Adult Day Care Benefits in Ohio: Who Pays and How to Find Help

Quick answer

Ohio may help pay for adult day care when the person needs daily support and the service is part of an approved care plan. The main routes are PASSPORT, MyCare Ohio, the Ohio Home Care Waiver, PACE, VA adult day health care, and local Area Agency on Aging caregiver programs.

Medicare by itself usually does not pay for non-medical adult day care. Some Medicare-linked programs, such as PACE, may include adult day services when the person qualifies.

What adult day care means in Ohio

Adult day care is daytime care outside the home. Ohio often uses the term adult day service. Some programs may call it adult day health, adult day health center service, or adult day health care.

A center may offer planned activities, meals, supervision, health checks, personal care help, medication help, and rides. Some programs focus on social needs. Others offer more health support.

For caregivers, the main benefit is time. Adult day care can make it possible to keep a job, go to appointments, rest after a hard night, or handle errands without leaving a loved one alone.

Ohio adult day programs are not all the same. A center may serve people with dementia, people with physical disabilities, people who need nursing support, or adults who mainly need a safe social setting. Ask what level of care the center can handle before you enroll.

Who may pay for adult day care in Ohio

The table below shows the main routes to check first. It does not promise approval. It helps you decide where to start.

Medicaid and waiver coverage

Medicaid is often the first payment route to check for adult day care in Ohio. But regular Medicaid coverage and waiver coverage are not the same.

A waiver is a Medicaid program that can pay for home and community services. These services may help a person avoid or delay nursing home care. Waivers have care need rules, financial rules, provider rules, and care plan rules.

Adult day care is not paid just because a family wants a break. It usually must be approved as part of the person’s service plan. The center also may need to be approved for that program.

PASSPORT

PASSPORT is one of Ohio’s main home and community programs for older adults. The Ohio Department of Aging says PASSPORT services can include adult day care, home delivered meals, non-medical transportation, personal care, homemaker help, medical transportation, nursing, and other supports.

PASSPORT is usually the first Medicaid waiver route to ask about when the person is age 60 or older, has or may qualify for Medicaid, needs a nursing home level of care, and wants to remain at home.

Ask for a PASSPORT assessment. The local PASSPORT Administrative Agency or Area Agency on Aging will explain the steps, check care needs, and tell you how to apply for Medicaid if needed.

Ohio has also added Structured Family Caregiving to PASSPORT. That is not the same as adult day care. It may matter if the person lives with a caregiver and needs daily support. Ask about it if you are also trying to learn whether a live-in family caregiver can be paid. You can also read Can I get paid to be a caregiver? and try the caregiver pay quiz.

MyCare Ohio

MyCare Ohio is for people who have both Medicare and Medicaid. Ohio says the Next Generation MyCare plan includes benefits available through traditional Medicare and Medicaid, including long-term care services in the community, assisted living, and nursing facilities.

If your loved one has MyCare Ohio, call the plan care manager. Ask if adult day, adult day health, transportation, or respite can be added to the care plan.

Use these words: “I need a care plan review. My family member cannot be left alone during the day. Can the plan assess for adult day services or adult day health services?”

Ohio Home Care Waiver

The Ohio Home Care Waiver is run by the Ohio Department of Medicaid. It is designed for people with physical disabilities and unstable medical conditions who need care in their home or community instead of a nursing facility, hospital, or rehab facility.

Ohio’s rules use the term adult day health center service for this waiver. This can be different from a private social adult day program. Ask the waiver case manager what type of center is allowed and whether the service can be added to the plan.

PACE

PACE stands for Program of All-Inclusive Care for the Elderly. In Ohio, PACE is for people age 55 or older who live in a PACE service area and need an intermediate or skilled level of care. Ohio says payment options may include Medicare, Medicaid, and private pay.

PACE can include services at a PACE center, in the home, and in the community. It may include adult day health services, meals, transportation, primary care, therapy, personal care, and other supports when the PACE team approves them.

PACE is not in every county. Check the Ohio Department of Aging PACE page before counting on it.

Medicare by itself

Original Medicare does not usually pay for long-term care or custodial care when that is the only care needed. Adult day care is often treated as long-term support, not a Medicare medical visit.

There are exceptions to check. PACE may include adult day primary care and related services. Some Medicare Advantage plans may offer extra benefits, but these vary by plan and year. Call the plan and ask for the rule in writing.

For more background, see Medicaid HCBS waivers explained, Medicaid spend-down, and Medicaid look-back period.

Adult day health vs social adult day care

Families often use one phrase for many kinds of programs. Payment offices may not.

A social adult day program may focus on activities, meals, supervision, and social time. A health model may include health monitoring, skilled nursing, medication help, therapy, or closer support with daily care.

Ohio’s adult day service rules refer to different service levels and required parts of service. Ohio Home Care Waiver rules use the term adult day health center service. VA uses adult day health care.

When you call a center, do not only ask, “Do you take Medicaid?” Ask the exact payment source. For example: “Are you approved for PASSPORT adult day?” or “Do you accept MyCare Ohio members through this plan?” or “Are you authorized for VA adult day health care?”

VA adult day health care

VA adult day health care is for eligible Veterans who need daytime support. VA describes adult day health care as a program where Veterans can go during the day for social activities, peer support, companionship, and recreation. It may also serve Veterans who need skilled services, case management, or help with daily tasks.

This route is not the same as a state Medicaid waiver. The Veteran usually needs to work through VA health care. A VA social worker, primary care team, or caregiver support staff member can tell you what is open near you and whether the Veteran may qualify.

VA respite may also help caregivers. VA respite can include in-home support, adult day health care, or a short stay in a facility when approved by VA.

If the Veteran also has Medicaid or Medicare, tell VA. More than one program may be involved, but they may have rules against paying twice for the same service.

For related help, see VA Aid and Attendance.

Dementia day programs

Adult day care can be a key support when a person has Alzheimer’s disease or another dementia. It may give the person a safe routine and give the caregiver steady time away.

Ohio’s Department of Aging points caregivers to dementia support and says Area Agencies on Aging can help connect families with home and community supports. Ohio also has the Golden Buckeye Center for Dementia Caregiving as a dementia caregiver resource.

Payment still depends on the program. A dementia diagnosis alone does not mean adult day care is free. Ask if the person should be screened for PASSPORT, MyCare Ohio, PACE, VA adult day health care, local respite funds, or private-pay dementia day programs.

Transportation and meals

Transportation can decide whether adult day care is possible. Some centers provide rides. Some contract with a transportation provider. Some expect the family to bring the person.

Ohio adult day service rules include transportation requirements unless the caregiver transports the person or chooses another person to do it. But the exact ride plan can vary by center, county, waiver, and care plan.

Meals also vary. Many adult day programs include lunch. Some may offer snacks, special diets, or help with eating. If your loved one has diabetes, swallowing problems, allergies, or weight loss, ask how the center handles meals before the first day.

Ask these questions:

• Is transportation included in the daily rate or billed separately?
• Can the driver help the person from the door to the vehicle?
• Can the ride handle a wheelchair, walker, or oxygen?
• What time is pickup and drop-off?
• Are meals included?
• Can the center follow a special diet?

How to find a program

Start with the payment route, not just the closest center. A nearby center may not accept the program that can pay for care.

Step 1: Call the Area Agency on Aging

Call 1-866-243-5678. Ask for the Area Agency on Aging that serves your county. Tell them the person’s age, county, Medicaid status, Medicare status, veteran status, diagnosis, and the hours of care you need.

Ask for screening for PASSPORT, caregiver respite, adult day services, meals, rides, and PACE if it is open in your area.

Step 2: Check Medicaid status

If the person has Medicaid, call the Ohio Medicaid Consumer Hotline at 800-324-8680 or call the Medicaid managed care plan. Ask who handles long-term services and supports.

If the person does not have Medicaid but may need it, ask how to apply through Ohio Benefits. If income or assets are an issue, read Medicaid spend-down and consider getting state-specific legal advice before moving money or changing accounts.

Step 3: Search adult day centers

Ohio points families to AdultDayOhio.org, a joint effort from the Ohio Department of Aging and LeadingAge Ohio. It has a county-based adult day center finder.

Use the finder to build a short list. Then call each center and ask about payment before you schedule a tour.

Step 4: Ask for a care plan review

If the person already has PASSPORT, MyCare Ohio, the Ohio Home Care Waiver, PACE, or VA care, ask for a care plan review. Explain why the current plan is not enough.

Give examples. “I work from 8 to 4.” “He left the stove on.” “She cannot take medicine safely without help.” “He needs help in the bathroom.” Real details help the assessor understand the need.

Questions to ask before enrolling

Ask these before the first paid day. A good center should be able to answer clearly.

• Do you accept PASSPORT, MyCare Ohio, Ohio Home Care Waiver, PACE, VA, private pay, or long-term care insurance?
• Are you certified or approved for the payment program we may use?
• What is included in the daily rate?
• Are transportation and meals included?
• Can you help with toileting, bathing, walking, eating, or transfers?
• Can you give medication or remind the person to take medicine?
• Do you serve people with dementia?
• What behaviors or medical needs would make someone not a good fit?
• What forms must the doctor complete?
• What happens if my loved one is sick, refuses to attend, or needs to leave early?
• Is there a trial day?
• Is there a waitlist?

If you are trying to keep working

Tell the agency or plan that work is part of the problem. Do not just say you are tired. Say what hours you need covered and what happens if care is not in place.

Adult day care may help cover a work shift, but the hours may not match your job. Ask about early drop-off, late pickup, part-time schedules, transportation times, and backup plans for center closures.

If adult day care does not cover enough hours, ask about a mix of services. That may include personal care, homemaker help, respite, home-delivered meals, transportation, or caregiver support.

You may also want to read respite care for caregivers, care cost calculator, and caregiver tax deductions.

About this guide

This guide was written for family caregivers in Ohio who need a real payment path for adult day care. It focuses on public programs, local screening, care plan steps, and what to ask before enrolling.

Program names, county routes, and plan rules can change. Always confirm with the Ohio Department of Aging, Ohio Medicaid, the Area Agency on Aging, the managed care plan, VA, or the adult day center before making a care decision.