Introduction
The exact offerings and times can vary by location, but in general Adult Day Care (ADC) centers provide supervision, social activities, exercise and meals for seniors during regular business hours – weekdays from 9-5. Some ADC locations might also provide medical oversight and care, as well as specialized services, including care for seniors with Alzheimer’s disease or other dementias. Medicaid will cover some form of ADC for qualified seniors in every state except one. It should be noted that ADC centers can also be used by adults with disabilities, but this article will focus on seniors.

The Three Types of Adult Day Care

ADC facilities are divided into three categories based on the level of care they provide – Social Adult Day Care, Adult Day Health Care and Specialized Adult Day Care.

• Social Adult Day Care may also be referred to as Adult Day Services. Social Adult Day Care facilities offer the most basic care of the three ADC levels. They provide seniors with supervision, social activities, exercise and meals, but they do not provide any personal care or medical care. So, Social Adult Day Care facilities would not be appropriate for seniors who need help with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) or who have a chronic illness or dementia. But they can be a great option for seniors who would otherwise be alone on a daily basis. The regular activities and socialization of this type of ADC can help seniors maintain their mental and physical well-being.

• Adult Day Medical Care is also called Adult Day Health Care in some places. Adult Day Medical Care locations offer supervision, activities and meals just like the Social Adult Day Care facilities described above, but Adult Day Medical Care facilities also offer medical benefits that might include medication management, regular health assessments, physical and occupational therapy, and personal care assistance with the Activities of Daily Living. Adult Day Medical Care facilities are able to offer this type of care because they have trained nurses and other types of healthcare professionals on their staff. This level of care can prevent nursing home placement for seniors who might not be able to feed themselves, remember their medication or stay safe if they were left alone for extended periods of time.

• Specialized Adult Day Care is for seniors who have Alzheimer’s disease or another form of dementia, such as vascular dementia or Lewy Body dementia, and need specific types of care in specially designed settings. So, Specialized Adult Day Care locations are staffed with professionals who have been trained to communicate with and care for dementia patients. These facilities might also include features that are beneficial for people with dementia, such as bright lighting, large digital clocks and security measures that prevent wandering. These facilities also offer the kind of medical oversight and care provided in Adult Day Medical Care, and the supervision, activities and meals offered in Social Adult Day Care.

Some ADC locations might offer all three types of care, while others may only offer one or two. All ADC facilities must be licensed and regulated by the state, and all administrators and staff members must be appropriately qualified and/or trained. Some states also require a certain staff-to-resident ratio for ADC facilities, which usually falls between 4-to-1 and 10-to-1 residents per staff member.

Adult Day Care Costs

The cost of services is included in the daily fee for most ADC facilities, which averaged $71/day in the U.S. in 2024, according to the Cost of Care Survey conducted by Genworth and CareScout. That daily fee can vary depending on the facility, and seniors can expect to pay more for Specialized Adult Day Care or Adult Medical Day Care than they would for Social Adult Day Care. The cost can also vary dramatically by state. In Delaware, for example, the average fee for Adult Day Care was just $25/day in 2024, it was $59/day in Ohio, and it was $202/day in Oregon.

Medicaid Coverage of Adult Day Care

Medicaid primarily covers ADC through Home and Community Based Services (HCBS) Waivers, but it will also cover ADC through Aged, Blind and Disabled (ABD) Medicaid, which is also known state or regular Medicaid for seniors. The only state that does not offer Medicaid coverage for ADC for seniors is Maine.

Applicants for HCBS Waivers or ABD Medicaid need to meet financial and medical requirements. The medical eligibility criteria for HCBS Waivers is needing a Nursing Facility Level of Care (NFLOC), or being at risk for needing a NFLOC. To receive long-term care benefits such as Adult Day Care via ABD Medicaid, however, applicants only have to show a need for that particular benefit.

Seniors and their families can get a better understanding of their level of care needs and how that matches up with the eligibility requirements in their state with our Level of Care Needs Assessment Service. They can also use this free online test to see if they meet their financial criteria. And seniors who don’t meet their financial requirements can still qualify with the help of a Certified Medicaid Planner.

Program of All-Inclusive Care for the Elderly (PACE)

Seniors age 55 and older who live in the community but require a NFLOC can qualify for the Program of All-Inclusive Care for the Elderly (PACE). All PACE programs have PACE day centers which provide Adult Day Care. All PACE centers operate at an Adult Day Medical Care level, and most can offer Specialized Adult Day Care for seniors with Alzheimer’s and other dementias. PACE will also coordinate all medical, social service and long-term care coverage into one streamlined plan for program members, including Medicaid and Medicare coverage. Although seniors do not have to be enrolled in Medicaid to be a PACE member, Medicaid will pay all PACE fees for its beneficiaries.

PACE is also known as Living Independence for the Elderly (LIFE) in some states. There are currently 194 PACE/LIFE programs operating in 33 states and Washington, D.C.