How to Qualify for Respite Care in NC | Medicaid & IDD Guide #2
Covenant Team
Aug 4, 2026
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How-To Guide · North Carolina
How to Qualify for Respite Care in North Carolina
A clear, step-by-step path to the support your family deserves, from first contact to an approved plan.
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Key Takeaways
- In North Carolina, respite care is most often funded through NC Medicaid, including the Innovations Waiver and 1915(i) services.
- Qualifying generally requires NC Medicaid and a qualifying diagnosis such as IDD, TBI, or a behavioral health condition.
- The Innovations Waiver has a waitlist. 1915(i) services do not, and offer up to 300 respite hours per year.
- An independent assessment confirms eligibility and identifies the services that fit your loved one’s needs.
Caring for a loved one is meaningful work, and rest is part of sustaining it well. Respite care gives family caregivers a trusted, short-term break while the person they support continues to receive quality care. Securing that support in North Carolina involves a few clear stages. Here is what to expect as you move forward.
Step 01 Connect with the right NC resources
Your first step is connecting with the people who can point you toward the right program. If your loved one already has NC Medicaid, start with your Tailored Care Manager or your LME/MCO care coordinator, who can explain which services may be available. You can also speak with your family doctor or a public health nurse for initial guidance, and non-profit organizations that specialize in disability services can help you navigate the system.
Not sure where you fit yet? Our team can help you understand your options. Explore our key caregiver resources or reach out directly.
Step 02 Complete a needs assessment
Before services can be approved, a formal independent assessment is required. An assessor evaluates your loved one’s medical and support needs alongside your situation as the caregiver. In North Carolina, assessment findings are reviewed by NC DHHS or its review contractor, Carelon.
This is your opportunity to describe daily challenges clearly and detail the level of care required, so the final plan truly reflects your family’s needs. Being specific here shapes everything that follows.
Step 03 Confirm program-specific eligibility
Eligibility criteria vary between programs, and matching your loved one to the right one is where families often need guidance. Two of the most common respite pathways in North Carolina are the NC Innovations Waiver and 1915(i) services.
Learning how to get respite care for a specific diagnosis, such as autism, often means connecting with specialized developmental disability services, each with its own requirements. Our team can help you compare pathways side by side.
Step 04 Finalize your plan and application
Once the assessment is complete and a program is identified, your care manager works with you to build an Individual Support Plan (ISP) or Person-Centered Plan (PCP) that includes respite. After submitting the required forms, confirm that the services align with the plan, then discuss scheduling and the scope of support so it provides meaningful, reliable relief.
From here, our respite service, GracePause, provides the trained, compassionate support that steps in when you step away.
Taking the Next Step Toward Support
You do not have to navigate this process alone. By gathering your information and connecting with a trusted provider, you can secure the support your family needs. At Covenant Case Management Services, we guide families through every step. Explore our services or learn more about what respite care is and how it helps.
Ready to explore respite care for your family?
Our care team serves families across 56 North Carolina counties. We will help you understand your eligibility, prepare for the assessment, and connect the right services to your loved one’s plan.
Frequently Asked Questions
Does Medicaid cover respite care in North Carolina?
Yes. Medicaid is the most common way families access respite care in NC. It is funded through Home and Community-Based Services waivers and state plan options, including the NC Innovations Waiver and 1915(i) services, for individuals who meet eligibility and diagnostic requirements. For a closer look at costs and coverage, see our guide on whether respite care is covered by insurance.
Do I need to be on the NC Innovations Waiver to get respite care?
No. The Innovations Waiver is one pathway, but it has a waitlist. 1915(i) services offer respite without a waitlist for individuals who have NC Medicaid and a qualifying diagnosis, so many families begin there.
How many respite hours can I get through 1915(i) services in NC?
1915(i) respite is available for up to 300 hours per year in North Carolina. Individuals enrolled in CAP/C or CAP/DA are not eligible for this particular respite service.
Is there a waitlist for respite care in North Carolina?
It depends on the program. The NC Innovations Waiver has a waitlist known as the Registry of Unmet Needs. 1915(i) services do not have a waitlist, which is why families who need support sooner often explore that pathway first.
What diagnosis qualifies for respite care in NC?
Eligibility generally requires NC Medicaid and a qualifying diagnosis, such as an intellectual or developmental disability, a traumatic brain injury, or a behavioral health condition. Specific criteria vary by program, and an independent assessment confirms which services fit your loved one’s needs.
Who can help my family navigate the respite care process?
A case management team can guide you through eligibility, assessment, and enrollment. Covenant Case Management Services supports families across 56 North Carolina counties. Connect with our team to get started.
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