Will Medicare reimburse payment made to a retirement senior living memory care for the respite stay for a person with dx dementia?

That was great! I read once that the person you get on the first call is not trained as they should be. They are reading out of a book. That you have the right to request their credentials if they turn down paying for something. Meaning, to make certain decisions concerning what is covered, they must be a nurse or a doctor.

You must be tenacious when itvcomes to Medicare Advantages.

Wanted to give an update on respite stay in a memory care, paid privately upfront and submitted to Medicare Advantage plan to see if they would consider the claim. The plan denied the claim, stating room and board not covered. Called and spoke with representative and she gave advice on what to include in an appeal letter to the plan. Appeal sent and plan reimbursed the full amount of the respite stay, over $4900….was shocked and grateful that they accepted and paid on appeal. Sometimes it pays to be tenacious!!

Bobbie61: Medicare does not pay for custodial care.

As said by other readers, Medicare pays for medical care the doctor prescribes. Supervision is custodial care that Medicare does not pay for.

No, respite is private pay. The only time Medicare will pay for 5 consecutive days is if on Hospice to give family a break.

Usually Medicare only pays for things that are medical, not custodial. This is a question best suited for a Medicare rep. If the answer is "no", then what does it matter? Are you asked in order to know if the claim should be submitted in the first place? Call them.