Medicare Coverage of a Family Caregiver
What It Is
Payment to the family caregiver of someone who's Medicare-enrolled
Medicare does not cover family caregiving to someone enrolled in Medicare.
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 a family caregiver, contact the plan directly.
What Medicare Pays
Medicare pays nothing for family caregiving.
Tip: If a patient is receiving Medicare-covered hospice care, family members can periodically receive a respite from their caregiving for up to five days at a time. This respite is provided by providing the person on hospice with round-the-clock inpatient care in a Medicare-approved hospice facility, hospital, or nursing home.
Tip: In a few states, there are programs that can sometimes pay a small but regular amount to family caregivers. If a person has very low income and few assets, he or she might qualify for such a program, which pays that person directly for his or her own home care. The person receiving those funds can then use them to pay a family caregiver, or anyone else, to provide care at home.
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.
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