Does Medicare Cover Respite Care?

Medicare covers most costs for up to five continuous days of respite care in either a hospital or skilled nursing facility if you are receiving hospice care.

Terry Turner, writer and researcher for RetireGuide
  • Written by
    Terry Turner

    Terry Turner

    Senior Financial Writer and Financial Wellness Facilitator

    Terry Turner has more than 30 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).

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  • Edited By
    Lee Williams
    Lee Williams, senior editor for RetireGuide.com

    Lee Williams

    Senior Financial Editor

    Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.

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  • Published: May 10, 2021
  • Updated: November 1, 2022
  • 4 min read time
  • This page features 7 Cited Research Articles
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APA Turner, T. (2022, November 1). Does Medicare Cover Respite Care? RetireGuide.com. Retrieved December 7, 2022, from https://www.retireguide.com/medicare/services/respite-care/

MLA Turner, Terry. "Does Medicare Cover Respite Care?" RetireGuide.com, 1 Nov 2022, https://www.retireguide.com/medicare/services/respite-care/.

Chicago Turner, Terry. "Does Medicare Cover Respite Care?" RetireGuide.com. Last modified November 1, 2022. https://www.retireguide.com/medicare/services/respite-care/.

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Respite Care Coverage at a Glance
Medicare PlanRespite Care Coverage
Part A (Inpatient) Covers up to five consecutive days of respite care at a time for qualifying hospice patients in a hospital or inpatient facility. You may be required to pay 5% of the cost.
Part B (Outpatient)N/A
Part C (Medicare Advantage)Covers everything covered by Medicare Part A and Part B. Select plans may provide additional respite care benefits.
Part D (Prescription Drugs)Generally covered. You pay a copayment of up to $5 for each prescription for outpatient drugs for pain and symptom management.
Supplemental InsuranceCan help cover out-of-pocket costs of respite care. Coverage varies by plan.

Does Medicare Pay for Respite Care?

Original Medicare — Medicare Part A and Part B — covers most respite care costs for hospice patients. Respite care must be provided in a Medicare-approved facility, such as a nursing home, hospital or inpatient facility.

Medicare will cover up to five straight days of respite care at a time. You are able to receive respite care more than once while in hospice, but Medicare will cover it only on an occasional basis.

What Are Your Costs?
You may be required to pay 5 percent of the cost for respite care if you have Original Medicare. A Medicare Advantage plan may offer additional benefits, and a Medigap plan may help with this out-of-pocket cost. Check with your plan administrator to see what your plan covers.

You or your caregiver should check with your hospice care provider to determine whether they can arrange respite care that Medicare will cover.

Respite care can last anywhere from a few hours to several weeks. It’s important to remember that Original Medicare will cover only five consecutive days at a time. Any costs beyond that limit will be your responsibility.

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Medicare Advantage and Respite Care

While Original Medicare covers respite care only if the patient receives hospice care in a Medicare-approved inpatient facility, some Medicare Advantage plans may provide more respite care benefits for services offered in outpatient hospice settings.

Medicare Advantage Plan Respite Care Options
Adult day care
Some Medicare Advantage plans may cover respite care in adult day care on an occasional basis or through a set schedule to give caregivers a routine break.
In-home respite care
In-home care is an option for people who are unable to leave their home while in home-based hospice care.
Short-term residential care
Some Medicare Advantage plans will cover respite care in hospice centers, nursing homes or assisted living facilities. Places that offer respite care typically have rooms set aside to specifically handle the needs of people in respite care.

Benefits vary between different Medicare Advantage plans. You should talk to your plan’s administrator about the respite care benefits included in your plan.

Annual Enrollment Ends December 7th
Have you selected your 2023 Medicare plan? The Medicare Annual Enrollment period ends tomorrow. Visit GoHealth today to see what savings you may qualify for with a new plan.

Medicare-Covered Services Provided by Respite Care Providers

Respite care can usually be tailored to the needs of the patient or client and the type of Medicare coverage they have.

Respite care can range from simple companionship to helping with light household chores to assisting with basic daily activities, such as helping the patient get dressed.

Examples of Respite Care Services
Basic medical care
Respite care providers are typically trained in basic medical care, such as help with taking medications or treating simple wounds. Check with your respite provider if you need more advanced care.
Companionship, personal attention and supervision
If you can still function on your own for the typical respite care timeframe, you may still benefit from having a respite care provider to supply added attention and supervision for your care.
Daily activities
Respite care providers are trained to help with daily activities that many people in hospice cannot perform on their own — including bathing, eating or dressing.
Household tasks and meals
Respite care providers can perform basic chores, such as laundry or light cleaning. They can also help with grocery shopping and meal preparation.
Transportation
In certain cases, respite care providers may be able to transport patients to appointments or the store to run necessary errands.

Respite care is intended to give your primary caregiver — typically a family member or friend — a chance to rest.

More than 40 million Americans serve as unpaid caregivers for adults 65 and older, according to the Pew Research Center. About 90 percent of those caregivers provide care to an aging relative.

Respite care can help caregivers deal with “caregiver burnout” — what the Cleveland Clinic calls “a state of physical, emotional and mental exhaustion.”

Contact your local Area Agency on Aging to find out about respite care options available in your area.

Learn About Other Services Covered Under Medicare
Last Modified: November 1, 2022

7 Cited Research Articles

  1. Esposito, L. (2022, April 13). Respite Care: Giving Family Caregivers a Break. Retrieved from https://health.usnews.com/senior-care/articles/respite-care-giving-family-caregivers-a-break
  2. Cleveland Clinic. (2019, January 13). Caregiver Burnout. Retrieved from https://my.clevelandclinic.org/health/diseases/9225-caregiver-burnout
  3. U.S. National Institute on Aging. (2021, May 14). What Are Palliative Care and Hospice Care? Retrieved from https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care
  4. U.S. National Institute on Aging. (2017, May 1). What Is Respite Care. Retrieved from https://www.nia.nih.gov/health/what-respite-care
  5. Stepler, R. (2015, November 18). 5 Facts About Family Caregivers. Retrieved from https://www.pewresearch.org/fact-tank/2015/11/18/5-facts-about-family-caregivers/
  6. Florida Hospice & Palliative Care Association. (n.d.). What Is Respite Care? Retrieved from https://www.floridahospices.org/faqs/what-is-respite-care/
  7. U.S. Centers for Medicare & Medicaid Services. (n.d.). Hospice Care. Retrieved from https://www.medicare.gov/coverage/hospice-care