Who Qualifies for Hospice Care?
Understanding eligibility is the first step. We're here to help you navigate the process with clarity and compassion.
General Eligibility Criteria
To be eligible for hospice care, a patient must meet two primary criteria:
Terminal Diagnosis
A physician certifies that the patient has a life-limiting illness with a prognosis of six months or less if the disease follows its normal course.
Comfort-Focused Care
The patient (or their representative) chooses to focus on comfort care rather than curative treatment for the terminal condition.
Important: A six-month prognosis doesn't mean your loved one will pass in six months. Many patients live longer and continue to receive hospice care. Patients can also leave hospice at any time if their condition improves.
Visit our Resources page for guides on understanding hospice care.
Common Qualifying Conditions
Hospice care is available for many life-limiting conditions. Here are some of the most common — but this list is not exhaustive. If you're unsure, call us.
Cancer (All Types)
Any cancer diagnosis where curative treatment has been exhausted or declined, with progressive decline in function.
Heart Disease & Congestive Heart Failure
Advanced heart failure (NYHA Class III–IV) with symptoms despite optimal medical therapy, or recurrent hospitalizations.
Lung Disease (COPD, Pulmonary Fibrosis)
End-stage COPD, pulmonary fibrosis, or other progressive lung disease with increasing dyspnea at rest despite treatment.
Dementia & Alzheimer's Disease
Advanced dementia with inability to ambulate, dress, or bathe independently, limited speech, and increasing medical complications.
Stroke & Cerebrovascular Disease
Severe stroke with significant functional impairment, poor recovery potential, and declining nutritional status.
ALS (Lou Gehrig's Disease)
Progressive ALS with rapidly declining function, breathing difficulty, and difficulty swallowing or speaking.
Kidney Disease (Renal Failure)
End-stage renal disease where the patient has chosen not to pursue or continue dialysis, with declining function.
Liver Disease
End-stage liver disease with complications such as ascites, hepatic encephalopathy, or recurrent infections.
HIV/AIDS
Advanced HIV/AIDS with progressive decline despite antiretroviral therapy, recurrent opportunistic infections.
General Debility & Failure to Thrive
Progressive weakness, weight loss, and declining function not attributable to a single specific disease — common in the elderly.
Parkinson's Disease
Advanced Parkinson's with severe rigidity, tremor, or cognitive decline that significantly limits daily function.
Multiple Sclerosis
Progressive MS with severe disability, recurrent infections, and declining ability to care for oneself.
Don't see your loved one's condition listed? Contact us — we can discuss eligibility for any life-limiting illness.
The Referral & Admission Process
Getting started with hospice is simpler than most families expect. Here's how it works.
Contact Us
Call us at (805) 361-0264 or fill out our contact form. Anyone can make a referral — you, a family member, a doctor, a social worker, or a friend.
Initial Conversation
A member of our team will discuss your loved one's situation, answer your questions, and determine if an assessment is appropriate. No obligation.
Clinical Assessment
A nurse visits the patient to conduct a comprehensive assessment. We coordinate with the patient's physician to obtain the necessary certification.
Care Plan Development
Based on the assessment, we create a personalized care plan that reflects the patient's wishes, goals, and medical needs.
Care Begins
Equipment and medications are delivered, and your care team begins visiting — typically within 24–48 hours of admission. We're by your side from day one.
Insurance & Payment Options
Hospice care is a benefit — not an expense. Most families pay nothing out of pocket.
Medicare Part A
The Medicare Hospice Benefit covers virtually all hospice-related costs — medications, equipment, supplies, nursing, aides, counseling, and more. Most hospice patients are eligible.
Medicaid (Medi-Cal)
Medi-Cal provides hospice coverage similar to Medicare. If you have both Medicare and Medi-Cal, Medicare is typically the primary payer for hospice services.
Private Insurance
Most private insurance plans include a hospice benefit. Coverage varies by plan — our team helps verify your benefits and explains what's covered before care begins.
No Insurance
No one is turned away for inability to pay. If you are uninsured or underinsured, we work with you to explore coverage options and ensure your loved one gets the care they need.
Not Sure if Hospice Is Right?
You don't have to have all the answers. That's what we're here for. Call us for a compassionate, no-obligation conversation about your loved one's situation. We'll help you understand your options and make the best decision for your family.
Browse our FAQ for detailed answers about costs, care, and what to expect.
Hablamos Espanol — our bilingual team is ready to assist you.
Every Family Deserves Support
If your loved one is facing a life-limiting illness, don't wait to explore your options. The sooner you reach out, the sooner we can help.