California is a designated age-friendly state with a wide range of benefits for seniors, including generally mild weather and affordable health care. Currently, about 15% of the state’s nearly 40 million residents are retirement-aged and in coming years that number is expected to climb to 19%, making this the fastest-growing age group in the state. Older adults who choose to remain in their homes have access to high-quality home care agencies that enable them to age in place. On average, this type of care costs $6,101 per month.
This guide provides more information on home care costs in California, along with an overview of options to pay for services, supportive resources in the community and the regulations home care agencies follow.
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While home care and home health care are both available in your own home, there are some key differences between these options. Home care primarily provides basic services that you’d otherwise be able to perform yourself if age or impairment wasn’t an issue, including transportation for doctor’s appointments and errands, meal preparation and simple chores around the house. Home health care is specialized and is usually performed by licensed health professionals. This type of care may include catheter care, medication administration and physical or occupational therapy. Despite their difference, both care types cost approximately $6,101 per month in California.
Nationally, seniors pay $4,957 per month for home care and $5,148 for home health care, but in certain regions of the country where the cost of living is higher, care tends to cost more. In California, agencies charge over $1,000 more per month for services with fees for both levels of care coming in at $6,101. To the north in Oregon, home health care is the same at $6,101 and home care is a little cheaper at $6,006. In Arizona, home care and home health care costs average $5,339 and $5,434, and in Nevada, both types of care cost $5,148.
| Home Care | Home Health Care | |
| California | $6,101 | $6,101 |
| National | $4,957 | $5,148 |
| Oregon | $6,006 | $6,101 |
| Nevada | $5,148 | $5,148 |
| Arizona | $5,339 | $5,434 |
Home-based care is among the costlier long-term care options in California, with home care and home health care costing approximately $6,101 per month. Only nursing home care, which provides skilled nursing services in an institutional setting, is more expensive at $9,794. Assisted living features a similar scope of services as home-based care in a residential setting for $5,250 per month. Adult day care is the cheapest option at $1,842.
If your retirement income isn’t enough to cover home-based care, you may be able to pay for services through Medi-Cal, California’s Medicaid program. Medi-Cal provides coverage for essential health benefits such as outpatient care, emergency medical services and home health care. While it doesn’t have coverage for basic in-home services such as housekeeping and companion care, you may be eligible to sign up for one of several Medi-Cal programs and waivers to get this coverage. These programs include the In-Home Support Services Program, the Multipurpose Senior Services Program Waiver, the Home and Community-Based Alternatives Waiver and the Program of All-Inclusive Care for the Elderly.
If you need help covering in-home care expenses, you may qualify for one of Medi-Cal’s four programs or waivers. These programs are designed to help you remain in your own home by providing you with the services you’d typically otherwise receive in an assisted living or skilled nursing facility. Program rules and eligibility requirements vary from one program to another, but in general, you must qualify for Medi-Cal and be assessed by the Department of Health Care Services to need the services a given program provides.
| Contact | Area Served | Services Provided | |
| In-Home Support Services Program | 866-376-7066 | Statewide | The IHSS waiver helps you avoid the transition to an assisted living facility or nursing home by paying for in-home care. Through this waiver, you can get services such as meal preparation, transportation, medication reminders, companionship, personal care and light housekeeping, depending on the needs assessment a county social worker conducts during an initial home visit. You may be eligible for this waiver if you’re at least 65 years old and enrolled in Medi-Cal. To begin the process, call or visit your local county’s IHSS office. |
| Multipurpose Senior Services Program Waiver | 800-300-1506 | 46 counties | The MSSP Waiver is for older adults who need nursing home level care but want to stay in their own homes. This waiver provides services such as case management, personal care services, housekeeping and chore services, money management and home-delivered or congregate meals, keeping you safe and comfortable at home. You’re eligible for this program if you’re at least 65 years old, eligible for Medi-Cal and would require nursing home placement if not for these services. You also must live within an active MSSP Site. More information on this program is available through your local DHCS office. |
| Home and Community-Based Alternatives Waiver | 833-388-4551 |
To qualify for Medi-Cal, you must meet the program’s income and asset limits. If you’re single, you may have an annual income of up to $18,768 and up to $2,000 in countable assets. Certain assets, including your primary dwelling, one vehicle and your personal belongings don’t count toward this limit. If you’re married, you and your spouse may have a joint income of up to $25,272 and up to $3,000 in countable assets.
| Income Limits* | Asset Limits | |
| Single Person | $18,768 | $2,000 |
| Two-Person Household | $25,272 | $3,000 |
Along with financial criteria, you must meet a few other eligibility requirements to qualify for Medi-Cal. These include:
For many people, the simplest way to apply for Medi-Cal is to submit an online application through www.CoveredCA.com. If you want help with the process, you can call or visit your local social services office. You may also print off, fill out and mail a completed Single Streamlined Application to the office
What Information You Will Need
Before submitting an application, it’s helpful to compile necessary documents that support your need and eligibility for Medi-Cal. These include:
How to Get Help Applying for Medicaid
Several agencies and helplines provide support for Medi-Cal beneficiaries, ensuring you get the information and guidance you need through the application process and as a policyholder.
| Contact | Area Served | Services Provided | |
| Certified Enrollment Counselor | 855-324-3147 | Statewide | You can contact your local Certified Enrollment Counselor for free personalized help with signing up for Medicaid and its waiver programs. CECs answer any questions you have about eligibility requirements and coverage and can provide more information on supporting documents you should submit along with your application. |
| Medi-Cal Managed Care Ombudsman | 888-452-8609 | Statewide | If you run into problems with your Medi-Cal coverage, such as denied coverage for services or canceled policies, you can reach out to the program’s dedicated ombudsman for free and impartial information and assistance. |
| Medi-Cal State Fair Hearing | 800-952-5253 | Statewide | If Medi-Cal denies or changes coverage for a service, you have the right to a fair hearing. To have your case considered, file a hearing request with the California Department of Social Services, State Hearings Division, within 90 days. |
Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.
Below is an overview of some of the services typically covered by Medicare for those who are eligible:
As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.
Read our guide to Medicare and Home Care Coverage for more information.