How Berkeley Families Pay for Adult Day Health Care in California
Once a family decides adult day health care might help, the next conversation is usually about money. In California there are more ways to pay for daytime care than many people expect, and the main one, Medi-Cal's Community-Based Adult Services benefit, is unusual compared with other states. This guide explains the realistic options for a Berkeley household, in the order most families check them.
Start with the benchmark price
It helps to know what you are paying for before comparing programs. The 2025 Cost of Care Survey from CareScout reports a California median of $94 per day for adult day health care, which works out to about $2,037 a month for five days a week across a year. CareScout's tool shows the same figure for the San Francisco–Oakland–Fremont area that includes Berkeley (CareScout Cost of Care tool). If you are paying privately, that is the reference point. If one of the programs below applies, your out-of-pocket cost may be much lower.
Option 1: Medi-Cal and Community-Based Adult Services (CBAS)
California's Medi-Cal program covers adult day health services through a benefit called Community-Based Adult Services, or CBAS. CBAS is delivered at centers that hold an Adult Day Health Care license from the California Department of Public Health and are certified by the California Department of Aging to take part in Medi-Cal (California Department of Aging, CBAS program overview).
In broad terms, a person may qualify when they:
- Are 18 or older and eligible for Medi-Cal
- Meet medical-necessity criteria, which typically means a chronic condition or disability that puts them at risk of needing institutional care without daytime support
- Are enrolled in a Medi-Cal managed care plan, unless they fall under a specific exemption
Eligibility is decided by the person's Medi-Cal managed care plan, or by the state for the small group still in fee-for-service Medi-Cal, after a face-to-face assessment (CDA, CBAS eligibility and service authorization). The center usually helps start the process, but the managed care plan makes the call on how many days are authorized.
What families in Alameda County should do
If your relative already has Medi-Cal, call the member services number on their Medi-Cal plan card and ask whether they can be assessed for CBAS. Then call the centers you are considering and ask whether they are CBAS-certified and contracted with that plan. Both answers have to be yes for the benefit to work at a particular center.
If your relative does not yet have Medi-Cal, applications go through the Alameda County Social Services Agency or the state's online portal. Medi-Cal rules on income and assets have changed several times in recent years, so check the current rules with the county rather than relying on what a friend was told a few years ago.
Option 2: VA Adult Day Health Care
Veterans enrolled in VA health care can receive Adult Day Health Care as part of their medical benefits package when there is a clinical need and the service is available in their area. The VA describes the program as being for veterans who need help with daily activities, who are isolated, or whose family caregiver is under strain (VA Geriatrics and Extended Care: Adult Day Health Care).
Copays for this kind of extended care depend on service-connected disability status and financial information the veteran gives VA. VA's copay page lists the current daily amounts for adult day health care and explains which veterans are exempt (VA health care copay rates). In the East Bay, the starting point is the veteran's VA primary care team, who can request a referral through the social work service.
VA pension with Aid and Attendance
Separately from health care, some wartime veterans and surviving spouses with limited income qualify for a monthly VA pension, and an extra amount called Aid and Attendance if they need help with daily activities. For the year running December 1, 2025 to November 30, 2026, VA lists a maximum annual pension rate of $29,093 for a veteran with no dependents who qualifies for Aid and Attendance, and a net worth limit of $163,699 (VA pension rates). Out-of-pocket care costs, including adult day care, can count as medical expenses that reduce countable income, which is why this benefit sometimes helps families who assume they earn too much.
Option 3: Long-term care insurance
If the person you care for bought a long-term care insurance policy, read the benefit section for the words "adult day care" or "community care." Many policies written in the last few decades cover adult day services once the policyholder meets the benefit trigger, typically needing help with two or more activities of daily living or having a cognitive impairment. Most policies also have an elimination period, a waiting period before benefits start. Call the insurer, ask for a claim packet, and ask the center whether it has worked with that carrier before. Centers that have done this paperwork before can save you weeks.
Option 4: Private pay, and making it last
Many families pay privately for at least part of the week. At the California median, three days a week costs about $1,222 a month over a full year. A few ways families make private pay more manageable:
- Start with fewer days and add more as needs grow
- Combine adult day care on weekdays with family coverage on other days
- Ask about half-day rates if a full day is more than the person needs
- Check whether a tax professional considers the cost a deductible medical expense or eligible for the dependent care credit in your situation
Option 5: Respite funding through caregiver programs
Family caregivers in Alameda County can contact the Bay Area Caregiver Resource Center at Family Caregiver Alliance, which offers consultation and, after an assessment, may help with respite for eligible caregivers (Family Caregiver Alliance, Bay Area Caregiver Resource Center). Funding is limited, but it is worth asking, especially if you are trying adult day care for the first time.
A simple order of operations
- Check for Medi-Cal eligibility or existing Medi-Cal coverage, and ask the plan about CBAS.
- If the person is a veteran, contact their VA care team about Adult Day Health Care.
- Pull out any long-term care insurance policy and read the adult day benefit.
- Ask a caregiver resource center about respite help.
- Fill the remaining gap with private pay, starting with a schedule you can sustain.
Talk it through with us
Berkeley Adult Day Healthcare is operated by West Oakland Health Council at 1890 Alcatraz Avenue. Our team can explain which payment routes we work with and what the next step looks like for your family. Call (510) 601-0167, read our guide for families, or arrange a visit between 9 and 5.
Frequently asked questions
Does Medi-Cal cover adult day care in Berkeley?
Medi-Cal covers adult day health services through Community-Based Adult Services (CBAS) for members who meet the medical-necessity criteria. The service must be authorized by the person's Medi-Cal managed care plan and provided at a CBAS-certified center.
Is there a waiting period for CBAS?
Timing varies. The managed care plan has to complete an assessment and authorize services, and the center must be contracted with the plan. Ask both the plan and the center about current timelines.
Can veterans get adult day care through the VA?
Yes. Veterans enrolled in VA health care may receive Adult Day Health Care if they have a clinical need and the service is available nearby. A copay may apply depending on the veteran's service-connected status and finances.
Does Medicare cover adult day health care?
Original Medicare generally does not pay for adult day care. Some Medicare Advantage plans offer limited supplemental benefits, so check the plan's Evidence of Coverage.
Sources
- CareScout Cost of Care Survey tool (2025 data)
- California Department of Aging: CBAS program narrative and fact sheets
- California Department of Aging: CBAS eligibility and service authorization
- VA Geriatrics and Extended Care: Adult Day Health Care
- VA health care copay rates
- VA pension rates for veterans
- Family Caregiver Alliance: Bay Area Caregiver Resource Center