Who Pays for a Week of Respite: Compare Four Sources Before You Book
Respite looks like one service on the phone and four different bills on paper, so sort the sources before you pick one.
A week of respite is a break for the person giving care, and it is the line most families price last. Before you book anything, sort the week by who would pay for it. The four usual sources sound alike on a phone call and differ sharply on paper.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Source one: the veteran benefit
If your parent is a veteran, ask whether VA caregiver support includes respite for the family caregiver. Check the eligibility rules on va.gov. Confirm three things: whether the veteran is enrolled in VA health care, whether respite is offered as a set number of days or as hours, and whether the stay happens at a VA contracted facility or at a community provider you choose. Write down the contact name and the timeline the VA gives for its review.
What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).
Source two: the Medicare hospice benefit
Medicare's hospice benefit includes a short inpatient respite stay for the caregiver, but only for a person already enrolled in hospice. It is not a general respite benefit. Medicare.gov lists the rules. Ask the hospice intake staff whether the stay is available, which facility would be used, and whether any part of the stay falls outside the hospice coverage.
Source three: the area agency on aging
Aging Ahead, the area agency on aging for the St. Louis region, can tell you which respite services are funded through older adult programs and what the eligibility screen asks. Many of these programs draw on federal Older Americans Act funds, which the Administration for Community Living oversees. Ask whether the program has a waiting list, whether it is free or charges on a sliding scale, and whether the hours can be used in blocks or only in fixed visits.
Source four: a Medicaid home and community based program
If your parent is enrolled in or applying to a Missouri Medicaid waiver, check whether that program includes respite and under what limit. Missouri DSS publishes the program rules. A waiver case manager can tell you whether respite is listed and whether it is paid to a licensed agency or to a worker you select. Do not assume a benefit exists because a friend's program offers one. Compare the paper of the program your parent actually qualifies for.
Put the four side by side
Build a one-page sheet with four columns: the source, who qualifies, what the respite covers, and what you would pay. Fill each column from the agency's own page or letter, not from memory. Leave the cost column empty until a named provider gives you a written rate, and ask whether that rate changes for nights, weekends, or holidays. If a source cannot answer in writing, mark it unknown. An unknown is still useful, because it tells you which office to call next.
Where this stops
Choosing a respite source is an eligibility and budget task you can do yourself. Whether a program denial can be appealed, or how a respite contract binds your parent, is a question for a lawyer. The Missouri Bar keeps a lawyer referral listing. Medical questions about the person receiving care belong to the physician. For how we check the claims in this piece, see How We Write, and for the paper trail, see Sources.