Adult Day Care Cost by State 2025

Staff wages are the largest expense for any adult day care center — typically 60–70% of operating costs. States with higher minimum wages and competitive labor markets (Maine, New England, Pacific Northwest) see direct cost pass-through. (Source: Genworth/CareScout Cost of Care Survey 2024)

States that require higher staff-to-participant ratios or mandate more licensed nursing hours (e.g., RN on-site) push up baseline costs regardless of program type. (Source: Genworth/CareScout Cost of Care Survey 2024)

States with few providers relative to senior population — North Dakota, South Dakota, Wyoming — have less competitive pricing. Rural centers also face higher transportation and supply costs. (Source: Genworth/CareScout Cost of Care Survey 2024)

States with generous Medicaid HCBS waiver reimbursements attract more providers, increasing competition and moderating private-pay rates. Texas and the South have higher Medicaid enrollment but lower reimbursement rates, keeping private-pay prices anchored lower. (Source: Genworth/CareScout Cost of Care Survey 2024)

Which state has the lowest adult day care cost?

Texas has the lowest median adult day care cost at approximately $59 per day ($1,300/month), well below the national median of $95/day. Other affordable states include North Carolina ($68/day), Alabama ($69/day), and Georgia ($71/day). Lower costs in these states reflect lower labor costs and active Medicaid enrollment. (Source: Genworth/CareScout Cost of Care Survey 2024)

Which state has the highest adult day care cost?

Maine has the highest median adult day care cost at approximately $158 per day ($3,467/month) — more than 2.5 times the national median. North Dakota ($151/day) and Vermont ($151/day) are close behind. High labor costs, strict staffing requirements, and limited provider competition drive costs in these states. (Source: Genworth/CareScout Cost of Care Survey 2024)

Does Medicaid cover adult day care in all 50 states?

Most states cover adult day care through Medicaid Home and Community-Based Services (HCBS) waivers for financially eligible seniors. However, waiver availability, income thresholds, and functional eligibility requirements differ by state. Some states have waiting lists. In every state, Medicaid-covered clients pay little or nothing out of pocket. Check with your state's Medicaid agency or Area Agency on Aging for current eligibility rules. (Source: CMS HCBS Waiver Program data)

How much more expensive is adult day care in high-cost states vs. low-cost states?

The spread is significant: Maine at $158/day is approximately 2.7 times more expensive than Texas at $59/day. A family using adult day care 5 days per week would pay roughly $14,300/year in Texas vs. $38,000/year in Maine. This makes state of residence one of the most important cost factors after program type and hours of use. (Source: Genworth/CareScout Cost of Care Survey 2024)

Are these daily rates for social or medical model adult day care?

The Genworth/CareScout figures represent adult day health care medians across both social and medical model programs in each state. Social model (activities, meals, supervision only) programs are typically 20–30% less expensive than medical model programs (nursing care, therapy, medication management). If your loved one needs medical-level services, expect to pay 20–40% above the state median shown here. (Source: Genworth/CareScout Cost of Care Survey 2024)