Will Medicare or Medicaid cover adult day care expenses?

Text Size: - +

8 Comments

 Print

Email Email

Q: I am the full-time caregiver for my mom, and I also work full-time. She cannot be left home alone all day, so I am looking into adult day care. Will her Medicare or Medicaid pay for it?

A: Neither Medicare nor Medicaid will pay for adult day care. Check with your local Area Agencies on Aging for a list of resources that might be able to help you offset the costs.

In some cases Medicaid will provide for care in the home or in an assisted living facility, under the HCBS (Home and Community Based Services) program available in many communities.

While Medicare does not cover adult day care centers, Medicaid will pay most or all of the costs in licensed adult day health care settings and Alzheimer's focused centers, for participants with very low income and few assets. adult day health care, which usually requires a health assessment by a physician before someone is admitted into the program. Adult day health centers, which typically use the term "Adult Day Health Care" (ADHC) in their names, often provide physical, occupational, and speech therapy, and are usually staffed with an RN and other health professionals.

A third type of day care provides social and health services specifically for seniors with Alzheimer's or a related type of dementia.

Other Payment Options

Private medical insurance policies sometimes cover a portion of adult day care center costs when licensed medical professionals are involved in the care. Long-term care insurance may also pay for adult day services, depending on the policy.


K. Gabriel Heiser is an elder law attorney and author of "How to Protect Your Family's Assets from Devastating Nursing Home Costs: Medicaid Secrets." Read his full biography

 
 

Comments

 
  •  Comments 1 to 8 of 8 
 
 

N1K2R3

Give a Hug

Jun 1, 2011

Have you priced the cost of LTC insurance? Have you seen the exemptions that are not allowed on these policies? It's a game that should be exposed.

 
 

MollyMac

Give a Hug

Jun 1, 2011

Medicaid DOES cover adult day programs. Each state regulates Medicaid uniquely.

 
 

What is the third type of day care provides social and health services specifically for seniors with Alzheimer's or a related type of dementia?

 
 

MollyMac

Give a Hug

Jun 1, 2011

There are three types of adult day care:
1. Adult day social care provides social activities, meals, recreation, and some health-related services.
2. Adult day health care offers more intensive health, therapeutic, and social services for individuals with severe medical problems and for those at risk of nursing home care.
3. Alzheimer’s specific adult day care provides social and health services only to persons with Alzheimer’s or related dementia.

 
 

N1K2R3

Give a Hug

Jun 2, 2011

Medicaid does cover adult day care programs?? I don't think so. As you know, Medicaid is a state-funded program and very expensive.

 
 

MollyMac

Give a Hug

Jun 2, 2011

It depends on the state.

 
 

DonnaNestle

Give a Hug

Jun 2, 2011

Medicaid will cover Adult Day in many states,Sometimes the Adult Day has to be a Medical Model. Some Adult day programs are only a Social Model, similar to a Senior Center. The best way to find out if your state is one, is to connect with your local Area Agency on Aging. If it is not covered, they can often help you with finding an alternative. Possibly they would have grants available to help, or would know of agencies that might offer a grant or sponsor a person to go to Adult Day. Many Adult Day programs also offer a sliding scale for folks who have limited resources. Most states like the idea of Adult Day programs, as it is much more costly to the State if a person has to move to a Nursing Home because families cannot afford to have a loved one in a safe place while they are working. It is also a great opportunity for folks to have socialization.

 
 

immare

Give a Hug

Jun 8, 2011

In the state of Illinois, for example, their is a program called the Community Care Program, that actually offers Adult Day Care services free for the low income. Check it out with the Illinois Department on Aging.

 
  •  Comments 1 to 8 of 8 

Add Your Comment

Find Senior Housing And Care That Fits You Needs

I am looking for:
Search location:











Housing


Care


Stay Connected

Sign up for our newsletter and receive practical tips and support for caregivers