Money Talks News may earn commission or revenue through links in the content below. Our editorial team independently selects all products. Compensation does not influence our recommendations.
“Should the American taxpayers be paying so folks can play mahjong?”
That’s what Dr. Mehmet Oz, President Donald Trump’s administrator of the Centers for Medicare and Medicaid Services, asked the director of a senior day care center in Queens, New York, on Oct. 20, according to Fox News (1).
The stop was part of a broader crackdown in which CMS officials made more than 80 visits to providers across the city that day, Fox reported. Oz alleged that some seniors were being paid to take part in billing schemes, but he didn’t provide supporting evidence (1).
I’ve been a CPA since 1981, and on the core point I’m with him. If a center bills Medicaid for people who never walked through the door, that’s taking money from taxpayers and from seniors who really need the help.
But there’s a bigger lesson here for families, and it has nothing to do with mahjong.
Medicare’s own website lists adult day health care among the long-term care services it doesn’t pay for (2). When Mom or Dad needs a safe place to spend the day, the bill lands on Medicaid, if your parent qualifies, or if they don’t, on family.
It isn’t cheap. The national median for adult day health care was $95 a day in 2025, or about $24,700 a year at five days a week, according to the CareScout Cost of Care Survey (3).
And getting Medicaid to help can take time. In 2024, 40 states reported waiting lists for Medicaid home- and community-based waiver programs, and the average wait was 40 months, according to the Congressional Research Service (4).
Here are 5 things I want every family to know before they need adult day care.
1. Medicare won’t pay for it, and Medigap won’t either
Medicare.gov says Medicare doesn’t cover long-term or custodial care unless medical care is needed. It adds that Medicare and most health insurance, including Medicare Supplement (Medigap) policies, don’t pay for long-term care in a nursing home or in the community (2).
Adult day health care is right there on its list of examples, along with help with bathing and dressing, home-delivered meals and transportation (2).
That surprises a lot of people. A program with a nurse on staff sounds medical. But if the main thing Dad needs is supervision and help getting through the day, plan on Medicare paying nothing toward it.
2. Medicaid may pay, but you may wait
Adult day health services are among the services states can cover through Medicaid home- and community-based services waivers, according to the Congressional Research Service (4). Medicare.gov notes you may be eligible for long-term care through Medicaid if you meet your state’s requirements (2).
The catch is the line. With 40 states reporting waiting lists in 2024 and an average wait of 40 months, a family that waits for a crisis to apply may be paying out of pocket for a long time (4).
At $95 a day, a year of five-day weeks runs about $24,700 (3). That’s the kind of bill that can drain a parent’s savings fast, or land on the kids. If you’re still young enough to plan, insurance is one way to keep it off them.
Long-term care insurance helps fill that gap, covering services like home care, assisted living, and help with daily tasks. Rates are typically lowest if you buy in your 50s or early 60s, couples often qualify for discounts, and premiums may even be tax-deductible.
Policies differ on exactly which services they cover, so read the benefit list before you buy. See a list of the best LTC insurance companies here.
Quick aside — most internet financial advice comes from people who weren’t alive during the last recession. I’ve been writing about money for more than 35 years. Want rock-solid advice? Sign up for the free Money Talks Newsletter. Takes 10 seconds. No fluff. No spam.
3. If your parent is a veteran, call the VA
The Department of Veterans Affairs runs an Adult Day Health Care program for veterans who need help with activities of daily living. Enrolled veterans can qualify if they’re eligible for community care and meet clinical criteria, according to the VA (5).
There may be a copay, depending on the veteran’s service-connected disability status, the VA says (5). Even so, it’s worth a phone call before you sign a private-pay contract.
4. Never sign for days your parent didn’t attend
Oz’s warning is worth taking seriously even if you never set foot in New York. If a center offers your parent cash or gifts to enroll, or asks you to sign attendance sheets for days nobody showed up, walk away.
That’s the kind of thing that can get your family tangled up in someone else’s fraud. You can report suspected Medicare or Medicaid fraud to the HHS Office of Inspector General at 1-800-HHS-TIPS (6).
5. Get the paperwork done before the crisis
Someone has to sign Mom up, handle the Medicaid application and pay the bills. That’s far easier when a financial power of attorney and a health care directive are already in place, rather than scrambling after a fall or a diagnosis.
Estate planning often gets delayed or overlooked. With LegalZoom, you can start your estate plan by answering questions online in ~15 minutes. Choose a will ($99–$249) or trust ($399–$549).
Each plan includes an advanced healthcare directive, financial power of attorney and HIPAA authorization. Trusted by 6 million customers. Check it out here.
My honest take
Oz is right that fraud is a problem, and nobody should defend billing taxpayers for empty chairs.
But the bigger story for most families isn’t a crooked center in New York. It’s that the median day program costs about $24,700 a year, Medicare won’t touch it, and the Medicaid line can stretch for years.
So have the talk now. Find out what Mom and Dad have saved, whether either is a veteran, and who would handle the paperwork. Then write it down.
Care is easy to put off when everyone’s healthy. It’s a lot harder to plan once someone isn’t.
Sources: 1. Fox News; 2. Medicare.gov; 3. CareScout via Business Wire; 4. Congressional Research Service; 5. U.S. Department of Veterans Affairs; 6. HHS Office of Inspector General
Add a Comment