Adult Day Care vs. Assisted Living: Cost, Quality of Life, and What Medicaid Covers

When a family realizes their aging parent needs more support, assisted living often comes up as the default answer — the mental model most people have for ‘what happens next.’ But adult day care is frequently the better choice: less expensive, Medicaid-covered, and it lets your loved one sleep in their own bed every night. Here’s a plain comparison of the two options. 

The Basic Difference 

Assisted living is residential placement. Your loved one moves out of the family home into a facility and lives there around the clock. Adult day care is daytime-only community-based care. Your loved one attends the day center on weekdays, returns home each evening, and sleeps in their own home with their family. It’s not a compromise — for many families, it’s genuinely the better model. 

Cost Comparison 

The cost difference is significant: 

• Adult day care in the Philadelphia area: roughly $75–$110 per day, or approximately $1,500–$2,200 per month for five days per week 

• Assisted living in Montgomery County / Philadelphia suburbs: typically $4,500–$7,000+ per month, depending on the level of care and amenities 

• Memory care assisted living (for dementia): often $6,000–$9,000 per month 

For many families, adult day care costs a fraction of what assisted living would cost — and for Medicaid-eligible participants, adult day care may be covered at no cost. 

Medicaid Coverage: A Critical Difference 

This is where the comparison becomes starkest. Pennsylvania’s Community HealthChoices Medicaid waiver covers adult day care for eligible participants. SarahCare is in-network with all three CHC Southeast Zone MCOs: Keystone First, UPMC Community HealthChoices, and PA Health & Wellness. 

Most assisted living facilities in Pennsylvania do not accept Medicaid at all — and those that do typically require a significant private-pay period before Medicaid kicks in. This means that a family with limited resources may find that adult day care, combined with home-based care, is their only Medicaid-covered option that preserves their loved one’s current living situation. 

For more on how Medicaid pays for adult day care in Pennsylvania, see: How Medicaid Pays for Adult Day Care in Pennsylvania (Community HealthChoices). 

Quality of Life: Sleeping at Home Matters 

There’s a meaningful quality-of-life argument for adult day care that often gets overlooked in purely clinical conversations. People do better when they sleep in familiar environments, maintain family relationships, and retain a sense of home. For individuals with dementia especially, moving to a new residential facility can accelerate cognitive decline — the disruption of environment and routine is itself harmful. 

Adult day care preserves the home. It gives your loved one structure, engagement, and professional care during the day without requiring the disruption of residential placement. 

In Our Experience at SarahCare 

We’ve had many families come to us who had already toured assisted living facilities and were planning a move. When they discovered that adult day care through Medicaid could provide comparable daytime programming and clinical oversight at little to no cost — while keeping their parent at home — the decision wasn’t difficult. The families most likely to regret not exploring adult day care are those who moved a parent into assisted living before asking whether there were alternatives. We encourage every family to ask the question before committing to a placement. 

When Assisted Living Is the Right Answer 

Adult day care doesn’t work for everyone. If a person needs 24-hour supervision, has complex medical needs that require around-the-clock nursing care, or has no family member available to provide evenings and overnight care, assisted living or skilled nursing may be more appropriate. The decision depends on the full picture of the person’s needs and the family’s capacity — not on default assumptions about what ‘comes next’ with aging. 

Frequently Asked Questions 

Ready to Learn More? 

Schedule a free tour of SarahCare Adult Day Center in Jenkintown. 

Call us: 215-999-1200 or contact us here.