There’s a lot of confusion over what Medicare does and doesn’t pay for, though there are boundaries such as the line between extended hospital stays and long-term care. There are also many myths and misconceptions about services like respite care. What is respite care? And does Medicare pay for it? 

What Is Respite Care? 

Respite care is intended to prevent caregiver burnout. It is by definition short-term relief for the caregiver. It might be one day a week every week or it may take the form of several days to stay in a facility. Respite care could take place in an adult day care, at home, or a healthcare facility. 

Does Medicare Pay for Respite Care? 

Most insurance plans won’t cover respite care, and most people cannot afford to pay for repeated use of respite care themselves. This leads many to ask if Medicare can cover respite care. 

Medicare only covers respite care as part of the hospice program. You can take advantage of the respite benefits only if they’re diagnosed with a terminal illness and getting end-of-life care. Furthermore, the care must come from a Medicare-certified hospice agency.

When Won’t Medicare Cover Respite Care? 

Medicare doesn’t pay for respite care unless someone is enrolled in the hospice program and Medicare Part A. Medicare will not pay for respite care for more than five days in a row if you or your loved one is in a hospital or skilled nursing facility like a nursing home. When the stay goes from lasting days to weeks, you have to start researching options like Medicaid or long-term care insurance. 

Should You Take Advantage of Respite Care? 

Cherished Hands Home Health LLC has written a great article about the benefits of respite care. Respite care in-home allows caregivers time to visit the doctor themselves or run errands without worrying about the person they’re leaving at home. You get peace of mind and can take care of yourself. For adults with Alzheimer’s or dementia, in-home respite care allows them to be taken care of at home much longer than if a family member tries to do it all themselves. That allows them to remain in a familiar place longer, reducing their anxiety and keeping them as independent as possible. 

You should take advantage of senior care options even if Medicare doesn’t cover them. Programs like senior daycares allow you to continue working or engaging in normal activities. Whether it is volunteering or continuing to go on your daily walk with friends, this type of healthy social interaction isn’t selfish. It is essential to your mental health. Family members often find themselves trapped at home with the person they’re caring for until they can’t take it anymore and then send someone to a nursing home, despite the expense. It is cheaper and healthier to take advantage of respite care services so that you can continue to take care of your loved one as long as possible.