How to Pay for Respite Care When You're the Primary Caregiver

Where the money comes from depends on who needs the care

Respite care is rarely free, but you don't always pay out of pocket. The funding source changes based on why someone needs care — whether it's a child with a disability, an aging parent, someone with a serious illness, or a family member with dementia. Government programs, insurance, and nonprofit organizations each cover different situations, and many people combine two or three funding sources to make it work.

Start by identifying which category fits your situation, because that determines which programs to contact. A child with cerebral palsy qualifies for different funding than an elderly parent with Alzheimer's, even though both need the same type of care.

Key Takeaways

• Medicaid covers respite care for children with disabilities and some elderly adults, but only through specific programs that vary by state.
• Medicare covers respite care only during a break from hospice services, not for general caregiver relief.
• The Veterans Administration pays for respite care for may be able to access veterans and their spouses through the Aid and Attendance benefit.
• Your state's developmental disabilities agency, aging agency, or local Area Agency on Aging can tell you which programs exist in your region and how to contact them.
• Many families use a combination of sources — insurance for some hours, Medicaid for others, and out-of-pocket payment for the remainder.

Medicaid programs that cover respite care

Medicaid is the largest single source of respite care funding, but it works differently depending on the person's age and condition. Most states offer respite through their Medicaid waiver programs, which are designed to let people stay at home instead of moving to a facility. These waivers have waiting lists in many states, sometimes years long, so even if you may have access to, you may not receive services immediately.

For children with disabilities, contact your state's Department of Developmental Disabilities or Division of Developmental Services — the name varies by state. They manage Medicaid waivers for children and can tell you whether respite is included in your state's program and whether there is currently a waiting list. Some states cover respite in their standard Medicaid program for children; others only through waivers.

For elderly adults or adults with disabilities, your state's Medicaid office or your local Area Agency on Aging can explain what's available. Many states cover respite through programs like the Community Care Waiver or the Home and Community-Based Services Waiver. The amount covered, the type of respite (in-home, facility-based, or both), and the hourly rate all vary significantly by state.

Medicare and hospice respite

Medicare covers respite care in only one situation: when someone is receiving hospice services and the primary caregiver needs a break. The hospice agency arranges the respite stay, usually in a facility, and Medicare pays for up to five consecutive days at a time. This is not a general caregiver relief program — it exists only as a break during end-of-life care.

If the person is on Medicare but not in hospice, Medicare does not cover respite care. Some Medicare Advantage plans (private insurance plans that replace Original Medicare) do cover limited respite, so check your plan documents or call the plan directly to ask.

Veterans Administration benefits for respite

The VA covers respite care through the Aid and Attendance benefit, which is available to may be able to access veterans and their surviving spouses. The veteran must have served during wartime and have a service-connected disability rated at 50 percent or higher, or be over 65 with a lower rating. The benefit pays a monthly stipend that can be used for respite care, adult day programs, or other support services.

Apply through your local VA regional office or through VA.gov. The application process takes several months, and you will need military discharge papers and medical documentation. If the veteran is already receiving other VA benefits, the process may move faster because the VA already has their service record.

Private insurance and employee benefits

Some private health insurance plans cover respite care, particularly if the person has a chronic illness or disability. Check your policy documents or call your insurance company's customer service line to ask whether respite is covered, what type of provider they will pay, and whether you need a referral from a doctor.

If you have health insurance through an employer, ask your benefits administrator whether the plan includes respite care or whether your employer offers an Employee Assistance Program (EAP) that might cover some hours. Some EAPs include a small number of free counseling or support sessions that could help you find local respite providers.

Long-term care insurance, if the person has it, often covers respite care. Review the policy or contact the insurance company to understand what's covered and what documentation you need to submit a claim.

Nonprofit organizations and community programs

Many nonprofits fund respite care for specific populations — families affected by autism, cerebral palsy, Alzheimer's disease, cancer, or other conditions. These organizations sometimes pay for respite directly or offer grants to families. Search for nonprofits focused on the specific condition affecting your family member, and ask whether they fund respite care or can refer you to organizations that do.

Your local Area Agency on Aging (for elderly adults) or your state's developmental disabilities agency (for children and adults with disabilities) can connect you with community programs that offer low-cost or free respite. Some communities have respite cooperatives where families trade childcare or elder care with each other, reducing or eliminating the cost.

Religious organizations, community centers, and local government aging departments sometimes offer respite programs at reduced rates. Call your city or county's department of aging or human services to ask what exists in your area.

Paying out of pocket and combining funding sources

Most families pay for at least some respite care themselves, either because programs don't cover enough hours or because there's a waiting list. Hourly rates for in-home respite typically range from $15 to $30 per hour depending on the region and the provider's qualifications, though rates are higher in urban areas and for specialized care. Facility-based respite (adult day programs or overnight stays) usually costs $50 to $150 per day.

Many families use multiple funding sources at once: Medicaid covers some hours, they pay out of pocket for additional hours, and a nonprofit grant covers a week of overnight respite each year. This patchwork approach is common and often necessary. Start by contacting the programs you may have access to for, find out how many hours or days they cover, and then budget for the remaining hours yourself or through other sources.

If cost is a barrier, ask the respite provider whether they offer sliding-scale fees based on income, or whether they have relationships with nonprofits that can help pay. Some providers reserve a portion of their slots for low-income families.

How to find out what's available in your area

The fastest way to learn what respite funding exists where you live is to contact your local Area Agency on Aging (for elderly adults) or your state's developmental disabilities agency (for children and adults with disabilities). Both can tell you which programs exist, whether you might may have access to, and what the waiting list looks like.

You can find your Area Agency on Aging by calling the Eldercare Locator at 1-800-677-1116 or visiting eldercare.acl.gov. For developmental disabilities, search your state's website for "developmental disabilities" or "intellectual disabilities" plus your state name, or call your state's 211 line (dial 211 or visit 211.org) and ask for respite care resources.

Bring the following information when you contact these agencies: the person's age, their diagnosis or disability, whether they currently receive Medicaid or Medicare, and roughly how many hours of respite you need per week or month. This helps them point you toward the right programs quickly.

Frequently Asked Questions

Does respite care cost money if I'm on Medicaid?

Medicaid covers respite care at no cost to you if your state's program includes it and you're on the waiver. However, many states have waiting lists, so you may may have access to but not receive services immediately. Some states only cover respite through waivers, which have limited slots.

Can I use my health savings account (HSA) to pay for respite care?

Yes, if the respite provider is a licensed medical or social service agency. You cannot use HSA funds to pay a family member or an unlicensed caregiver. Ask the provider whether they are set up to accept HSA payments, or contact your HSA administrator to confirm the provider qualifies.

What if there's a waiting list for Medicaid respite in my state?

Ask the agency managing the list whether you can get on it now even if services won't start for months or years. Some states prioritize people based on caregiver age or health, so being on the list early can help. In the meantime, explore nonprofit funding, private insurance, and out-of-pocket options to cover your immediate needs.

Can I hire a family member to provide respite care and get paid through a program?

Some Medicaid waivers allow you to hire a family member as a paid respite provider, but rules vary by state and by specific program. Ask your state's developmental disabilities agency or Medicaid office whether this is an option. If it is, there are usually training requirements and paperwork involved.

How do I know if my private insurance covers respite care?

Call your insurance company's customer service number (on the back of your insurance card) and ask specifically whether respite care is covered under your plan. Ask what type of provider they will pay, whether you need a doctor's referral, and what documentation you need to submit a claim. Get the answer in writing if possible.