Which Medicaid Plans Cover Adult Day Care in Montgomery County, PA?

If your loved one is on Medicaid in Montgomery County and you’re exploring adult day care, you’ll be dealing with one of three Managed Care Organizations (MCOs) through Pennsylvania’s Community HealthChoices program. SarahCare Adult Day Center in Jenkintown is in-network with all three. Here’s what you need to know about each plan and how adult day care coverage works. 

The Three CHC MCOs in Montgomery County 

Keystone First Community HealthChoices 

Keystone First is one of the largest Medicaid managed care plans in Pennsylvania, with a deep footprint in the Southeast Zone including Montgomery County. Keystone First Community HealthChoices members who qualify for Long-Term Services and Supports can access adult day care as a covered benefit. SarahCare is a Keystone First network provider. Service Coordinators at Keystone First work with members to develop care plans that can include adult day services at SarahCare. 

UPMC Community HealthChoices 

UPMC Community HealthChoices provides integrated medical and long-term support services for Medicaid participants in the Southeast Zone. UPMC CHC members who meet LTSS eligibility criteria can have adult day care covered under their care plan. SarahCare is in the UPMC CHC network, and our staff coordinates regularly with UPMC Service Coordinators to facilitate enrollment and care plan development. 

PA Health & Wellness 

PA Health & Wellness (a Centene company) is the third CHC MCO operating in the Southeast Zone. PA Health & Wellness Community HealthChoices members who qualify for LTSS can include adult day services in their care plan. SarahCare accepts PA Health & Wellness authorizations and works with the plan’s Service Coordinators on enrollment. 

How to Request Adult Day Care Through Your MCO 

If your loved one is already enrolled in one of these three plans, the process for adding adult day care services generally works as follows: 

1. Contact your MCO’s Member Services line and request to speak with your Service Coordinator, or request a care plan review. 
2. Explain that you are interested in adding adult day services to the care plan. Provide any recent changes in health status or care needs that support the request. 
3. Specify that you would like to attend SarahCare Adult Day Center in Jenkintown (261 Old York Road, Suite A51, Jenkintown, PA 19046). 
4. The MCO will review the request, potentially conduct or update the LTSS needs assessment, and issue an authorization if approved. 
5. SarahCare’s enrollment team coordinates with the MCO to confirm the authorization and schedule your start date. 

What We See in Practice 

When families call us asking which Medicaid plan to choose for their loved one, our honest answer is that all three plans work well for adult day care access at SarahCare — we have positive working relationships with Service Coordinators across all three MCOs. The plan selection decision matters more for medical care choices, specialists, and hospitals. For adult day care specifically, any of the three CHC plans gives you access to SarahCare. 

Additional Medicaid Resources in Montgomery County 

Montgomery County has additional resources for seniors that can work alongside or provide a bridge to CHC services. The Montgomery County Office of Senior Services (MCOSS) administers OPTIONS, a state-funded program that can provide home and community-based services to seniors who are not yet enrolled in CHC. Contact MCOSS at 610-278-3601 for information on OPTIONS eligibility and services. 

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.

Written by Sophia Aloia  |  Content & SEO Manager, SarahCare 

Sophia Aloia helps Montgomery County families navigate Community HealthChoices Medicaid options for adult day care, coordinating directly with MCO Service Coordinators to get participants enrolled at SarahCare.