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Respite Care Medicare Coverage Detailed

Your Medicare Coverage

Respite Care Detailed

Coverage: Conditions that must be met before Medicare will provide coverage, and limits to coverage.

Hospice is a special way of caring for people who are terminally ill, and for their family. This care includes physical care and counseling. The goal of hospice is to care for you and your family, not to cure your illness.

Medicare covers hospice care if:

  • You are eligible for Medicare Part A; and
  • Your doctor and the hospice medical director certify that you are terminally ill and probably have less than six months to live; and
  • You sign a statement choosing hospice care instead of routine Medicare covered benefits for your terminal illness; and
  • You get care from a Medicare-approved hospice program.


Medicare will still pay for covered services for any health problems that are not related to your terminal illness.

Respite Care: Medicare also covers respite care if you are getting covered hospice care. Respite care is inpatient care given to a hospice patient so that the usual caregiver can rest. You can stay in a Medicare-approved facility, such as a hospice facility, hospital or nursing home, up to 5 days each time you get respite care. There is no limit to the number of times you can get respite care. The amount you pay for respite care can change each year.

CoPayment: The amount you need to pay.

You pay $0 for hospice care.

You pay a copayment of up to $5 for outpatient prescription drugs.

Room and board is generally not payable by Medicare, except in certain cases. For example, if you get general hospice services while you are a resident of a nursing home or a hospice's residential facility. However, room and board are covered for inpatient respite care and during short-term hospital stays.

You pay 5% of the Medicare-approved amount for inpatient respite care. The amount you pay for respite care can change each year.

Medicare Part: The part of Medicare that pays for this service or supply.

A

Organization Name: The organization name that this coverage topic is associated with.

Important Notes: Details regarding important notes about the coverage.

None