Who Pays For Respite Care? Explore Your Options

Respite care is a type of caregiver support. A respite caregiver temporarily takes over the responsibilities of care for the primary caregiver. Respite care services are essential for helping caregivers maintain their own wellness and provide good care for their loved ones.

The costs of respite can be an added stress for the caregiver and their loved one. In this post, we’ll talk about:

Why you need respite care
How you can benefit from respite care
The different types of respite care
How the costs of respite services are covered

Check if you have free access to Trualta to join our community of caregivers and get more information on respite care and other caregiving topics.

How You Can Benefit From Respite Care

According to the National Institute on Aging, respite care is short-term care designed to provide relief to caregivers. In other words, it’s care for your loved one that allows you to take a break from your caregiving duties. Respite services may be provided by professionals or informally by a family member or friend.

As a primary caregiver, you can use the time off however you choose. For most caregivers, respite is a necessary break. It allows you time for self-care, travel, and your other interests. Respite is an important way for a family caregiver to reduce the risk of burnout.

Caregiver burnout is a state of prolonged and overwhelming stress. It’s common in family caregivers, especially primary caregivers. Burnout can cause significant mental health and physical health issues if not prevented or managed. Of course, when you’re well, you can provide better care for your loved one.

How Much Does Respite Care Cost?

Cost is an important consideration when selecting and benefiting from respite services. The cost of respite care varies significantly depending on different factors:

The types of respite care you choose
Where the respite care is provided
How long or how frequently you use respite care services
Your loved one’s insurance plan
Your location, as services may cost more in some areas

Learn more about the types of respite care below to understand the cost of services. You may need to find a balance between the level of care your loved one needs and the overall costs. For example, some options are less expensive but might not provide skilled health care.

Types Of Respite Care

Respite care can take many forms, from informal arrangements to hospitalization or assisted living. The type you choose depends on your loved one’s needs and preferences, as well as your needs and costs.

Informal Respite Care Services

Making informal arrangements is the simplest and most cost-effective way to take a break from caregiving responsibilities. This typically means asking another family member or friend to step in and provide care while you take time away from your duties.

You might rely on them for just a few hours once in a while, or they might take over for several days. Some informal arrangements include a regular break, such as once a week.

Adult Day Care

If you only need time off during the day, you can take your loved one to an adult day care center.

Adult day services vary, so check what they offer before choosing a day care center.

Most facilities provide:

Recreation
Social opportunities
Meals
Supervision
Some offer personal care or even limited health care.

According to 2023 survey data, the median cost for adult day services is $95 per day.

Residential Respite Care

You may need a type of residential care if you need overnight services. This is also a better option if your loved one needs medical care. Residential respite is offered in different types of facilities:

Assisted living facility
Assisted living memory care
Nursing home
Hospital
Hospice care facility

Residential care offers more specialized and longer-term services, making it a more expensive option for respite care. The median monthly cost for assisted living in 2023 was $5,350.

Hospice Respite Care

Hospice care is a special type of health care. It’s end-of-life care with a primary focus on comfort and support. This means that your loved one is receiving care to manage their symptoms and improve quality of life, not to treat their underlying condition.

Respite care for a hospice patient is more specialized and may have higher costs. On the other hand, you’re more likely to find volunteer organizations that assist with respite for family caregivers of loved ones in hospice.

Professional In-Home Care Services

Many caregivers and their loved ones prefer to hire in-home care with a home health aide or other professionals. They come to your loved one’s home to provide care while you take time off from your responsibilities. This can be affordable for short periods but very expensive if your loved one needs 24-hour care or several days of care.

A healthcare worker wearing blue scrubs, a black face mask, and a backpack stands at the entrance of a home, waving while holding a black medical bag. An older woman with gray hair, wearing a light-colored sweater, faces the healthcare worker from inside the home. The entrance features a wooden door with decorative glass panels, and a thermostat is mounted on the wall.

Paying For Respite Care Services

Respite care costs can vary. Covering the costs of respite may deter some caregivers from taking advantage of this beneficial service, but it shouldn’t. There are several ways to pay for or get assistance paying for respite if you can’t pay for it out of pocket.

Private Insurance Plans

Unfortunately, most insurance plans don’t cover respite services. However, if your loved one has long term care insurance, it might cover some or all of the costs of respite. Check with the insurer to learn more about the specific benefits. Not all long term care policies cover respite services.

Does Medicare Cover Respite Care?

Many people assume Medicare will cover the costs of respite, but this isn’t always true. For coverage, your loved one must be enrolled in Original Medicare Part A or Medicare Advantage and qualify for hospice care. To qualify for hospice care, they must be certified by a physician to have a life expectancy of six months or less.

If they meet these qualifications, Medicare will pay for up to five consecutive days of respite care services. Medicare comes with a small 5% copay, so it covers 95% of respite care. The copay cannot be more than the year’s hospital deductible.

Medicare Advantage (Part C) includes some extra benefits that Original Medicare does not include. If your loved one is enrolled in Part C and is not in hospice care, check their plan for these extras. It might cover some costs of adult day services, in-home care, and supportive services like meals and non-medical transportation.

Does Medicaid Cover Respite Care?

Medicaid might provide some coverage for respite services. Medicaid programs vary by state, so check with your state’s agency that administers Medicaid for more information. Most states offer home and community-based services (HCBS) waivers.

HCBS waivers help qualified individuals get services in their homes or community. They’re designed to delay the transition to assisted living or nursing homes. Coverage for respite care is limited but possible depending on your state’s program and your loved one’s status.

The ARCH National Respite Network provides state summaries of Medicaid waiver information. You can use this resource to learn more about what waivers are available in your state’s program.

Veteran Benefits & Respite Care

If your loved one is a veteran and qualifies for U.S. Department of Veterans Affairs (VA) benefits, they may have coverage for respite care. This VA page explains the qualifications for respite care and includes a link to the appropriate form.

Coverage options include paid home health care, adult day care or senior care, and nursing home care. This type of coverage limits veterans to 30 days of a respite program per year.

Another option may be to use the VA Aid and Attendance or Housebound Benefits to pay for occasional respite care. This benefit is a payment in addition to the monthly VA pension to be used for assistance for homebound veterans who need help with daily activities.

Respite Care Assistance Programs & Volunteer Organizations

If you’re paying for respite out of pocket or have exceeded coverage under Medicare or other programs, consider respite care assistance programs or grants. These services provide financial assistance for respite care. Other organizations connect families with volunteers to provide respite services.

Lifespan Respite Care Programs

Many states have a Lifespan Respite Care Program (LRCP). An LRCP offers vouchers or grants to help pay for a respite care provider for qualifying families. This link from ARCH will help you find a voucher program if your state has one.

State Respite Coalitions & Other State Services

Many states have State Respite Coalitions, organizations that represent and support caregivers and their care recipients. The services offered vary by state. They often include a service to connect you with respite services and voucher programs.

Other services and respite care benefits vary by state. The Family Caregiver Alliance is a good resource for determining the programs and services available in your state.

National Caregiver Support Program

The National Caregiver Support Program is administered by local Area Agency on Aging (AAA) groups. Find your local AAA to learn more about the program, which offers funding for respite care.

The funding covers caregivers caring for adults over the age of 60, anyone with Alzheimer’s or other dementia, and grandparents or other older adults caring for young children or adult children with disabilities.

Faith-Based Services

Check with local faith-based groups to find support services for caregivers. Many of these groups utilize volunteers or offer low-cost services for senior care and people with disabilities. Their services often include respite care.

Private Funding Sources

Finally, it’s worth checking out various private funding sources. Some organizations offer general respite care funding, while others cover care costs for specific conditions, like Alzheimer’s disease or other dementia diagnoses.

For more information, contact organizations like the Alzheimer’s Foundation, the National Multiple Sclerosis Society, or the National Organization for Rare Diseases.

Caregiving is a big responsibility that requires a lot of time and commitment. Stress and burnout are common, which is why respite is so important. Don’t let costs keep you from getting the respite care you need for your own wellness and the care and safety of your loved one.

Check if you have free access to Trualta to join our community of caregivers and get more information on respite care and other caregiving topics.

References

Who Pays For Respite Care? Explore Your Options

How You Can Benefit From Respite Care

How Much Does Respite Care Cost?