Each year, millions of Americans selflessly donate their time and talents to care for aging friends and family members. For the average informal caregiver, looking after an older loved one is a highly gratifying experience. But as the days go by, many family caregivers develop a condition known as caregiver burnout. Some turn to professional respite caregivers to step in temporarily as a result.

However, paying for in-home respite care services can be challenging. Here’s how newer Medicare Advantage insurance plans can help reduce the financial burden.

What Is Respite Care?

Caring for someone who’s elderly, sick, or disabled can be a 24-hour job. Every so often, you’ll need to take some time off to look after your own needs. Respite care is a commonly used term that describes a temporary break for caregivers. Those caregiving breaks can be for as long or as short as you need for them to be, whether it’s a few hours, days, weeks, or longer.

Possible sources of respite care include:

  • Family members, friends, and neighbors
  • Community volunteers that work with the aging
  • A residential center that offers overnight stays
  • Adult daycare
  • A professional in-home respite caregiver

In part fueled by Covid-19 safety precautions, more and more families are now hiring in-home respite care providers to look after aging loved ones. Although it does cover home healthcare services (skilled nursing care) for a specified length of time, Medicare Part A will not pay for home-based services like:

  • 24-hour care
  • Meal delivery services
  • Homemaker services
  • Personal care or custodial care (bathing, dressing, toileting, etc.)

Introducing Medicare Advantage

Medicare Advantage, or Medicare Part C, is a supplemental plan covering non-skilled in-home care. Available through private insurance companies, Medicare Advantage plans are an alternative to traditional Medicare programs (Part A and B) that do not cover non-skilled home healthcare services.

Not all Medicare Advantage (MA) plans have the same benefits and coverage. Because they are sold through independent insurance providers rather than offered by the federal government, plan benefits vary by company. Different types of Medicare Advantage plans are also available, including Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Private Fee-for-Service (PFFS) plans, and Special Needs Plans (SNPs).

MA Eligibility Requirements Vary by State

Most people are not eligible for a supplemental Medicare Part C plan unless they’ve already been approved for Original Medicare. All applicants must also be under the care of a licensed physician who then regularly reviews their care plan services. Those applying for Medicare Advantage benefits must also be receiving physical or occupational therapy and be certified as homebound.

In general, eligibility for an MA plan depends on the requirements outlined in each one. In-home MA coverage varies according to the provider and the state of residency. Different areas may have unique eligibility and benefit requirements, for example, in a state like California.

Medicare Advantage Respite Care Options

Some Medicare Advantage plans cover respite care delivered in one of three ways. The first is a short-term stay in a nursing home or assisted living facility. Older adults recovering from surgery or those whose informal caregivers are temporarily unable to care for them may benefit from this type of respite care.

Adult daycare is another respite care option. These centers combine the social aspects of a senior center with the supervision and personal care of an assisted living facility. In-home respite care is the third option for seniors that prefer to stay at home when their primary caregivers are temporarily unavailable. In these cases, professional caregiver services may be covered by an MA plan.

To learn more about Medicare Advantage plans, visit www.medicare.gov.

Flexible In-Home Respite Care for Seniors in Los Angeles

Finding a qualified replacement when it’s time to take a well-deserved caregiving break can be challenging. At New Wave Home Care, we’ve been helping families in Southern California keep aging loved ones safe and comfortable in their own homes for 10+ years now. As a licensed home care provider, we support clients and their families with personalized in-home solutions that include companionship care, personal care, transitional care, respite care, dementia and Alzheimer’s care, and hospice support.

When you choose New Wave Home Care in Pasadena, you can rest assured that your loved one is getting the specialized care they need from a trusted, friendly caregiver. To learn more now or schedule a FREE in-home assessment for a senior in the greater Los Angeles area, please visit us at www.newwavehomecare.com.