Adult Day Care in Delaware: Programs, Medicaid Coverage, and Costs

You need to work during the day, but your parent cannot be left alone. An in-home aide for 8 hours costs $200 or more out of pocket. Adult day care programs offer structured daytime supervision at a fraction of the cost — and if your parent qualifies for Medicaid, Delaware covers it entirely through managed care.

What Adult Day Programs Provide

Licensed adult day services in Delaware operate at facilities across New Castle, Kent, and Sussex counties. A typical program runs weekdays during business hours and includes:

• Structured social activities and recreational programming
• Nursing monitoring (medication management, vital signs, chronic condition oversight)
• Physical exercises and therapeutic activities
• Nutritional support including hot meals and snacks
• Personal care assistance (toileting, mobility support)
• Transportation to and from the facility (at some programs)

Programs serve both seniors with physical limitations and those with cognitive impairment, including Alzheimer's and other forms of dementia. Staffing ratios and programming vary by facility, so visiting before enrollment matters.

Medicaid Coverage Through DSHP-Plus

Adult day services are a covered benefit under Delaware's Diamond State Health Plan Plus (DSHP-Plus) managed care program. Coverage requires:

1. Active DSHP-Plus enrollment — your parent must have passed both the financial screening ($2,000 asset limit, $2,982/month income cap or Miller Trust) and the clinical assessment (Nursing Facility Level of Care via the UAI)
2. MCO authorization — your parent's assigned Managed Care Organization (AmeriHealth Caritas, Delaware First Health, or Highmark Health Options) must include adult day services in the approved care plan
3. Clinical documentation — a negative TB test and medical history must be on file before the first day

The MCO care coordinator assesses whether adult day care is appropriate for your parent's needs and authorizes a specific number of days per week. If your parent's condition changes, the care plan can be adjusted.

When covered through DSHP-Plus, there is no out-of-pocket cost to the family.

Enrollment Timeline

Expect 7 to 14 days from initial contact to first attendance. This includes the MCO authorization process, the facility's intake assessment, medical clearance, and scheduling.

For families not yet on Medicaid, most facilities accept private pay. Some programs also receive state-funded grants that subsidize costs for eligible participants — the Delaware ADRC (1-800-223-9074) can identify which programs have available grant-funded slots.

Adult Day Care vs. In-Home Care

Both options serve families who need daytime coverage, but they solve different problems:

Adult day care works best when:

• Your parent benefits from social interaction and structured activity
• You need reliable coverage during work hours
• Your parent is mobile enough to travel to and from a facility
• You want nursing oversight without the cost of private skilled home health

In-home care works best when:

• Your parent has mobility limitations that make travel difficult
• They need help in their own environment (meal prep, housekeeping, bathing)
• Cognitive impairment makes unfamiliar settings distressing
• You need flexible hours beyond standard business-hours programs

Many families use both: adult day services during the workweek and in-home care for evenings or weekends. DSHP-Plus can cover both if the MCO care coordinator includes both in the authorized service plan.

Getting Started

Contact the Delaware ADRC at 1-800-223-9074 to identify licensed adult day programs in your county and determine whether your parent qualifies for Medicaid coverage. If your parent is already enrolled in DSHP-Plus, speak directly with their MCO care coordinator about adding adult day services to the care plan.

The Delaware Home Care Guide covers adult day services as part of the broader DSHP-Plus care planning process, including how to coordinate day programs with in-home care, respite, and other authorized services.

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