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Cost & Payment Options
The cost of attending an adult day program is determined by the type of program you choose, how often you attend, and whether you receive any government-paid health insurance, private scholarships or federal subsidies. Here are some rough guidelines:
For Those Paying Privately
- Adult day care programs start at about $30 per day. Providing a wide range of activities and support for frail adults who are at risk for falls, accidents, and depression, these programs are more affordable than home care, and more effective at alleviating isolation, encouraging appropriate exercise and providing some intellectual stimulation. Scholarships and subsidies are often available to make this option even more affordable.
- Adult day health care programs start at about $75 per day. These programs include medical services such as nursing, physical therapy, speech therapy, and occupational therapy. Some of these programs specialize in dementia care, insuring a low staff-to-participant ratio and extra family services.
- If you have any long-term care insurance, ask your insurance carrier if they cover or pay part of the expense of an adult day (ADC or ADHC) program - many do. Almost all adult day programs can accept payment from long-term care insurance companies, but check with program staff to be sure.
If You Qualify for Medi-Cal
- The cost of an Adult Day Health Care program (ADHC) is generally covered in full, at no cost to you, pending Medi-Cal approval. Staff of the adult day program will talk with family members and the person's physician, and then ask the person to meet with specialists to determine how many days per week this person would medically benefit from attendance. Staff then makes a formal request to Medi-Cal, which in turn will authorize all, some, or (very rarely) none of the requested days. It does sometimes happen that Medi-Cal approves only 3 or 4 days per week and the person wants and needs to attend 5 days a week. In these cases, the person or their family has the option of paying out of pocket for those "extra" days.
- Adult Day Care (ADC) programs are considered a "non-medical" program and therefore cannot receive either Medi-Cal or Medicare reimbursement. However, some can accept long-term care insurance, and for those paying out-of-pocket, this is the most affordable option.
If You Qualify for Both Medi-Cal and Medicare
- Programs of All-inclusive Care for the Elderly (PACE) are affordable options for individuals who qualify for both Medi-Cal and Medicare. These programs provide adult day care and other medical services including access to specialists and 24-hour emergency services. You must use medical professionals within the PACE system for full coverage. You pay only your Medi-Cal "share of cost" for PACE. If you have no share of cost for this program is free of charge to you.
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