Medicare Part A is the primary payer for hospice care in the United States, and it is the gold standard for comprehensive coverage. All covered hospice services — nursing, physician oversight, aide, social work, chaplain, all related medications, all medical equipment and supplies — are covered at 100%. The only out-of-pocket costs under Medicare hospice are: a $5 per prescription co-pay for outpatient pain medications (if applicable), and 5% of the approved amount for Inpatient Respite Care stays. No deductible. The benefit periods are: two 90-day periods followed by unlimited 60-day periods, each requiring physician re-certification.

Medi-Cal covers hospice care for California residents who are not Medicare-eligible. Coverage is equivalent to the Medicare Hospice Benefit — all clinical services, medications, and equipment are covered. For patients who are 'dual-eligible' (both Medicare and Medi-Cal), Medicare pays first and Medi-Cal covers the small cost-sharing amounts, resulting in zero out-of-pocket cost. California has one of the most generous Medi-Cal hospice benefit structures in the country.

Kaiser Permanente provides comprehensive hospice coverage through its integrated care model. Kaiser members with a hospice-qualifying diagnosis are referred to Kaiser's hospice coordination program, which then authorizes care with contracted hospice agencies like Westlake Village Hospice. Kaiser's coverage is at least equivalent to the Medicare Hospice Benefit for all standard hospice services. Kaiser Senior Advantage (Medicare Advantage) members have dual-pathway coverage — Medicare covers the core hospice benefit and Kaiser may provide supplemental benefits.

AltaMed Health Services is one of the largest federally qualified health center (FQHC) networks in Los Angeles and Orange counties, serving primarily Medi-Cal and Medicare patients. We have an established relationship with AltaMed for hospice coordination. AltaMed patients are typically covered through Medi-Cal managed care, and our billing team handles the entire authorization and claims workflow with AltaMed's care management team.

For patients with private commercial insurance that does not have a pre-existing hospice contract with our agency, we obtain what is called a 'Letter of Agreement' (LOA) — a one-time authorization from the insurance company approving hospice services at a negotiated rate. Most major private insurers — Blue Shield, Anthem Blue Cross, Cigna, Aetna, UnitedHealthcare, and regional plans — cover hospice care as a standard benefit. Our admissions team contacts your insurer directly, obtains the LOA, and begins care without any administrative burden on your family.

Does Westlake Village Hospice accept Kaiser Permanente?

Yes. We accept Kaiser Permanente hospice referrals and work with Kaiser's hospice coordination team to ensure a smooth transition. Kaiser Permanente typically authorizes hospice care at an equivalent level to the Medicare Hospice Benefit — covering all nursing visits, medications, medical equipment, aide services, and counseling related to the terminal diagnosis. If the patient's Kaiser plan includes a Medicare Advantage (MA) component, we coordinate with both Kaiser and Medicare to align benefits appropriately.

What is Medi-Cal (Medicaid) hospice coverage, and how does it work in California?

Medi-Cal, California's Medicaid program, covers hospice care at the same level as Medicare for patients who do not have Medicare Part A but who are eligible for Medi-Cal. For patients who have both Medicare and Medi-Cal (called 'dual eligible'), Medicare is the primary payer and Medi-Cal covers the small hospice cost-sharing amounts (the $5 prescription co-pay and the 5% Respite Care co-insurance). In practice, dual-eligible patients pay nothing for hospice care. Our admissions team verifies both Medicare and Medi-Cal eligibility and handles all dual-eligibility billing.

What if a patient has a Medicare Advantage (Part C) plan instead of traditional Medicare?

Medicare Advantage plans are required by law to cover hospice care at least as generously as traditional Medicare Part A. However, Medicare Advantage plans handle hospice billing differently — the hospice agency bills traditional Medicare directly for the clinical hospice services, and the Medicare Advantage plan may cover supplemental benefits (such as dental or vision) that traditional Medicare does not include. In practice, the coverage is equivalent or better for hospice. Our team confirms your specific Medicare Advantage plan's details before enrollment begins.

Are there any insurance plans that Westlake Village Hospice does NOT accept?

We accept most major insurance plans including Medicare, Medi-Cal, Kaiser Permanente, Altamed, and most private insurances through 'Letters of Agreement' (LOAs) for non-contracted plans. There are some very small, regional HMO plans for which we may not have established contracts — if you are unsure whether your insurance is accepted, call our admissions team and we will verify your coverage within one business day, at no cost or obligation to you.