Medicare and Hospice Respite

Find out When Medicare Helps Pay for Hospice Respite Care

What It Is

Inpatient respite care for a hospice patient who's otherwise cared for at home, in order to provide a break for the usual family or other primary caregiver. Respite care can be provided in a hospice facility, nursing facility, or hospital.

What's Covered

Medicare Part A covers up to five days of respite care for a patient who's receiving hospice care. A covered five-day respite care stay may be repeated if hospice staff agrees with the usual caregiver that the further respite is needed.

If you have a Medicare Part C Medicare Advantage plan: Medicare Part C Medicare Advantage plans, also called Medicare Advantage plans, must cover everything that's included in original Medicare Part A and Part B coverage. But sometimes a Part C plan covers more, with extra services or an expanded amount of coverage. (Co-payments for Part C plans may also be different than those for Part A or Part B.) To find out whether your plan provides extra coverage or requires different co-payments for respite care in hospice, contact the plan directly.

What Medicare Pays

Medicare Part A pays 95 percent of the Medicare-approved amount for respite care room, board, and care.

Important: Regardless of the rules regarding any particular type of care, in order for Medicare Part A, Medicare Part B, or a Medicare Part C plan to provide coverage, the care must meet two basic requirements:

  • The care must be "medically necessary." This means that it must be ordered or prescribed by a licensed physician or other authorized medical provider, and that Medicare (or a Medicare Part C plan) agrees that the care is necessary and proper. For help getting your care covered, see FAQ: How Can I Increase the Odds That Medicare Will Cover My Medical Service?

  • The care must be performed or delivered by a healthcare provider who participates in Medicare.

Was this medicareinformation helpful?

1 Comment So Far. Add Your Wisdom.

over 1 year ago

Hospice benefits that are covered by Medicare are very generous. To be sure that Medicare covers the care provided, ask the hospice agency first. They will tell you if the care is a Medicare covered benefit.


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