-Cal, ask IEHP which hospices are in its network. With IEHP DualChoice, you may choose any Medicare-certified hospice. Then call the hospice you chose.

3. Step 3

   Have your cards ready

   Have your IEHP card and the list of medicines. DualChoice members should also have the red, white and blue Medicare card, because the hospice bills Original Medicare. IEHP's handbook notes you may be asked to show it for hospice services.

4. Step 4

   Tell IEHP

   Call your IEHP care coordinator or Member Services so your other care stays coordinated. A DualChoice member does not need IEHP's permission to start hospice.

What if the person lives in a nursing home?

Medi-Cal keeps paying nursing home room and board for residents who qualify. Under DHCS All Plan Letter 25-008, IEHP pays that room and board to the hospice, and the hospice pays the nursing home. IEHP cannot require an authorization for it. For a resident with both Medicare and Medi-Cal, Medicare pays the hospice care and Medi-Cal still covers room and board. For an IEHP DualChoice member, that room and board still goes through IEHP's Medi-Cal side.

Before you choose a hospice, ask IEHP and the hospice how room and board will be handled. The family should not see a new bill because of hospice, apart from any share of cost the resident already pays. See who pays for the nursing home on hospice.

Can Beta Hospice take my IEHP plan?

Call and ask. We check each person's coverage before care starts. With IEHP DualChoice, Original Medicare pays the hospice, so you can choose any Medicare-certified hospice, including Beta Hospice. If the person lives in a nursing home, room and board still goes through IEHP, so ask about it. With IEHP Medi-Cal only, it depends on IEHP's network or on an agreement IEHP makes for one member, so ask IEHP for its hospice list.

Choosing hospice, and which hospice, is your decision. You can stop hospice at any time and go back to your regular coverage.

Common questions

Read more

The fuller pages: Medi-Cal and hospice, hospice with a Medicare Advantage plan, Kaiser Senior Advantage and hospice, paying for care, is it time for hospice? and how to start hospice.

Beta Hospice serves San Bernardino County, Riverside County, Los Angeles, Orange and Ventura counties from one office in San Bernardino. Inland Empire Health Plan (IEHP) is named on this page only to describe its members' benefits. Beta Hospice is not part of IEHP, and this page does not say that Beta Hospice is in IEHP's network.