Does Medicare Cover Respite Care? Your Options, Explained

Respite care provides temporary relief to a primary caregiver. It gives a caregiver a much-deserved break from providing care for their loved one. Respite care can be offered in hourly increments or for days at a time, and it can occur at home or at a care facility.

Caregivers can use respite care to:

• Take care of themselves (exercise, rest, etc.)
• Go to the doctor
• Run necessary errands
• Maintain social connections
• Go to work

Let our care assessment guide you

Yes, respite care is covered by Medicare if all of the following circumstances apply:^[01]

• The person qualifies for Medicare.
• The person is already receiving hospice care.
• The respite care occurs in a qualified hospital or skilled nursing facility.

Generally, Medicare covers up to five days of respite care in a row. However, respite may be used more than once depending on your loved one’s unique circumstances. Keep in mind that there may be out-of-pocket costs associated with respite care for Medicare beneficiaries.

Does Medicare pay for respite care at home?

Medicare doesn’t cover respite care services received at home — care must occur in a Medicare-approved facility.^[01] For instance, Medicare pays for respite care in a nursing home, otherwise known as a skilled nursing facility.

To avoid the inconvenience of transferring a loved one from their home into a facility while they’re on hospice care, consider arranging for help from family members or paying out of pocket for an in-home respite caregiver.

How much does respite care cost?

The cost of senior care greatly varies depending on an individual’s care needs, place of care, and length of care. To provide you with a better idea of costs, here’s a breakdown of median respite care costs based on location:

• Respite care in an assisted living facility is approximately $160 per day.^[02]
• Respite care at home is approximately $240 per day when 8 hours of care are provided.^[02]
• Respite care in a skilled nursing facility is approximately $260 per day.^[03]
• Respite care in an adult day health care facility is approximately $78 per day.^[03]

If your loved one doesn’t qualify for respite care through Medicare, there may still be other options available to them:

• Medicaid. While respite care isn’t a standard benefit for Medicaid, some states offer Medicaid waivers that may help cover the cost of respite care for eligible individuals. Contact your state Medicaid office to see if your state offers respite care through a Medicaid waiver.^[04]

• VA health care. Veterans enrolled in VA health care are generally eligible for respite care if they meet the clinical criteria for this type of care and the service is available in their location. Depending on service availability in your area, the respite care may occur at home, at a community nursing home, or at a VA community living center. Call 877-222-VETS (877-222-8387) to learn more.^[05]

• Long-term care insurance. Though policies vary, some may cover respite care. It’s a good idea to speak with your loved one’s long-term care insurance provider to learn about their unique policy.

• Informal respite care. Your community may offer free or discounted hourly respite care for seniors through local organizations, such as places of worship or elder-focused nonprofits. You may also be able to find hourly respite care by enlisting trusted family members or friends to stay with your loved one.

• Private-pay home care. In some cases, you may need to pay for an in-home caregiver to provide respite care on your own.

Read more:Hiring an In-Home Caregiver: A Step-by-Step Guide

As a family caregiver, you want to give your loved one the life they deserve. However, as your loved one’s care needs increase, it may not always be feasible to maintain quality of life at home anymore. If you’re feeling constantly worn down as a primary caregiver, or if you can no longer provide appropriate care for your parent, it may be time to consider residential senior living options, such as assisted living or memory care.

You don’t have to walk this journey alone. A Place for Mom’s Senior Living Advisors are here to help you. They can offer senior care advice, find senior living communities that meet your loved one’s unique needs, and even set up tours of communities — all at no cost to your family.