Being the primary caregiver for a person with dementia, Alzheimer’s disease, a disability, or a chronic or terminal illness is demanding both physically and mentally. You need to be present 24/7, working hard to give custodial care to your loved one while juggling the housework and daily chores at the same time.
As sole caregiver, you must give all your support to your loved one, but it is necessary for you to get support for yourself too. The responsibility of caring for someone who relies on you totally can be overwhelming and it can take a toll on your well-being. In order to continue taking care of someone else, you have to make sure you are getting the breaks you need.
For Medicare recipients who are getting constant care from a loved one, taking advantage of respite care may be the only way their caregivers can get a much-needed break. That is why it is so important to know the facts about whether Medicare benefits offer coverage.
Medicare Benefits for Respite Care
Original Medicare Part A covers respite care when it is a part of the recipient’s hospice care. For Medicare to pay for respite care, the patient must first meet Medicare’s requirements for hospice.
Eligibility for hospice care through Original Medicare Part A includes getting certification of a terminal illness from a physician and a hospice doctor, the acceptance of palliative care in place of curative care, and a signed statement declaring the choice of hospice care rather than other Medicare-covered treatment.
Even though Medicare recipients can get hospice care at home or in Medicare-approved nursing or inpatient hospice facilities, Medicare insurance only covers respite care that takes place in an inpatient facility that is Medicare-approved. It pays for respite care lasting up to five days at a time. The care is available on an occasional basis, but the number of stays is unlimited. Recipients may be responsible for five percent of the Medicare-approved cost for inpatient respite care.
What Does Respite Care Include?
When you make the decision to use respite care, you check in to a Medicare-certified professional care facility like a hospital, hospice care facility or nursing home. They provide around-the-clock staff to give all the necessary health and custodial care to the care recipient.
There are other ways to get respite care for your loved one, but they are not covered by Original Medicare benefits. In-home respite care agencies send trained staff members to your home. They may help with personal care, homemaking services, and skilled health care depending on your requests. Outside the home there are adult day care centers where seniors who are not independent can spend time with others.
Costs of Respite Care Through Medicare
Medicare covers most of the cost for respite care when it is a part of the patient’s hospice care, and only on an occasional basis lasting no more than five days in a row.
If you require respite care more often, or wish to have someone come into your home, Medicare does not cover the cost. Prices vary depending on where you live, the agency you use, and the services that you ask for.
The country’s daily average cost for in-home homemaker services are around $130.00. For health aid services it is about $135.00 per day. The average daily charge for adult day care centers is $70.00. Respite care at a skilled nursing facility costs approximately $235.00 to $270.00 per day depending on whether the room is semi-private or private.
In the United States, over 40 million people are the primary caregivers for a family member. Providing daily care for someone who is ill, disabled, or has dementia is a huge task. Caregivers often forego their personal wellness to keep up with the care of their loved one, so it is important for both caregivers and care receivers to take advantage of respite care whenever possible.