Wondering if Medicare pays for respite care? Here is exactly what is covered and what is not.
Medicare's hospice respite benefit
Original Medicare covers respite care only for people enrolled in hospice. Under the hospice benefit, Medicare pays for short-term inpatient respite care - up to five consecutive days at a time - in a Medicare-approved facility, so the usual family caregiver can rest. You pay a small coinsurance, roughly 5% of the Medicare-approved amount for the respite stay. This benefit can be used more than once, though frequent use may be reviewed. To learn how the hospice respite benefit works for your family, call 1-800-MEDIGAP for free guidance.
Respite options outside hospice
If your loved one is not in hospice, Original Medicare does not cover respite care. Other options can help instead: Medicaid Home and Community-Based Services waivers, Veterans benefits including Aid and Attendance, long-term care insurance, and programs through your local Area Agency on Aging. Some Medicare Advantage plans now offer in-home support or caregiver-relief benefits as supplemental coverage. Because availability and rules vary by plan and state, a licensed agent at 1-800-MEDIGAP can help you identify the respite resources you qualify for.