Respite Care

How to plan for respite care?

Assess your needs as a caregiver:

• How often do you need respite care?
• Are there convenient locations near you?
• Do you need transportation services?
• Do you need evening and weekend respite care?
• What other services do you need?

Assess the needs of the person you’re caring for:

• What services and type of care do they need?
• Do they feel comfortable around the staff?
• What types of socialization or activities do they enjoy?
• Do they need payment assistance options?
• Do they prefer respite care in-home or out-of-home?

How long can respite care last?

Respite care can last anywhere from a few hours to a few weeks. It can be scheduled regularly or as needed. If you will use insurance to help pay for respite care, find out their coverage rules and how many days in a row they will cover. Find out how many total days will be paid for.

Who qualifies for respite care?

Respite care is for primary caregivers caring for someone who needs help with their basic daily needs including:

• Dressing
• Bathing
• Toileting
• Meal preparation
• Taking medicine

Respite care is for family caregivers whose loved is experiencing:

• A long-term illness
• End-of-life care or hospice
• A physical or mental disability
• Aging

Medicare and Medicaid sometimes cover respite care. Long-term care insurance often covers respite care. If you don’t qualify for respite care through insurance, you may find local businesses and community programs that offer differing levels of respite care. Many people also lean on family members and friends for breaks when needed.

What services does respite care offer?

Respite care services vary based on location and type. They usually include helping your loved one with actions called activities of daily living or ADLs, such as:

• Eating and drinking
• Bathing
• Dressing
• Using the bathroom
• Transferring
• Medications
• Exercise and taking walks

Sometimes respite care happens in a group setting. This get together offers group activities like playing Bingo, listening to music, and socializing.

What are the different types of respite care?

Respite care can be offered at home, in a nursing home, or at an adult day center or community respite center. These vary by where you live, the respite insurance you have, your budget and your loved one’s needs.

In-home respite care: You get to take a short break from caregiving while knowing your loved one gets to stay safe and comfortable at home. In-home respite care choices include:

• Personal care and homemaker services: If your respite needs include help with ADLs and cleaning and cooking, you can find personal care and homemaker services. They provide respite care for short or long periods of time.
• Skilled health care: You can hire a licensed nurse to provide care for short or long time periods if your loved one needs specialized medical care.

Out-of-home respite care: Works well for longer respite stays or when you can’t find affordable in-home care. The most common types of out-of-home respite care are:

• Adult day care centers: They offer daytime care for adults who need supervision and help with their ADLs.
• Short-term care and socializing: Local volunteer groups may offer free respite care. These include religious organizations, community centers, and other non-profit organizations.
  • You can find out about these through your local Area Agency on Aging.
  • You can find trained care personnel through a home care agency.
• Residential facilities: These offer longer stays with around the clock care. They often require a person to stay a minimum number of nights to be a respite care patient.

How can I find affordable respite care near me?

• The ARCH National Respite Network and Resource Center has a respite locator that shows you respite care providers by state. ARCH online tools also help to:
  • Find financial assistance for family caregivers. These include Medicaid, Veterans Services, and a locator tool for people seeking information about being paid to care for an aging loved one.
  • Learn about groups that have respite care information.
• You can also ask your primary care physician or other medical specialists about local options.
• Contact your local Area Agency on Aging about what respite care programs they may provide.
• The U.S. Veterans Affairs has info on respite care. You can click on the Am I Eligible picture to learn if the vet you care for is eligible. Click on another picture to learn about respite services for veterans.
• Call 211 or go to 211.org. It’s a United Way community service that’s open 24/7. They will tell you about respite programs and other services in your area. They can help you find government programs to help your family.
• Reach out to your State Health Insurance Assistance Program.
• Research your state’s home and community-based services waivers (HCBS Waivers).
• These non-profit and special interest organizations provide information that may apply to your loved one’s needs:
  • This Easter Seals page describes in-home services. There is a link on that page that leads to the adult day care info.
  • The National Adult Day Services Association gives you info about adult day services and how to find providers.
  • The Alzheimer’s Association has a page about in-home care and other info. This is important as your loved one needs special care.

Will Medicare cover respite care?

Original Medicare (Medicare Part A and Part B) only covers respite care for patients in hospice care.

• Medicare covers 95% of approved cost of respite care for hospice for up to 5 days in a row at approved facilities. The discharge day does not count towards the 5 days so think of it as 5 nights.
• How do I calculate how much hospice respite care will cost me with Medicare coverage? Here is an example that helps Medicare payment for respite care make sense: If respite care costs $500 for 5 days, you will have to cover 5% of the total cost. That is $25.

Medicare Advantage includes respite care as an added benefit on certain plans.

• This means that some Medicare Advantage health insurance plans include respite care. Be careful, as some do not.
• Be sure to check with your loved one’s insurer to see if they are covered. Medicare Advantage plans that cover respite care include:
  • Short-term residential facilities
  • In-home respite care
  • Adult day care

Will Medicaid cover respite care?

• If a person enters a Medicaid-covered hospice, respite care is based on Medicare’s annual hospice rates and the Center for Medicaid and CHIP Services.
• If a person is not in medicaid-covered hospice, Medicaid coverage of respite care varies by state. This is because the federal government gives states the flexibility to manage their own home and community-based services waivers (HCBS Waivers). This lets states decide how to use Medicaid funds based on community needs.
• You can learn more about your state’s HCBS waivers on the Medicaid State Waivers List. Be sure to filter by Waiver Authority “1915(c).”

Will my health insurance cover respite care?

Most long-term-care insurance programs will cover part of a person’s respite care. Contact your long-term-care insurance provider for details.

How much does respite care cost?

These costs vary based on location, facility type and patient needs.

• Home respite care varies widely based on community and region. Use Genworth’s cost of care calculator to figure costs based on your area and respite care needs. In 2022, the median, daily costs for a home health aide is around $159 and for homemaker services is around $156. The median, hourly costs for a home health aide or homemaker is around $25.
• Community-based respite care or Adult Day Services are the most affordable option since many offer sliding-scale fees. Many are a part of Medicaid HCBS waiver programs. Expect these to cost an average of $75 a day.
• Respite care in a skilled nursing facility is more expensive and based on Genworth’s estimates the median cost is around $271 per day  in 2022. There are usually a minimum number of nights to stay and qualify for respite care.