Medicare can cover short-term inpatient respite care through its hospice benefit so a caregiver can rest. This is a specific hospice service, not a general allowance for any caregiver break or long-term supervision at home.
How covered respite care works
| Requirement | What to confirm |
|---|---|
| Hospice eligibility | The person has Part A, meets the terminal-illness certification requirements and elects hospice care. |
| Arrangements | The hospice provider arranges the inpatient respite stay in an appropriate Medicare-approved facility. |
| Length | Up to five days for each respite stay. |
| Frequency | More than one stay can be covered, but only on an occasional basis. |
Do not book a facility independently and assume the hospice will reimburse it. Ask the hospice team to explain the care plan, facility, dates and arrangements before a planned stay.
What you may pay
You may pay 5% of the Medicare-approved amount for inpatient respite care. The copayment cannot exceed the inpatient hospital deductible amount. Ask the hospice for the estimated charge and written explanation of anything outside the benefit.
Ordinary room and board in a nursing home or other residence is generally not covered merely because a person receives hospice services. A hospice-arranged covered inpatient respite stay is a different situation.
What about dementia or help at home?
A dementia diagnosis or caregiver exhaustion does not by itself establish hospice eligibility. The clinical team must determine whether the hospice requirements are met. Home health also has its own skilled-care and homebound requirements; it does not cover round-the-clock home care or personal care alone.
If the person is not eligible for hospice respite, ask the local aging-services office or state Medicaid agency about other support and their eligibility rules. Availability and costs differ.
Before the stay
- Contact the existing hospice care team.
- Confirm eligibility and that the hospice is arranging the stay.
- Get the facility name, admission and return dates, and estimated charges.
- Make sure the facility has the current care plan and a contact for questions.
- Ask what happens if additional care is needed after the planned respite ends.
Related coverage questions
- Medicare Hospice Coverage: Eligibility, Care and Costs
- Advance Care Planning and Medicare: A Practical Starting Point
- Medicare Home Health Care: Services, Eligibility and Costs