Does Medicare Cover Respite Care?

Respite care offers a short break to caregivers responsible for providing around-the-clock care for people who are unable to care for themselves. People with disabilities, Alzheimer's disease or terminal illnesses may require this type of custodial care. Medicare does cover respite care but only under certain conditions.

When Does Medicare Cover Respite Care?

Medicare only covers respite care for beneficiaries receiving hospice care. To receive hospice benefits under Medicare, a beneficiary must:

• Have Medicare Part A
• Have certification from a physician and a hospice doctor indicating the beneficiary has a terminal illness with a life expectancy of six months or less
• Agree to receive palliative care rather than curative care
• Sign a statement agreeing to hospice care instead of other treatment covered by Medicare
• Receive care from a hospice agency or facility certified by Medicare

Does Medicare Cover Respite Care Delivered at Home?

No. Although Medicare may cover hospice care delivered at home through an approved agency, Medicare only covers respite care provided in a Medicare-approved facility, such as a hospice facility, hospital or skilled nursing center.

Time Limitations

Medicare covers up to five days of respite care at a time. Respite care is covered on an occasional basis. There is no limit on the number of respite care stays Medicare covers.

What Does Medicare-Covered Respite Care Include?

While in Medicare-covered respite care, beneficiaries receive all necessary medical and nursing care as well as medical supplies and medications.

Beneficiary Costs for Medicare-Covered Respite Care

If the beneficiary obtains respite care through their hospice team and receives care in a Medicare-approved facility, the beneficiary may be responsible for 5% of the Medicare-approved costs. They may also have to pay $5 for each prescription medication.

Resources for Respite Care

People who aren't receiving hospice care may need respite care, and that's not covered by Medicare. The ARCH National Respite Locator Service helps people search by state to find respite care. Senior living communities and adult day care facilities may offer respite services. National Adult Day Services Association provides a tool to help people find nearby adult day care options.