Resources for families
Medi-Cal and hospice
Medi-Cal covers hospice. The benefit mirrors Medicare's: nurse and team visits, medicines, equipment and supplies related to the terminal illness. If you have both Medicare and Medi-Cal, Medicare pays for hospice first and Medi-Cal helps with what is left. If you are in a Medi-Cal managed care plan, the plan covers hospice and may need to approve it, so check with the plan before care starts.
Reviewed by our medical director, September 24, 2026
On this page (7 sections)
What Medi-Cal hospice covers
Medi-Cal hospice is for people with a terminal illness when a doctor certifies that life expectancy is six months or less if the illness runs its usual course. It covers the same kinds of care as Medicare hospice: nursing, doctor services, hospice aide visits, social work, counseling, medicines for symptoms, medical equipment and supplies, short-term inpatient care and respite care, and grief support for the family.
Adults who choose hospice agree to comfort-focused care for the terminal illness in place of treatment meant to cure it. Children and young people under 21 on Medi-Cal are different: they can receive hospice and keep treatment for their illness at the same time.
Choosing hospice is your decision. You can stop hospice at any time and return to your regular Medi-Cal coverage.
How it works for your kind of coverage
| Your coverage | Who pays for hospice | What to check |
|---|---|---|
| Medi-Cal only, in a managed care plan | Your Medi-Cal plan | Whether the hospice is contracted with your plan and whether the plan needs to approve hospice first. We check both for you before care starts. |
| Medi-Cal only, not in a plan (fee-for-service) | Medi-Cal directly | That the hospice is a Medi-Cal provider. |
| Medicare and Medi-Cal together (often called Medi-Medi or dual eligible) | Medicare pays for hospice first. Medi-Cal acts as the second payer. | That the hospice is certified by Medicare and is a Medi-Cal provider. |
| A Medicare Advantage or Medi-Medi plan | When you choose hospice, Original Medicare generally pays the hospice, even though you stay a member of your plan. The plan still covers care unrelated to the terminal illness and any extra benefits. | Call the plan so your care manager knows. Ask what stays the same. |
| Medi-Cal with a share of cost | Medi-Cal pays after the monthly share of cost is met | See the share of cost section below. |
We check your benefits and tell you your costs before care starts. See paying for care.
Managed care plans
Most people with Medi-Cal are in a managed care plan. The plan is chosen by county, and the choices differ between San Bernardino, Riverside, Los Angeles and Orange counties. Hospice is a covered benefit in every Medi-Cal managed care plan. A plan may require the hospice to be in its network or to ask for authorization, and federal and state rules expect plans to act on hospice requests quickly.
You still have a say in which hospice you use. If the hospice you want is not in your plan's network, ask the plan what your options are.
Room and board in a nursing facility
Hospice coverage pays for hospice care. It does not pay for a place to live. There is one important Medi-Cal exception. When a person with Medi-Cal lives in a nursing facility and chooses hospice, Medi-Cal continues to cover the nursing facility room and board. The payment is routed through the hospice, which passes it to the facility. The family should not see a new bill because of this change, apart from any share of cost the resident already pays the facility.
This applies to nursing facilities. Regular Medi-Cal does not pay room and board in assisted living or board and care homes. See hospice in assisted living.
Medi-Cal palliative care (SB 1004)
Not everyone with a serious illness is ready for hospice or eligible for it. Under a California law known as SB 1004, Medi-Cal managed care plans must offer palliative care to members who meet the plan's criteria. These generally cover advanced stages of cancer, heart failure, chronic obstructive pulmonary disease (COPD) and liver disease, and plans may include other conditions.
Medi-Cal palliative care can be given along with treatment aimed at the illness. It usually includes advance care planning, help with pain and symptoms, a care team, care coordination and a number to call. It is arranged through your plan, not through the hospice benefit.
To ask about it, call your plan's member services number and ask for a palliative care referral under SB 1004, or ask your doctor to request one. For how palliative care differs from hospice, see hospice and palliative care compared and palliative care.
How to check with your plan
- Step 1
Find your plan's name and member number
They are on your plan ID card. Your white and blue Medi-Cal Benefits Identification Card (BIC) is separate. Have both.
- Step 2
Call member services
The number is on the back of the plan card. Say the person's doctor is recommending hospice, or that you want to ask about hospice or palliative care.
- Step 3
Ask four questions
Which hospices near me are in your network? Do you need to approve hospice before it starts, and how long does that take? Will I have a care manager? What stays the same with my other benefits?
- Step 4
Tell the hospice what you learned
The hospice confirms benefits on its side and requests any authorization. You should be told about any cost before care begins.
- Step 5
If you hit a wall
Ask the plan how to file an urgent grievance. You can also contact the Medi-Cal Managed Care Office of the Ombudsman at DHCS, or ask a hospice social worker for help.
Common questions
Does Medi-Cal cover hospice at home?
Yes. Medi-Cal covers hospice wherever the person lives, including a private home, a nursing facility or an RCFE (residential care facility for the elderly).
Do I pay anything for hospice with Medi-Cal?
People with full-scope Medi-Cal and no share of cost generally are not billed for covered hospice services. If you have a share of cost, it applies first. We check your benefits and tell you your costs before care starts.
I have Medicare and Medi-Cal. Which card do I use?
Both. Medicare is the main payer for hospice, and Medi-Cal is the second payer. Give the hospice all of your cards, including any plan card.
Do I lose my Medi-Cal plan if I choose hospice?
No. You stay in your plan. It continues to cover care that is not related to the terminal illness.
Does Medi-Cal pay for a caregiver at home?
Not through hospice. In-Home Supportive Services (IHSS) is a separate Medi-Cal program that can pay for caregiver hours for people who qualify. People on hospice can also have IHSS. Apply through your county.
We do not have Medi-Cal yet. Is it too late?
Not necessarily. Applications go through your county social services office or Covered California. A hospice social worker can point you to the right office. See paying for care and is it time for hospice?.
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
- California Department of Health Care Services (DHCS) (opens in a new tab)
- DHCS: Palliative care policies (SB 1004) (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’s 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 person’s 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