Covered Services You May Not Be Aware Of:
Long Term Supportive Services (LTSS) Respite Service
Respite services are a part of the support a family may need to care for their loved one at home. The word “respite” means to take a break from the daily efforts of caring for a child with special needs.
CareSource covers respite care (planned or on an emergency basis) that gives short-term help to an unpaid caregiver. Medicare-certified home health agencies can give services in the member’s home, or the member can have up to 14 days of inpatient respite.
Respite services are open to members under age 21 that are:
- not in foster care,
- need skilled nursing or rehabilitation services at least once a week,
- eligible for social security income for children with disabilities or supplemental security income (SSI) and
- need at least 14 hours per week of home health aide services for two months or more before respite care is requested.
Behavioral Health Respite Services
Members who are caregivers for children under the age of 21 with certain Behavioral Health diagnoses may be able to get short term respite services as part of a total treatment plan. Services are provided by a Community Behavioral Health Center. Respite can be provided in a variety of settings both in and out of the child’s home. Qualifying children do not require inpatient hospitalization for their behavioral health issues, but are at risk for out-of-home placement. Respite can be used to both prevent hospitalization and preserve the child’s family unit.
How to Get LTSS or Behavioral Health Respite Services
Members must be working with CareSources’ Care Management program. Respite services are limited to 100 hours each calendar year, unless more hours are medically necessary. If you are working with a Care Manager, talk to him or her about respite services. If you feel your child may need this benefit and you are not working with a Care Manager, please call our Member Services team at 1-800-488-0134 (TTY: 1-800-750-0750 or 711).