Respite Care is a Medicare benefit

Despite the broad availability of professional home care, a vast majority of home care is provided by family members.  It can be exhausting work with rarely the opportunity for time off.  Splitting shifts with other family members can help, but when the care is provided by a main caregiver, sometimes time away is vital to the health of the caregiver him or herself.  Care for the patient in these situations is called “respite care”.

A broader discussion of this topic was covered earlier in this series.

Respite care is the professional care that allows primary caregivers to hire to take over their responsibilities in their absence.  This absence can range from a few hours to a few days.  It can be provided by in-home care professionals.  Depending on the circumstance it can also be provided by a hospital, long-term care facility or an adult daycare center.

Respite care is generally available when the primary caregiver is facing physical or emotional fatigue.  It is also available when a caregiver has an appointment, event or obligation or when the caregiver is ill and cannot take care of the patient on his or her own.

Respite care is available to all Medicare recipients who are on hospice with a limited life horizon (six months).  Medicare Part A pays for up to five days of inpatient respite care at a time.  The co-pay is 5% but with a Medicare supplement plan, this is paid, as well.

In 2018 the Bipartisan Budget Act of 2018 added respite care to Medicare Advantage plans. While not all Medicare Advantage carriers include respite care, those who do may include custodial support for patients who cannot leave their home or adult daycare for those who can.  The Medicare carrier will usually allocate a set dollar amount or number of hours that are covered under the plan.

Respite care represents an important break for caregivers.  Their role can feel overwhelming and even create additional stress for the patient.  Coverage for respite care provided by Medicare is a welcome benefit to many beneficiaries and their unpaid caregivers.

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