Who Pays for Respite Care? [Payment Options & FAQs]

Who Pays for Respite Care? Key Points

• Family members or loved ones typically pay for respite care out-of-pocket
• Depending on the plan and policy details, Medicare might offer partial coverage for respite care
• Other respite care payment options include long-term care insurance and veterans’ benefits

Most families pay for respite care out-of-pocket, spending an average of 26% of their income — a cost that can impact their long-term finances.

The good news is that caregivers have access to other resources that can help reduce these out-of-pocket costs.

In this article, we will:

• Explain who typically pays for respite care
• Discover common respite care payment options
• Highlight affordable respite care solutions available through Always Best Care

Who Pays for Respite Care?

Family members or loved ones usually pay for respite care using their own money.

As a family caregiver, you may also qualify to deduct some of these expenses as medical costs. In addition, you might be able to use a Flexible Spending Account (FSA) or Health Savings Account (HSA) to help cover expenses and ease the financial burden.

Does Medicare Pay for Respite Care?

Yes, Medicare covers respite care, but only under the Part A hospice benefit.

To qualify, your elderly loved one must be enrolled in Medicare Part A and meet hospice eligibility —meaning a physician has certified a terminal illness with a life expectancy of six months or less.

Does Medicaid Cover Respite Care?

Yes, but it’s important to know that Medicaid doesn’t include respite care as a standard benefit.

However, in most states, Medicaid covers some form of respite care through Home and Community-Based Services (HCBS) waivers.

These waivers can help individuals who prefer to receive long-term care at home or in their communities rather than in nursing homes or other institutional settings.

To receive Medicaid-funded respite care, your family member must first qualify for Medicaid. Coverage is often limited and subject to strict criteria, such as income, assets, and medical need.

For example, some states require proof of nursing home-level care, while others enforce income or asset limits for eligibility.

Since each state runs its own Medicaid program, requirements and benefits vary. If you need more details, you can get in touch with your family member’s state Medicaid agency.

Other Common Respite Care Payment Options

Respite care may be partially covered by insurance, depending on the plan type and the individual’s policy.

Here’s what you should know about coverage under each type of insurance:

1. Veteran Benefits

If your family member is a veteran receiving benefits from the Department of Veterans Affairs (VA), they might be eligible for respite care services.

The VA provides care at home, in a VA Community Living Center, or in a community nursing home. They may also qualify for additional coverage through VA Aid and Attendance or Housebound benefits.

2. Long-Term Care Insurance

If your family member has a long-term care insurance policy, it might cover respite care, depending on the specific terms and benefits of the plan.

Many policies include benefits for temporary or substitute caregivers, particularly if the care recipient already qualifies for in-home care or assisted living services.

Review the policy for details on short-term care provisions, daily benefit limits, and any applicable waiting periods.

3. Private Health Insurance

If you have employer-sponsored health insurance, contact your plan provider to find out if it includes supplemental benefits for caregivers.

You can also ask your employer whether they offer an Employee Assistance Program (EAP) that provides caregiver support services.

Factors That Affect Respite Care Costs

The cost of respite care is influenced by a range of factors, including:

• Type of care: In-home care is typically more affordable than facility-based care, though prices increase with the level of assistance needed. Adult day centers offer a more cost-efficient option for daytime care, while short-term stays in assisted living or skilled nursing facilities tend to be more expensive. Depending on the provider and the duration of care, costs may be billed hourly, daily, or monthly.
• Location: Urban areas and regions with a higher cost of living generally have higher respite care rates than rural areas. For instance, care homes in cities like San Francisco or New York typically cost more than in rural parts of the Midwest, where rates are usually more affordable.
• Duration and frequency: Respite care costs vary based on the length and frequency of care — whether it’s provided by the hour, by the day, overnight, or for an extended period. Occasional short-term breaks are generally more affordable than ongoing or long-term stays.
• Level of care: Individuals with complex medical needs or advanced cognitive conditions, such as dementia, often require specialized and higher-cost care.
• Service provider: Costs can differ depending on whether care is arranged through a private agency or nonprofit organization.

How To Find Affordable Respite Care Services

Finding affordable respite care starts with knowing where to look and which resources to explore. Here’s how you can get started:

1. Contact your local Area Agency on Aging (AAA): These agencies can refer you to low-cost or subsidized respite care programs in your community. To find your local AAA, visit Eldercare Locator.
2. Explore Medicaid waiver programs: If your loved one qualifies for Medicaid, check with your state’s Medicaid office about Home and Community-Based Services (HCBS) waivers, which often include respite care.
3. Reach out to nonprofits and charities: Organizations, such as the Alzheimer’s Association, might offer respite care grants or low-cost services for caregivers of individuals with disabilities or chronic illnesses.
4. Check with faith-based and community organizations: Some churches, synagogues, and local nonprofits offer volunteer-based respite care or caregiver support groups that include temporary care options.
5. Ask about sliding scale fees: Many adult day centers, in-home care providers, and community facilities adjust fees based on income.
6. Review employer benefits and FSA/HSA options: If you’re employed, check whether your company offers caregiver support programs or allows you to use FSA or HSA funds to help cover your elderly loved one’s respite care expenses.

Explore Cost-Efficient Respite Care Services at Always Best Care

Respite care can be expensive, and while programs like Medicare, Medicaid, and the VA offer some coverage, not everyone qualifies.

The good news? Additional options can help offset the cost of short-term care. With the right resources and a bit of research, you can find a solution that provides the relief you need and the quality care your loved one deserves.

At Always Best Care, we offer personalized respite care services designed to meet your loved one’s unique needs — whether you need support for a few hours, a week, or more.

Our compassionate, trained caregivers provide high-quality assistance, giving family caregivers a well-deserved break while ensuring loved ones receive safe, dependable care at home.

Who Pays for Respite Care? FAQs

Do employers offer respite care benefits?

Yes, some employers provide caregiver support services, including Employee Assistance Programs (EAPs), flexible paid leave options for caregiving, and access to Flexible Spending Accounts (FSAs) that might cover certain respite-related expenses.

Check with your HR department to explore what benefits are available.

What are sliding scale respite care services?

Sliding scale respite care services adjust costs based on the caregiver’s ability to pay, making care more accessible.

These options are often offered by nonprofits, adult day programs, or community health organizations to make care more affordable for families with limited financial resources.

Can family care providers get paid for caregiving?

Yes, family members can receive payment for caregiving through programs like Medicaid waivers or state-specific caregiver support initiatives.