In-Home Care in Iowa

The Midwest state of Iowa offers cultural amenities, world-class hospitals and a range of programs to help seniors remain in their homes throughout their retirement years. Nearly 18% of the state’s population is aged 65 and over, and in the coming years, that population is projected to grow.

Iowa’s overall cost of living is about 15% lower than the national median, which may help older adults maintain a comfortable standard of living throughout retirement. Property taxes are relatively high, but housing costs are about 40% below the national average, and Social Security benefits are exempt from state income taxes. This may help offset home care costs, which exceed the national average at $5,529 per month. This type of care includes non-medical services, such as companion services, transportation, personal care and meal preparation. Home health care is similar but also includes some skilled nursing services.

This guide introduces home care in Iowa by providing more information on monthly care costs, including an overview of monthly costs in major cities throughout the state. It also outlines common ways seniors pay for services, a list of resources that help older adults obtain the care they need and answers to frequently asked questions.

The 2021 Genworth Cost of Care Survey shows that seniors who obtain in-home care services in Iowa pay $5,529 per month on average. By comparison, nationally, this care type costs $4,957 monthly. In Minnesota, seniors pay about $1,000 less than Iowa residents for home care, with agencies charging $4,508, and in Missouri, rates are comparable at $4,767. In Nebraska, seniors pay $5,148 for home care, and in Illinois, rates come in at $5,339. In-home care costs in South Dakota are several hundred dollars higher than in Iowa at $5,911.

Home care rates are fairly consistent throughout Iowa, with costs in nearly all surveyed cities coming within a few hundred dollars of the state median. Waterloo is the cheapest surveyed city to obtain care, with agencies charging $4,767 per month for services. In Davenport, rates are higher at $5,148, and in Dubuque, home care agencies charge $5,291 monthly. Seniors in Sioux City pay $5,339 on average, and in Cedar Rapids, rates are consistent with the state median at $5,529. Des Moines, Iowa’s capital city, is the most expensive place to obtain care, with residents paying $5,815 for services.

Seniors in Iowa have a variety of long-term care options to choose from, enabling them to obtain the care that fits their budgets, care needs and lifestyle preferences. For older adults who want to remain in their own homes but need help with some activities of daily living, in-home care costs $5,529. Those who require the skilled nursing services provided by home health care pay slightly more at $5,577. Adult day health care is an affordable alternative for those with restrictive budgets, costing $1,353 monthly. Assisted living provides personal care services, meals and recreational activities in a residential facility for $4,367. Nursing home care is for those who need around-the-clock medical monitoring and skilled nursing services and costs $6,874.

Iowa Medicaid is robust health insurance jointly funded by the state and federal government to cover many necessary medical expenses for qualifying individuals. This program covers home health care for those who need skilled nursing services, but non-medical home care services aren’t eligible for coverage under the regular program. Seniors seeking this coverage must apply for the Elderly Waiver.

Unlike regular Medicaid, which is an entitlement that is guaranteed to everyone who qualifies, the Elderly Waiver has limited enrollment slots. In some cases, eligible seniors are placed on a wait list until a slot opens up. As of April 2022, up to 7,930 Iowans may be enrolled in this program, and there is currently no wait list.

You can apply for Medicaid through your local Department of Human Services office. For greater convenience, you can apply for services online through the DHS Services Portal.

What Information You Will Need 

Along with submitting an application, you must provide supporting documents that show you’re eligible for Medicaid. These include:

• Birth certificate 
• Driver’s license or state-issued ID  
• Social Security card  
• Copies of mortgage or lease agreements  
• Bank statements  
• Policy numbers for any other health insurance coverage, including Medicare 

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

• Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
• Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
• Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
• Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.