Respite Coverage & Private Insurance

There’s a growing imperative to develop robust supports for Colorado’s caregivers providing uncompensated care for friends or family who have trouble meeting their own needs. Respite — temporary care provided by an outside individual or organization so caregivers can have a break from their care responsibilities — must be part of any enhanced support system. Already high demand for respite is only expected to grow as demographic changes increase the need for and value of caregiving.

Despite its importance, many Coloradans have difficulty accessing respite. Obstacles stem from a multitude of interconnected factors including inadequate Medicaid reimbursement rates, workforce shortages, and limited state and federal funding. Fortunately, there’s growing recognition Colorado can (and should) do more to alleviate these challenges. In 2015, Colorado’s legislature created the Colorado Respite Care Task Force to study how the state can increase access to respite. In 2016, the Task Force released its recommendations, several of which were funded through subsequent legislation.

To build on recent momentum, some advocates have begun exploring how private insurance can be used to increase respite access. Though not officially one of the Respite Care Task Force’s recommendations, its 2016 report states Colorado should explore ways to “encourage employers to fund respite services directly or include them in their health benefit plans.” Our latest brief examines how the state and advocates can advance this suggestion.

Thanks to assistance from the Colorado Consumer Health Initiative (CCHI), this brief offers an analysis of how respite services are currently covered by private insurance in Colorado, information about the limited action other states are taking to advance this work, and concludes with recommendations for advocates interested in increasing private access to respite. Recommendations include:

  • Sponsoring a thorough analysis of respite’s benefits and costs
  • Educating insurers and businesses on the benefits of respite
  • Exploring alternative private-sector funding mechanisms

Caregivers are essential to the health and well-being of our communities. Respite is an important support which allows these men and women to look after their own needs as they simultaneously care for their loved ones. By exploring and moving forward with innovative solutions that increase access to respite, we’ll be fostering a healthier, more supportive, and robust state.