Page Reviewed / Updated – March 11, 2024

Medicaid’s Benefits for Adult Day Care

All 50 states and Washington D.C. offer assistance for adult day care in one form or another through their Medicaid programs.

Does Medicaid pay for adult day care? In a word, yes. However, a better question might be, Under what circumstances will Medicaid pay for adult day care, and is my loved one eligible? To answer this question requires some background information about Medicaid.

First, it is important to think of Medicaid not as a single program, but rather as a collection of many different programs. Not only does each state have their own rules with regards to Medicaid’s benefits, but each state typically has several different Medicaid programs, all of which have their own policies for adult day care coverage.

Finally, the target group of the Medicaid program also impacts eligibility. As an example, seniors must meet one set of eligibility criteria. Adults aged 18-64 have to meet a second, differing set of eligibility criteria. And the developmentally disabled a third set.

Medicaid Waivers

The state Medicaid programs most likely to cover adult day care are called Medicaid Waivers. There are several versions of waivers. One may find these referred to as HCBS Waivers, 1915(c) Waivers, 1115 Demonstration Waivers, or Home and Community Based Waivers. Historically, long-term care Medicaid was provided only in nursing homes. However, Medicaid waivers now allow states to offer long-term care Medicaid services outside of nursing homes to individuals who generally require a nursing home level of care but who live at home.

It is under these waivers that most individuals receive assistance from Medicaid for adult day care. There are waivers that cover adult day care in most states. Furthermore, those states that do not cover adult day care through a Medicaid waiver offer alternative public funding for adult day care. A major advantage of Medicaid waivers is they almost always have higher monthly income limits than do regular Medicaid programs. A downside of waivers is that they have enrollment caps and very often there are waiting lists.

Regular / State Plan Medicaid

To a lesser extent, “regular Medicaid” or Medicaid State Plans, offers adult day care as a benefit. Presently, approximately 15 states and the District of Columbia cover adult day care services via their Medicaid State Plan. State Plan Medicaid is an entitlement. This means that those persons who meet the eligibility requirements are entitled to receive the benefits.

As mentioned above, this is not the case with Medicaid waivers, which have a limited number of slots. Stated differently, persons can meet the eligibility requirements and still be “wait-listed” to receive benefits. The downside to State Plan Medicaid (when compared to waivers) is that very often the monthly income limit for eligibility is considerably lower than is the limit for Medicaid waivers.

Medicaid Adult Day Care Eligibility

Every Medicaid program in every state has its own eligibility considerations. Generally speaking, most adult day care is provided under Medicaid waivers. Eligibility for waivers considers the applicant’s income and financial resources, as well as their functional ability. In most states, waivers require the participant to be in need of nursing home level care.

In 2022, most waivers limit the participant’s monthly income to less than $2,2829. Excluding the value of their home, their countable assets are limited to $2,000 for the majority of states. (California is one exception, where there is now no asset limit.) Applicants with resources or income in excess may be able to qualify for Medicaid by working with a Medicaid planning professional.

Eligibility for Medicaid-funded, adult day care under a Medicaid state plan is both less and more restrictive than with a waiver. Applicants do not necessarily need to require nursing home level care. This is good news for persons with Alzheimer’s or dementia who require supervision, but not 24 / 7 care.

Financially, the asset limit is the same as with Medicaid waivers, but the monthly income limit is likely more restrictive. Typically, it is pegged to the Supplemental Security Income benefit rate ($943 / month in 2024 for a single applicant or $1,415 for a married couple), or 100% of the Federal Poverty Level ($1,255 / month in 2024 for a single applicant or $1,703.33 for a married couple). Again, as with waivers, there is some flexibility when calculating what qualifies as monthly income.

Types of Adult Day Care Benefits

Before a discussion of the state by state benefits, it is helpful to have additional background information on what defines adult day care and what different types of adult day care exist. Medicaid in your state may cover some types of adult day care and not others.

Generally speaking, adult day care involves the day-time supervision of needy individuals in a group environment in a center or location. There are three types of adult day care. Each type may be referred to by several different names.

1. Social Adult Day Care – sometimes called Adult Day Services or abbreviated ADC or ADS, provides non-medical supervision. The focus is on maintaining health through recreational and social activities and nutritious meals.

2. Adult Day Health Care – also called Adult Day Medical Care or ADHC, provides a higher level of care services with trained nurses on staff. In addition to activities and meals, physical, occupational, and speech therapies may be provided. In addition, assistance with the activities of daily living, with medical equipment, and medication administration is provided.

3. Specialized Adult Day Care – typically for Alzheimer’s patients, this may even be referred to as Alzheimer’s Day Care or Day Treatment. Though usually it is open to individuals with most forms of dementia. In Alzheimer’s Day Care, there is an additional focus to prevent wandering, injury and behavioral challenges.

While these distinctions exist, in practice and in different states, the lines between these types of adult day care may not be so clear. Often times, one center will provide all 3 types of care.

Regardless of the Medicaid program or waiver from which one receives the adult day care benefit; all programs will put limits on the amount of adult day care the beneficiary can receive.  Limits are typically dependent on the individual.  However, one can expect a maximum of 8 hours per day / 5 days per week.

Coverage Reasoning

Why does Medicaid cover the cost of adult day care?  Medicaid is usually thought of as the major payer of nursing home care for low income, elderly individuals.  Why then do these programs cover the cost of adult day care?  Medicaid, like most government programs, is under pressure to contain its costs.  By paying for adult day care, Medicaid helps many families care for loved ones at home.  In doing so, this reduces the number of nursing home admissions that are paid for (or will eventually be paid for) by Medicaid.  Therefore, paying for adult day care is, in fact, a cost saving measure for most Medicaid programs. This is because the cost of adult day care is minor when compared to the cost of full-time nursing home care.

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State by State Guide to Medicaid’s Adult Day Care Benefits

The following information is current as of August 2022. It should be emphasized that even though Medicaid will pay for adult day care in every state, it is not always the best source of funding. Medicaid’s reimbursement rates for adult day care are not high and not all adult day care centers will accept Medicaid enrollees. Readers are encouraged to consider both Medicaid and the alternative options available to them in each state (listed in the column on the right side of the table).

2022 Medicaid Adult Day Care Benefits – State by State

StateMedicaid Policies & Programs that Cover Adult Day CareOther ADC and Assistance Options
Alabama In Alabama, the Elderly and Disabled Medicaid Waiver pays for Adult Day Health Care. As does Alabama Community Transition Waiver, but only for nursing home residents returning home. Find Local Adult Day Care in AL
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Alaska The Alaskans Living Independently Waiver pays for Adult Day Care. Another option is the Adults with Physical & Developmental Disabilities Waiver. AK Adult Day Services Program
Find Local Adult Day Care in AK
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Arizona Arizona, through its managed care system called Arizona Long Term Care Services (ALTCS), covers adult day care. Arizona Non-Medical HCBS
Find Local Adult Day Care in AZ
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Arkansas ARChoices covers adult day care. Find Local Adult Day Care in AR
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California Under the Community-Based Adult Services program, adult day care is a benefit. Medi-Cal also continues to cover adult day care through the Multipurpose Senior Services Program Waiver. Find Local Adult Day Care in CA
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Colorado Colorado pays for adult day care and adult day health care through the Elderly, Blind and Disabled Waiver. Home Care Allowance
Old Age Pension
Find Local Adult Day Care in CO
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Connecticut Connecticut’s Personal Care Assistance (PCA) Program covers adult day care, as does the Home Care Program for Elders, which is both a Medicaid and non-Medicaid program. Statewide Respite Care Program
Congregate Housing Services Program
Home Care Pro
Find Local Adult Day Care in CT
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Delaware Delaware has switched from Medicaid waivers to a managed Medicaid program. As such, the Elderly and Disabled (E&D) Waiver is no longer valid. However, adult day care is a benefit under the relatively new Diamond State Health Plan Plus. Adult Day Care Treatment
Assistance for Caregivers Program
Find Local Adult Day Care in DE
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D.C. The District of Columbia has a single, inclusive waiver called the Elderly and Person with Disabilities (EPD) Waiver, which offers adult day care as a benefit. It is also covered under the District’s regular Medicaid program. Find Local Adult Day Care in DC
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Florida Florida no longer has Medicaid waivers through which to provide for adult day care. However, the state’s Medicaid managed care program does offer this benefit. Read about the Statewide Managed Long Term Care program. Alzheimer’s Disease Initiative
Community Care for the Elderly
Project R.E.L.I.E.F.
Home Care for the Elderly Program
Florida Local Services Program
Find Local Adult Day Care in FL
Georgia Both Georgia’s Community Care Services Program and the SOURCE Waiver include adult day health care as a benefit. Non-Medicaid HCBS
Find Local Adult Day Care in GA
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Hawaii Hawaii has a managed Medicaid program called Med Quest. Under Med Quest, there are benefits for both adult day social and medical care. Kupuna Care
Kupuna Caregivers Program
Community Living Program
Find Local Adult Day Care in HI
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Idaho Idaho Medicaid has the HCBS Aged & Disabled Waiver, which covers adult day care, as well as the Medicare Medicaid Coordinated Plan. Senior Services Respite
Find Local Adult Day Care in ID
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Illinois The Illinois HCBS Waiver for the Elderly covers adult day care, as does the Community Care Program. Two managed Medicaid programs are also relevant: HealthChoice Illinois and Medicaid-Medicare Alignment Initiative. Illinois Community Care
Find Local Adult Day Care in IL
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Indiana Indiana’s Aged and Disabled Waiver (A&D) pays for adult day care. Indiana Choice
Find Local Adult Day Care in IN
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Iowa Iowa HCBS Elderly Waiver covers adult day care, as does the Health and Disability Waiver for persons under 65 years of age. Case Management for Frail Elders
Find Local Adult Day Care in IA
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Kansas Kansas’ HCBS Frail and Elderly Medicaid Waiver pays for adult day care. Kansas Senior Care Act
Find Local Adult Day Care in KS
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Kentucky Kentucky’s Home and Community Based (HCB) Waiver Program for Aged and Disabled pays for adult day health care, but not adult day social. The Supports for Community Living Waiver also has this benefit, but not for most seniors. Hart-Supported Living
Homecare Program
ADC and Alzheimer’s Respite
Find Local Adult Day Care in KY
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Louisiana The following Louisiana waivers pay for adult day care: Adult Day Health Care (ADHC) Waiver and the Community Choices Waiver. Find Local Adult Day Care in LA
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Maine MaineCare offers the Older Adults and Adults with Disabilities Waiver, which covers adult day health care as does the state regular Medicaid program. Maine Home-Based Care
Caregiver Respite
Find Local Adult Day Care in ME
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Maryland Maryland has several programs which cover adult day care or adult day medical care. These are the Waiver for Older Adults, Community Pathways, the Medical Day Care program and the Increased Community Services Program. Senior Care Program
Find Local Adult Day Care in MD
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Massachusetts Mass-Health covers adult day care under the Frail Elder Home and Community-Based Services Waiver (HCBS). Under regular Medicaid there is also an Adult Day Health benefit. HCP and ECOP Programs
Find Local Adult Day Care in MA
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Michigan Through the Michigan Choice Waiver Program, the state will pay for adult day care. Under the self-directed Home Help Program, it is likely participants can use funds to pay for adult day care as well. Finally, the newer Health Link Program helps, but is not available in all counties. Find Local Adult Day Care in MI
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Minnesota Minnesota pays for adult day care through the Medicaid Waiver called the Elderly Waiver. As with most waivers, participation is limited. Another option is the Community Access for Disability Inclusion Waiver. Alternative Care Program
Essential Community Supports
Find Local Adult Day Care in MN
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Mississippi In Mississippi, the Elderly and Disabled (E&D) Waiver includes adult day care as a benefit to its beneficiaries. Mississippi In-Home Services
Find Local Adult Day Care in MS
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Missouri Missouri Medicaid’s Aged and Disabled Waiver pays for adult day care. The Medicaid Care Options (MCO) has specific benefits for individual participants, and ADC is an approved benefit. Find Local Adult Day Care in MO
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Montana Montana’s Home and Community Based Services Medicaid Waiver will cover the cost of adult day care for its participants. Find Local Adult Day Care in MT
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Nebraska Nebraska offers residents the Aged and Disabled Medicaid Waiver. Under this waiver, adult day care is an included benefit. The PAS program provides for a person attendant, which can be an employee of an adult day care center. Nebraska Social Services for Aged
Lifespan Respite Subsidy Program
Find Local Adult Day Care in NE
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Nevada Nevada Medicaid pays for adult day care through the HCBW for the Frail Elderly as well as through their State Plan. Nevada COPE
Find Local Adult Day Care in NV
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New Hampshire The Choices For Independence Medicaid program pays for adult day care, though the program does not refer to this service using that phase. Instead they use the phrase Adult Medical Day Services. The distinction is important as the program does not cover adult day social care. Find Local Adult Day Care in NH
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New Jersey New Jersey has a statewide managed Medicaid program. The adult day care benefit was preserved under this new program. Read more. NJ Alzheimer’s Adult Day Care
NJ Assistance for Community Caregiving
Statewide Respite Care
Find Local Adult Day Care in NJ
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New Mexico New Mexico has re-designed their Medicaid program. It is now called Centennial Care, and there is a program within Centennial Care called Community Benefit. Under Community Benefit, adult day care is offered. Older Americans Act
Find Local Adult Day Care in NM
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New York New York’s Managed Long Term Care Program Waiver covers both adult day social care and health care as does the State Plan. Adult day health care is also available via the Assisted Living Program. Expanded In-Home Services for the Elderly
Community Services for the Elderly
Find Local Adult Day Care in NY
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North Carolina North Carolina, through the CAP/ DA Medicaid Waiver, pays for adult day care. The Special Assistance In-Home Program for Adults provides a cash benefit, which can be used for adult day care. North Carolina Project C.A.R.E.
Find Local Adult Day Care in NC
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North Dakota North Dakota’s Medicaid Waiver for Aged and Disabled pays for adult day care. ND Older Americans Act Services
SPED and EX-SPED
Find Local Adult Day Care in ND
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Ohio The PASSPORT Waiver covers adult day care. A managed Medicaid program called MyCare Ohio, although not available statewide, also provides assistance. Older American Act Services
Ohio Elderly Services Program
Find Local Adult Day Care in OH
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Oklahoma Through Oklahoma Medicaid’s ADvantage Program Waiver, services in adult day health care communities are covered. There is also an Adult Day Services Program available through the state Medicaid plan. Oklahoma Adult Day Services
Find Local Adult Day Care in OK
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Oregon Oregon offers adult day health through the K Plan, also called Community First Choice. This program does not limit enrollment. Project Independence
Find Local Adult Day Care in OR
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Pennsylvania Services My Way, a self-directed care program, pays for adult daily living services. Another Medicaid program, Community HealthChoices, is available for persons dually eligible for Medicaid and Medicare. Options Program
Find Local Adult Day Care in PA
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Rhode Island Rhode Island Global Consumer Choice Compact Waiver pays for adult day health care. The State Plan also has this benefit. Home and Community Care Co-Pay
CareBreaks Program
Find Local Adult Day Care in RI
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South Carolina The Community Choices Waiver covers adult day health care and transportation, as does the Community Supports Waiver. Find Local Adult Day Care in SC
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South Dakota South Dakota Medicaid’s Home & Community Based Waiver Services for the Elderly’s benefits include adult day care. Caregiver Support Program
Find Local Adult Day Care in SD
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Tennessee The TennCare CHOICES in Long-Term Care Program covers adult day care. OPTIONS for Community Living
Find Local Adult Day Care in TN
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Texas Texas has now moved to a statewide Medicaid managed care program called the Star Plus Waiver. Adult day care is an included benefit of this program and the State Plan. Day Activity and Health Services has this benefit, but is limiting enrollment. Community Care for Aged/Disabled
Find Local Adult Day Care in TX
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Utah Utah Medicaid pays for adult day health services under the Aging Waiver for Individuals Age 65 or Older, as well as the New Choices Waiver. The Alternatives Program
Find Local Adult Day Care in UT
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Vermont The Vermont Global Commitment to Health Waiver has this benefit, as does the Choices for Care Waiver, which consolidated with the Global Waiver. CFC Moderate Needs Group Services Program is part of Choices for Care and also offers adult day care. The state also a specific program called Adult Day Services, which offers ADC under the regular Medicaid program. Dementia Care Respite Grants
Find Local Adult Day Care in VT
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Virginia Virginia pays for adult day care through the Commonwealth Coordinated Care Plus Waiver. Virginia Adult Services
Find Local Adult Day Care in VA
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Washington The COPES Program (Community Options Program Entry System Waiver) covers both adult day and adult care health care as does New Freedom. The newer Medicaid Alternative Care Program also covers it. Tailored Support for Older Adults
Find Local Adult Day Care in WA
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West Virginia West Virginia Medicaid does not include direct assistance for adult day care. Family Alzheimer’s In-Home Respite
Find Local Adult Day Care in WV
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Wisconsin Wisconsin residents can receive adult day care through the IRIS Program. Worth noting is that COP-W and CIP-II have both expired. However, the benefit will continue to be available under Family Care and Partnership. Alzheimer’s Caregiver Support
Find Local Adult Day Care in WI
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Wyoming Wyoming HCBS Waiver paid for adult day care until it was absorbed by the Community Choices Waiver. The relatively new waiver continues to offer the same benefits. Wyoming Home Services
Find Local Adult Day Care in WY
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