“Is this covered?” is the first question almost every family asks us. The honest answer: for many Pennsylvania families, an adult day program is fully or mostly covered through a Medicaid waiver — they just don’t know which one applies to them. Here’s how the main waivers actually work.
Pennsylvania doesn’t have one waiver — it has several, run by two different state offices, aimed at different groups of people. That’s the part that confuses families. Which waiver applies depends mostly on why the person needs support: an intellectual or developmental disability, a physical disability, or age-related needs. Here is the short version, then the detail.
The waivers that can pay for adult day services
| Waiver | Who it’s generally for | Run by |
|---|---|---|
| Consolidated Waiver | Adults with an intellectual disability or autism who need a broad range of supports, with no annual spending cap on covered services. | ODP (Office of Developmental Programs) |
| Community Living Waiver | Adults with intellectual disability or autism, similar services to Consolidated but with an annual funding cap. | ODP |
| P/FDS Waiver | Person/Family Directed Support — a capped waiver for people with intellectual disability or autism who need a smaller amount of support. | ODP |
| Community HealthChoices (CHC) | Adults 21+ who are dual-eligible (Medicare + Medicaid) or need a nursing-facility level of care — often older adults and people with physical disabilities. | OLTL, through a managed-care plan |
| OBRA Waiver | Adults 18–59 with a severe developmental physical disability (for example cerebral palsy or epilepsy) who need an ICF level of care. | OLTL |
Penn Village works with families across these programs, and our Medicaid & waiver program assistance page walks through how we help with the enrollment paperwork once you know your waiver.
If the disability is intellectual or developmental (including autism)
These are the ODP waivers — Consolidated, Community Living, and P/FDS. They’re administered through your county’s intellectual disability office and a Supports Coordinator assigned to your family. Adult day services are a covered service under these waivers, which is how many of the families in our intellectual disabilities program attend at little or no out-of-pocket cost.
The main practical difference between the three is the funding cap. Consolidated has no annual cap on covered services; Community Living and P/FDS are capped. Which one a person is offered depends on assessed need and county availability — not something you choose off a menu. Note that ODP updates these waivers periodically (the most recent amendments took effect January 1, 2026), so your Supports Coordinator is the source of truth on current service limits.
If the person is an older adult or has a physical disability
Community HealthChoices (CHC) is Pennsylvania’s managed long-term-care program for adults 21 and older who are dual-eligible or need a nursing-home level of care. It runs through a managed-care plan (you pick the plan), and adult day services can be part of the care plan your service coordinator builds.
The OBRA Waiver serves adults 18–59 with a severe developmental physical disability — cerebral palsy and epilepsy are the classic examples — who need an Intermediate Care Facility level of care. Someone already on OBRA can continue past 60; new applicants 60+ are generally directed to CHC or the LIFE program instead. If this describes your family member, our guide on adult day programs for cerebral palsy is a useful companion read.
How to find out which one applies to you — free
Four steps that take a few phone calls, not months
- Identify the office. Intellectual disability/autism → your county ID/A office and ODP. Older adult or physical disability → the Independent Enrollment Broker for CHC, or your local Area Agency on Aging.
- Ask for an assessment. Eligibility is based on a needs assessment plus financial (Medicaid) eligibility. The assessment is how the level-of-care question gets answered.
- Get a coordinator assigned. A Supports Coordinator (ODP) or Service Coordinator (CHC) builds the service plan that lists adult day services.
- Bring us in. Once you know the waiver, our adult day care eligibility team helps complete enrollment so your loved one can start attending.
Most families discover their relative was eligible for far more help than they’d been managing alone — they just hadn’t reached the right office yet.
If you’re a veteran or caring for one, there’s a separate path: see our VA-supported programs page, since VA benefits can also cover adult day care. And if you’re still deciding whether a day program is even the right model versus home care, start with the day programs for adults with disabilities in Philadelphia overview.
Not sure which waiver fits your family?
We read this paperwork every week. Tell us your situation and we’ll point you to the right office — no commitment.
Schedule a Free TourA note on accuracy: Waiver names, eligibility rules, and limits change over time and final eligibility is determined by the Commonwealth of Pennsylvania, your county, and your assigned Supports Coordinator or Service Coordinator — not by Penn Village. This guide is general information, current as of 2026, and not a benefits determination. Always confirm specifics with your coordinator or county office.
Related reading & resources
