If you're caring for a parent or spouse in North Dakota and the days have started to run together, respite care can give you a funded break. In North Dakota, respite is paid for through the Medicaid Home and Community-Based Services (HCBS) waiver, the state-funded SPED program, and the Family Caregiver Support Program, which the federal National Family Caregiver Support Program funds; families of veterans can also use VA respite. Call the ND Aging & Disability Resource-LINK at 1-855-462-5465 to find what you qualify for.
Caregiving without breaks catches up with you. Respite isn't stepping away from your responsibility. It's what makes caring at home possible for the long run.
Why Caregivers Need Breaks
Family caregiver burnout isn't a personal failing. Federal data show family caregivers fare worse than non-caregivers across most health indicators: nearly 1 in 5 reports fair or poor health, and elderly caregivers who already have a chronic illness and are under caregiving stress face a 63% higher mortality rate than their non-caregiving peers.cdc.gov. (n.d.). CDC — Dementia Caregiving as a Public Health Strategy. Retrieved Sep 2, 2026, from https://www.cdc.gov/caregiving/php/public-health-strategy/index.html That's the reason to arrange planned breaks before you reach a crisis, not after.
If you need a break soon, start with the ND Aging & Disability Resource-LINK at 1-855-462-5465.Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
Who Pays for Respite Care in North Dakota?
Medicare pays for respite only in narrow cases, covered below.Centers for Medicare & Medicaid Services. (n.d.). Hospice Care Coverage. medicare.gov. Retrieved Jul 12, 2026, from https://www.medicare.gov/coverage/hospice-care,Centers for Medicare & Medicaid Services. (n.d.). GUIDE (Guiding an Improved Dementia Experience) Model. cms.gov. Retrieved Jul 17, 2026, from https://www.cms.gov/priorities/innovation/innovation-models/guide For most families, five doors matter: the Family Caregiver Support Program, the Medicaid HCBS waiver, the state-funded SPED program, adult day programs, and VA respite. Each has its own test: the Family Caregiver Support Program serves the caregiver groups federal law names, the HCBS waiver serves Medicaid-eligible members, SPED uses a functional test and a sliding fee, and VA respite starts with enrollment in VA health care.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html,Centers for Medicare & Medicaid Services. (n.d.). North Dakota Waiver Factsheet - Medicaid.gov. medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND,ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf,U.S. Department of Veterans Affairs. (n.d.). VA Family Caregiver Assistance Program (PCAFC) — Veterans Affairs. va.gov. Retrieved Sep 2, 2026, from https://www.va.gov/family-and-caregiver-benefits/health-and-disability/comprehensive-assistance-for-family-caregivers/
| Pathway | Who Qualifies | What It Requires | How to Access |
|---|---|---|---|
| Family Caregiver Support Program (NFCSP) | Family caregivers of someone 60+ or of anyone with dementia; relatives 55+ who live with and are the primary caregiver for a child or for an adult 18 to 59 with a disability | No cost to qualifying people; for a caregiver of an older person, respite requires that person to be frail | ND Aging & Disability Resource-LINK: 1-855-462-5465 |
| Medicaid HCBS waiver respite | Medicaid members 65+, or 18 to 64 with disabilities, who meet a nursing-facility level of care | Medicaid eligibility plus a level-of-care test | Resource-LINK: 1-855-462-5465; Medicaid questions: 1-800-755-2604 |
| SPED respite (state-funded) | People 65+ or with disabilities, living in a private home, impaired in at least 2 activities of daily living or 4 instrumental activities, such as household tasks | A full-time primary caregiver who needs occasional relief; sliding fee by family size and income | Resource-LINK: 1-855-462-5465 |
| Adult day programs | HCBS waiver members, anyone paying privately, or caregivers using Family Caregiver Support Program respite in an adult day setting | Program eligibility, or private pay at a North Dakota median of $255 a day | Resource-LINK: 1-855-462-5465 |
| VA respite | Veterans enrolled in VA health care who meet clinical criteria; PCAFC Primary Family Caregivers | A copay may apply after the first 21 days in 12 months unless the veteran is exempt | VA Caregiver Support Line: 1-855-260-3274 |
You can also search the "Find a Respite Provider" locator from the ARCH National Respite Network. The federal Lifespan Respite Care Program funds grants that build state respite systems; it's not meant to be the sole payer for your respite.Administration for Community Living. (n.d.). Lifespan Respite Care Program. acl.gov. Retrieved Sep 2, 2026, from https://acl.gov/programs/support-caregivers/lifespan-respite-care-program
1. No-Cost Respite: North Dakota's Family Caregiver Support Program
If money is the barrier, start here.
What it is: The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act and administered federally by the Administration for Community Living (ACL), makes grants to states. In North Dakota, NDDHHS Adult and Aging Services delivers it as the Family Caregiver Support Program, which offers information about local services, a trained caregiver coordinator, counseling, support groups and training, respite care "offering a short break to caregivers who provide 24-hour care," and help with the cost of incontinence supplies and assistive devices such as a shower bench or safety rails.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html,Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
Who qualifies: Under federal law, you qualify if you're one of these caregivers:U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html
- An adult family member or other informal caregiver of someone age 60 or older, or of someone any age with Alzheimer's disease or a related disorder.
- A relative (not a parent) age 55 or older who lives with and is the primary caregiver for a child under 18 because the parents can't or won't, with legal custody, adoption or guardianship, or raising the child informally.
- A relative, including a parent, age 55 or older who lives with and is the primary caregiver for an adult age 18 to 59 with a disability.
The frailty test: If you care for an older person, respite is available only when that person is frail. That means they can't perform at least two activities of daily living without substantial help, including verbal reminders, cueing or supervision, or they need substantial supervision because a cognitive or other mental impairment makes their behavior a serious health or safety hazard.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html
What to expect: NDDHHS says these services are provided at no cost to qualifying people and are federally funded, and caregivers have the opportunity to contribute toward the cost. Ask exactly what respite is available in your county before you plan around it.Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
How to access: Call the ND Aging & Disability Resource-LINK at 1-855-462-5465 (711 for TTY), or the Eldercare Locator at 1-800-677-1116 to reach local aging services.Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND,eldercare.acl.gov https://eldercare.acl.gov/home · Accessed Sep 2, 2026
Best for: North Dakota family caregivers who don't have Medicaid or veteran benefits to draw on.
2. If Your Loved One Is on Medicaid: Respite Under the HCBS Waiver
If your loved one is already on North Dakota Medicaid, you may be leaving paid respite hours on the table.
What it is: North Dakota Health and Human Services (NDDHHS) runs the consolidated Home and Community-Based Services (HCBS) waiver, effective January 1, 2026, through its Aging Services Division. The waiver covers respite care, adult day care, homemaker, chore, family personal care and other services for people age 65 and older, and people 18 to 64 with physical or other disabilities, who meet a nursing-facility level of care. NDDHHS defines respite as relief for the primary caregiver of a person who is ill or disabled. Waiver services go only to Medicaid-eligible members whose needs can be met at home, and generally only when care at home costs no more than nursing-facility care would; exceeding that limit needs prior approval.Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
Money rules: For long-term care Medicaid, a single person must have less than $3,000 in countable assets, or $6,000 for a couple. The home, one car, home furnishings, irrevocable burial plans and personal items don't count. Home equity has its own cap for home and community-based benefits, set by state rule and raised each year, which doesn't apply when a spouse, or a child under 21 or who is blind or disabled, lives in the home. If your loved one's income is over the Medicaid limit and they have a medical need, ND Medicaid has a coverage option with a client share. North Dakota Medicaid may also review asset transfers over the last five years.Centers for Medicare & Medicaid Services. (n.d.). North Dakota Waiver Factsheet - Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
What to expect: The HCBS waiver requires a nursing-facility level-of-care determination. While it's pending, use Family Caregiver Support Program respite and adult day programs as the bridge, because those don't require the waiver to be in place. In its 2026 waiver application, the state reported that it does not have a waiting list for waiver services.Centers for Medicare & Medicaid Services. (n.d.). North Dakota Waiver Factsheet - Medicaid.gov. medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
Paying a family member: This is a personal care service, separate from respite. Through family personal care, the person receiving care can choose a spouse or a parent, grandparent, adult child, adult sibling, adult grandchild, adult niece or adult nephew, but it pays only a legal spouse or family member who lives in the same home and enrolls as a QSP.Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND A relative who lives elsewhere, such as an adult child in their own home, can be paid for waiver personal care as an enrolled QSP.North Dakota Health and Human Services. (1915). Application for 1915(c) HCBS Waiver: ND.0273.R06.07 - Jan 01, 2026 (North Dakota consolidated HCBS waiver, Appendix C-1/C-3 and C-2-d/C-2-e) - hhs.nd.gov. hhs.nd.gov. Retrieved Oct 14, 2026, from https://www.hhs.nd.gov/sites/default/files/documents/Adult%20and%20Aging/1915c-hcbs-waiver-2026-exclusion.pdf Medicaid State Plan personal care can also pay an enrolled relative such as an adult child, but not a spouse or legal guardian.ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-02-02 (Medical Services), section 75-02-02-09.5 Limitations on personal care services - ndlegis.gov. Retrieved Oct 14, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-02-02.pdf Our North Dakota Family Personal Care guide covers the hour rules.
How to access: Call the Resource-LINK at 1-855-462-5465 to ask about applying for home and community-based services.ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf For Medicaid eligibility questions, ND HHS lists its Medical Services Division as the contact for Medicaid waivers, toll-free at 1-800-755-2604.Centers for Medicare & Medicaid Services. (n.d.). North Dakota Waiver Factsheet - Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
Best for: Families where the care recipient is enrolled in or eligible for North Dakota Medicaid.
3. If Medicaid Doesn't Fit: SPED Respite
If your loved one's savings are over Medicaid's limits, SPED may be the door that fits.
What it is: Service Payments for the Elderly and Disabled (SPED) is a state program that pays qualified service providers for home and community-based services for people 65 and older and people with disabilities. Under the SPED rule, the state may provide respite care in the person's home, the provider's home, a nursing home, a swing-bed facility, a basic care facility or a hospital.ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf,nd.gov. (2025). Family Home Care 525-05-30-30 - ND HHS Home and Community Based Services policy manual (revised 10/01/2025). Retrieved Oct 15, 2026, from https://www.nd.gov/dhs/policymanuals/52505/Content/525_05_30_30.htm
Who qualifies: Your loved one must live in North Dakota in a private residence, not an institution, with an impairment that has lasted or is expected to last three months or longer. An adult must be impaired in at least two activities of daily living or at least four instrumental activities of daily living, such as household tasks, totaling at least four points if they live alone or six if they live with an able-bodied adult. They also can't be responsible for 100% of the cost under SPED's sliding fee scales, which are based on family size and income.ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf
When SPED pays for respite: Your loved one must have a full-time primary caregiver and need a qualified caregiver while you're away. Your need for relief must be occasional, not caused by your job or school schedule.nd.gov. (2025). Family Home Care 525-05-30-30 - ND HHS Home and Community Based Services policy manual (revised 10/01/2025). Retrieved Oct 15, 2026, from https://www.nd.gov/dhs/policymanuals/52505/Content/525_05_30_30.htm
Medicaid first, sometimes: Not every SPED applicant has to apply for Medicaid. If the case manager finds your loved one's resources are over Medicaid's limits, they don't have to complete a Medicaid application. But someone who appears eligible for Medicaid can't refuse to apply and get SPED instead, with limited exceptions.ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf Our SPED Family Home Care guide explains the related program that pays a live-in relative.
How to access: Call the Resource-LINK at 1-855-462-5465.ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf
Best for: Families whose loved one isn't eligible for Medicaid but needs hands-on help at home.
4. Daytime and Short-Stay Relief: Adult Day Programs and Facility Respite
If you need the same reliable hours every week rather than occasional relief, an adult day program may be the steadiest option.
What they are: Adult day health care services provide supervision, engagement and structured daytime support. North Dakota's HCBS waiver lists adult day care among its covered services for eligible members.Genworth Financial. (2025). CareScout Releases 2025 Cost of Care Survey Results. investor.genworth.com. Retrieved Sep 5, 2026, from https://investor.genworth.com/news-events/press-releases/detail/1054/carescout-releases-2025-cost-of-care-survey-results,Centers for Medicare & Medicaid Services. (n.d.). North Dakota Waiver Factsheet - Medicaid.gov. medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
Overnight and short-stay respite: Family Caregiver Support Program respite can be given at home, in an adult day care setting, or in an institutional setting.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html SPED respite can be provided in a nursing home, swing-bed facility, basic care facility or hospital.nd.gov. (2025). Family Home Care 525-05-30-30 - ND HHS Home and Community Based Services policy manual (revised 10/01/2025). Retrieved Oct 15, 2026, from https://www.nd.gov/dhs/policymanuals/52505/Content/525_05_30_30.htm Ask the Resource-LINK which short stays are available near you.
What it costs: CareScout's 2025 Cost of Care Survey puts North Dakota's median adult day health care rate at $255 a day, or $66,300 a year at five days a week, the 2nd highest in the nation and well above the national median of $95 a day.assets.carescout.com. (2025). CareScout Cost of Care Survey 2025 - Median Cost Data Tables (annual median costs by state; document 282102, 03/02/26). Retrieved Sep 6, 2026, from https://assets.carescout.com/x/8fcb50422f/282102.pdf,Genworth Financial. (2025). CareScout Releases 2025 Cost of Care Survey Results. investor.genworth.com. Retrieved Sep 5, 2026, from https://investor.genworth.com/news-events/press-releases/detail/1054/carescout-releases-2025-cost-of-care-survey-results That's a provider's rate, not your family's net cost: the survey notes that private pay rates in this setting are heavily influenced by Medicaid reimbursement rates, and actual expenses vary with care needs, provider availability and local market conditions.Genworth Financial. (2025). CareScout Releases 2025 Cost of Care Survey Results. investor.genworth.com. Retrieved Sep 5, 2026, from https://investor.genworth.com/news-events/press-releases/detail/1054/carescout-releases-2025-cost-of-care-survey-results For more North Dakota figures, see The Cost of Senior Care in North Dakota.
Who pays:
- Family Caregiver Support Program respite can be provided in an adult day care setting; ask the Resource-LINK what your county offers.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html
- North Dakota Medicaid covers adult day care and respite under the HCBS waiver for eligible members.Centers for Medicare & Medicaid Services. (n.d.). North Dakota Waiver Factsheet - Medicaid.gov. medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
- Private pay is the default for families not using other programs, at a North Dakota median of $255 a day.assets.carescout.com. (2025). CareScout Cost of Care Survey 2025 - Median Cost Data Tables (annual median costs by state; document 282102, 03/02/26). Retrieved Sep 6, 2026, from https://assets.carescout.com/x/8fcb50422f/282102.pdf
Best for: Caregivers who need consistent weekday relief and care recipients who benefit from structured daytime support.
5. If There Is a Veteran in the Family: VA Respite
If there's a veteran in your family, check this door alongside the others.
VA respite for enrolled veterans: All veterans enrolled in VA health care are eligible for VA respite if they meet the clinical criteria and the service is available. VA offers home respite, where someone comes to the veteran's home or the veteran attends an adult day health care program, and nursing home respite in a VA Community Living Center or a community nursing home. If the respite comes from a community agency, adult day health care center or nursing home, the veteran also needs to meet community care eligibility.U.S. Department of Veterans Affairs. (n.d.). VA Family Caregiver Assistance Program (PCAFC) — Veterans Affairs. va.gov. Retrieved Sep 2, 2026, from https://www.va.gov/family-and-caregiver-benefits/health-and-disability/comprehensive-assistance-for-family-caregivers/
What it costs: VA describes overnight and daily respite as each available up to 30 days a calendar year. There's no copay for the first 21 days of extended care services in a 12-month period; after that, the copay is $97 a day for institutional respite and $15 a day for non-institutional respite, to the extent the veteran has available resources. Veterans with a compensable service-connected disability, and some with low income, are exempt.U.S. Department of Veterans Affairs. (n.d.). VA Family Caregiver Assistance Program (PCAFC) — Veterans Affairs. va.gov. Retrieved Sep 2, 2026, from https://www.va.gov/family-and-caregiver-benefits/health-and-disability/comprehensive-assistance-for-family-caregivers/
PCAFC: Primary Family Caregivers approved for the Program of Comprehensive Assistance for Family Caregivers (PCAFC) receive at least 30 days of respite care per year. A spouse can serve as the caregiver. Approval isn't automatic: the veteran must meet all of VA's eligibility requirements, and you and the veteran apply together.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
How to access: Call the VA Caregiver Support Line at 1-855-260-3274, staffed Monday through Friday, 8 a.m. to 8 p.m. Eastern Time, and ask to be connected to your local Caregiver Support Program team. It isn't a crisis line: anyone in crisis can reach the Veterans Crisis Line at any hour by calling 988 and pressing 1, texting 838255, or chatting at VeteransCrisisLine.net.U.S. Department of Veterans Affairs. (n.d.). VA's National Caregiver Support Line (CSL) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Aug 1, 2026, from https://www.caregiver.va.gov/help_landing.asp
Best for: Families of veterans enrolled in VA health care, particularly those approved for PCAFC.
Does Medicare Cover Respite Care in North Dakota?
Only in two narrow cases.
Hospice: A person on the Medicare hospice benefit can receive short-term inpatient respite care in a facility so the family caregiver gets a break. You may pay 5% of the Medicare-approved amount for that inpatient respite, and the copayment can't be more than the inpatient hospital deductible.Centers for Medicare & Medicaid Services. (n.d.). Hospice Care Coverage. medicare.gov. Retrieved Jul 12, 2026, from https://www.medicare.gov/coverage/hospice-care
The GUIDE dementia model: Medicare's GUIDE Model pays participating provider organizations for respite for eligible patients with moderate or severe dementia who have a relative or unpaid nonrelative as their primary caregiver, up to $2,625 per patient for the performance year that began July 1, 2026. The money goes to the provider, not to your family. Your loved one must be in Original Medicare Parts A and B, not Medicare Advantage or hospice, and patients living in assisted living or a similar residential care setting can't get GUIDE respite. Ask their doctor whether they take part in GUIDE.Centers for Medicare & Medicaid Services. (n.d.). GUIDE (Guiding an Improved Dementia Experience) Model. cms.gov. Retrieved Jul 17, 2026, from https://www.cms.gov/priorities/innovation/innovation-models/guide
Outside those cases, respite funding in North Dakota comes from the HCBS waiver, SPED, the Family Caregiver Support Program, the VA, or private pay.
How to Get Started in North Dakota
Call the ND Aging & Disability Resource-LINK at 1-855-462-5465
Ask what Family Caregiver Support Program respite your county has, and how to apply for home and community-based services such as the HCBS waiver or SPED.Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND,ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf
Call the ND HHS Medical Services Division at 1-800-755-2604 with Medicaid eligibility questions
ND HHS lists it as the contact for Medicaid waivers.Centers for Medicare & Medicaid Services. (n.d.). North Dakota Waiver Factsheet - Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND
Use the Eldercare Locator for other local services
Call or text 1-800-677-1116, or search eldercare.acl.gov, to find local services such as in-home help and transportation.eldercare.acl.gov https://eldercare.acl.gov/home · Accessed Sep 2, 2026
If your loved one is a veteran, call 1-855-260-3274
The VA Caregiver Support Line, staffed weekdays from 8 a.m. to 8 p.m. Eastern Time, can connect you to your local VA Caregiver Support Program team.U.S. Department of Veterans Affairs. (n.d.). VA's National Caregiver Support Line (CSL) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Aug 1, 2026, from https://www.caregiver.va.gov/help_landing.asp
Where to Get Help in North Dakota
These are the free front doors. Start with the first one that fits your situation.
Frequently Asked Questions
Does North Dakota Medicaid cover respite care?
Yes, for eligible members. The Home and Community-Based Services (HCBS) waiver covers respite care and adult day care for Medicaid-eligible members age 65 and older, and members 18 to 64 with disabilities, who meet a nursing-facility level of care. Call the ND Aging & Disability Resource-LINK at 1-855-462-5465 to ask about applying.Centers for Medicare & Medicaid Services. (n.d.). North Dakota Waiver Factsheet - Medicaid.gov. medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND,ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf
Is there respite in North Dakota if we don't have Medicaid?
Often, yes. The federally funded Family Caregiver Support Program provides respite at no cost to qualifying people, though caregivers may contribute toward the cost, and for a caregiver of an older person, respite requires that person to be frail.Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND,U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html The state-funded SPED program can also pay for respite, with a sliding fee based on family size and income. Call the Resource-LINK at 1-855-462-5465.ndlegis.gov. (n.d.). N.D. Admin. Code ch. 75-03-23 (SPED and Medicaid waiver home and community-based services), sections 75-03-23-01(22), 75-03-23-02 and 75-03-23-03 - ndlegis.gov. Retrieved Oct 15, 2026, from https://www.ndlegis.gov/information/acdata/pdf/75-03-23.pdf,nd.gov. (2025). Family Home Care 525-05-30-30 - ND HHS Home and Community Based Services policy manual (revised 10/01/2025). Retrieved Oct 15, 2026, from https://www.nd.gov/dhs/policymanuals/52505/Content/525_05_30_30.htm
Can a family member be paid to provide care in North Dakota?
Yes, but that's personal care, not respite. Family personal care under the HCBS waiver pays a spouse or listed relative who lives in the same home and enrolls as a Qualified Service Provider, and a relative who lives elsewhere can be paid for waiver personal care.Centers for Medicare & Medicaid Services. (1915). North Dakota Waiver Factsheet - Medicaid.gov (all ND 1915(c) waivers, active and terminated). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/ND,North Dakota Health and Human Services. (1915). Application for 1915(c) HCBS Waiver: ND.0273.R06.07 - Jan 01, 2026 (North Dakota consolidated HCBS waiver, Appendix C-1/C-3 and C-2-d/C-2-e) - hhs.nd.gov. hhs.nd.gov. Retrieved Oct 14, 2026, from https://www.hhs.nd.gov/sites/default/files/documents/Adult%20and%20Aging/1915c-hcbs-waiver-2026-exclusion.pdf See our North Dakota Family Personal Care guide.
Does Medicare pay for respite care in North Dakota?
Only in narrow cases. A person on hospice can receive short-term inpatient respite care, and may pay 5% of the Medicare-approved amount, capped at the inpatient hospital deductible.Centers for Medicare & Medicaid Services. (n.d.). Hospice Care Coverage. medicare.gov. Retrieved Jul 12, 2026, from https://www.medicare.gov/coverage/hospice-care Medicare's GUIDE dementia model also pays participating providers for respite for eligible patients with moderate or severe dementia.Centers for Medicare & Medicaid Services. (n.d.). GUIDE (Guiding an Improved Dementia Experience) Model. cms.gov. Retrieved Jul 17, 2026, from https://www.cms.gov/priorities/innovation/innovation-models/guide
How does a veteran family in North Dakota get VA respite?
Veterans enrolled in VA health care can get VA respite if they meet the clinical criteria, with no copay for the first 21 days of extended care in a 12-month period.U.S. Department of Veterans Affairs. (n.d.). VA Family Caregiver Assistance Program (PCAFC) — Veterans Affairs. va.gov. Retrieved Sep 2, 2026, from https://www.va.gov/family-and-caregiver-benefits/health-and-disability/comprehensive-assistance-for-family-caregivers/ Primary Family Caregivers approved for PCAFC receive at least 30 days of respite care a year.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf Call the VA Caregiver Support Line at 1-855-260-3274, weekdays from 8 a.m. to 8 p.m. Eastern Time.U.S. Department of Veterans Affairs. (n.d.). VA's National Caregiver Support Line (CSL) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Aug 1, 2026, from https://www.caregiver.va.gov/help_landing.asp
Learn More
Find personalized help navigating respite care options in North Dakota at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.
Still have questions?
Brevy answers from this guide and every other guide here, and can check what you qualify for.