Does Medicare Cover Respite Care?

Does Medicare Cover Respite Care?

Being a caregiver is physically and mentally taxing. You're taking care of someone you love — and that's on top of your other responsibilities. Many caregivers are helping elderly parents while raising families of their own.

Respite care can help you avoid caregiver burnout and give you some short-term relief. It can also be a critical part of a long-term care plan.

But what about the cost of respite care? And does Medicare cover respite care? Here's what you need to know.

What Is Respite Care?

Respite care helps primary caregivers take a break from their duties. Caregiver burnout is real, and many caregivers can quickly become mentally and physically drained, especially if they don't have a team to help them. Respite care helps caregivers get a well-earned break without sacrificing their loved ones' quality of care.

Depending on the level of care needed, respite care can be for a few hours a day so you can run errands, or it can last a few weeks so you could travel or take an extended break.

Respite care comes in a variety of forms. It can take place in your home, at an adult day care facility or at a residential assisted living center that allows overnight stays. Nurses, home health aides and other respite care providers help take care of daily activities, and they can also help with medication management, exercise and bedtime preparation.

Some specialized day care centers offer group care sessions and let respite care workers take people in their care to classes or small group events.

How Can I Cover the Costs of Respite Care?

The costs of respite care depend on several factors, such as the care you need, how long you'll need it and what kind of insurance you have. Standard health insurance usually doesn't cover respite care, so you'll need to figure out your potential out-of-pocket costs. However, if the person you're caring for has a long-term care insurance policy, it usually covers respite care, in-home care and facility care.

You could find relief through charitable organizations. For example, some local chapters of the Alzheimer's Association offer resources at a reduced or no cost.

Does Medicare Cover Respite Care?

Many older patients use Medicare as their primary insurance, so it's not uncommon to wonder whether Medicare covers respite care.

What does Medicare cover? Medicare Part A pays for inpatient respite care at approved facilities, such as hospitals and skilled nursing facilities, for up to five days per stay as part of a patient's hospice care. You can get respite care more than once, Medicare says, though "only on an occasional basis." (Medicare does not specify an official limit.) If you're applying for respite care, the person you are caring for needs to qualify for Medicare's hospice requirements. If you qualify for respite care through Medicare, you might also have to pay 5% of the Medicare-approved costs.

Medigap, or Medicare Supplement insurance, could also help pay for respite care. Medigap is private supplemental health insurance, and it fills some of the gaps that Original Medicare doesn't cover. Some Medigap policies cover some respite care costs, including time at skilled nursing facilities and in-home health care. Check your policy before making any decisions.

Caregivers Deserve Care, Too

If you're a caregiver and you're feeling physically or mentally exhausted, respite care can improve your well-being and return you to a position to provide the best possible care to your loved one. If you think that respite care is what you need, review your Medicare, Medigap or long-term care insurance benefits to see whether they can defray some of the costs.

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