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In-Home Care in California

Of California’s nearly 40 million residents, those aged 65 and over account for just under 15% of the population. Over the coming years, that community is projected to grow significantly and is expected to account for 19% of the population in 2030, resulting in an increased need for accessible care. To that end, the state is home to top hospitals such as UCLA Medical Center, which is nationally ranked in over a dozen specialties and conditions, and Stanford Hospital, which has national rankings in 11 specialties.

The state also has numerous home care agencies, which provide basic homemaker services, and home health care providers, which administer specialized skilled nursing services. Both levels of care cost $6,101 per month, though your fees may be higher or lower depending on your care needs.

This guide provides more information on what seniors in California pay for care, including how rates vary in communities throughout the state and compared to other long-term care options. It also gives an overview of ways to pay for services, free and low-cost services that help seniors age in place and current laws and regulations that govern in-home care agencies in California.

The Cost of In-Home Care in California

According to data published in the 2021 Genworth Cost of Care Survey, California residents typically pay $6,101 per month for home care, which is over $1,000 higher than the national median rate of $4,957. In Oregon, monthly costs are comparable at $6,006, but in Arizona and Nevada, agencies charge lower monthly rates of $5,339 and $5,148.

California

$6101

The United States

$4957

Oregon

$6006

Nevada

$5148

Arizona

$5339

Where you live in California significantly influences what you pay for home care. The cheapest city to obtain in-home services is El Centro, where monthly fees average $3,432. In Visalia, residents pay $5,339, and in Chico and Vallejo, costs are closer to the state median at $5,720 and $5,958, respectively. In California’s capital city of Sacramento, seniors pay $6,292 for care. Santa Cruz and San Luis Obispo are the most expensive places in California to obtain in-home care, with residents paying respective rates of $6,864 and $7,150 per month.

Chico

$5720

Sacramento

$6292

Vallejo

$5958

Santa Cruz

$6864

Visalia

$5339

San Luis Obispo

$7150

El Centro

$3432

Depending on the level of care you obtain and the setting you live in, long-term care costs in California range from less than $2,000 to close to $10,000. The cheapest care option is adult day health care at $1,842 per month and is for those who want to live at home and access personal care, meals and recreational activities in a daytime community setting. Assisted living provides these services along with housing for $5,250 per month. In-home care and home health care cost $6,101 per month, and nursing home care is the costliest option in the state at $9,794. 

In-Home Care

$6101

Home Health Care

$6101

Adult Day Health Care

$1842

Assisted Living

$5250

Nursing Home Care

$9794

Does Medicaid Cover Home Care in California?

Seniors in California may be able to cover in-home care and home health care through Medi-Cal, the state’s Medicaid managed care program. This program pays for medically necessary outpatient care, emergency services and hospitalization, rehabilitative services, laboratory services, preventative care and prescription drugs, as well as home health care to help beneficiaries avoid nursing home placement.

The regular Medi-Cal program doesn’t have coverage for basic in-home services such as meal preparation and help with daily living activities, but it has provisions for these services under several waivers and programs, including the In-Home Support Services Program, the Multipurpose Senior Services Program Waiver, the Home and Community-Based Alternatives Waiver and Program of All-Inclusive Care for the Elderly. Unlike regular Medi-Cal, these programs have enrollment caps, and eligible applicants may be placed on a wait list.

Home Care Waiver Programs in California 

Numerous Medi-Cal programs and waivers cover home care services, letting older adults with limited budgets obtain personalized care. Each program has its own rules, but in general, applicants must meet Medi-Cal’s financial and functional need guidelines to be eligible for services. Additionally, you may only be enrolled in one program at a time. 

How to Know if You’re Eligible for Medicaid in California

To be eligible for Medi-Cal, your income and assets must be within the program’s guidelines. Single applicants can have an annual income of up to $18,768, and married applicants can have household incomes up to $25,272. Single applicants are allotted $2,000 in countable assets, and those who are married may have up to $3,000.  

2022 Medicaid Income Limits for Seniors in California  

Income limits*Asset limits
$18,768$2,000
$25,272$3,000

*Per year 

  • A U.S. citizen or legal resident 
  • A permanent resident of California 
  • At least 65 years old 

How to Apply for Medicaid in California

To apply for Medi-Cal, you can apply over the phone or in-person at your local county social services office, or you can mail the office a completed Single Streamlined Application. Alternately, you can apply online through www.CoveredCA.com. 

What Information You Will Need 

Having certain documents on hand before beginning the application process can help ensure a quick decision. Pieces of information you may need to provide include:

  • Your birth certificate 
  • A state-issued ID, such as a driver’s license 
  • Proof of all income and assets 
  • Proof of U.S. citizenship or legal residence 
  • Proof of other insurance coverage, such as Medicare or TRICARE 
  • Proof of home address 

How to Get Help Applying for Medicaid

There are numerous resources in California to help seniors get the information and advice they need to apply for Medicaid, understand their benefits and navigate the process of finding covered in-home care services. 

ProgramContactAreaServedServices provided
Certified Enrollment Counselor855-324-3147StatewideCertified Enrollment Counselors provide free assistance with submitting Medi-Cal applications, choosing the best managed care program and enrolling in waivers and programs that may pay for in-home and home health care services.
Medi-Cal Managed Care Ombudsman888-452-8609StatewideThe program’s dedicated ombudsman provides free, unbiased information and assistance with obtaining Medi-Cal coverage and resolving issues regarding benefits. The ombudsman can answer your questions about the enrollment process and covered services and help you find solutions to problems with your coverage.
Medi-Cal State Fair Hearing800-952-5253StatewideIf a beneficiary's coverage is canceled or modified, they have the right to file a hearing request with the California Department of Social Services, State Hearings Division, within 90 days. This resource provides more information on the process along with important contact information.

Does Medicare Cover In-Home Care in California?

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)

Other Financial Assistance Options for In-Home Care in California

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost Resources for Seniors in California

Finding the best home-based care solutions for your needs can be a confusing process, but fortunately, several agencies and programs throughout the state are ready to help. The following table highlights useful resources for older adults whether they want to remain in their homes or transition back after a hospital or nursing home stay.  

ResourceContactAreaServedService
Area Agencies on Aging800-510-2020StatewideThirty-three Area Agencies on Aging serve those aged 60 and over in California, each with its own designated area. These agencies provide information and referrals for community-based services such as non-emergency medical transportation, home-delivered and congregate meals and legal and financial counseling. Agencies may also offer in-home care and home health care services directly or through contracted providers for competitive rates.
California Department of Veterans Affairs800-952-5626StatewideThe California Department of Veterans Affairs has benefits counselors at county offices throughout the state that are trained to help veterans and their dependents obtain state and federal benefits, including those that may cover in-home care costs. The office can also screen visitors for eligibility for health insurance, VA medical care and transportation services.
California Community Action Partnership Association916-443-1721StatewideCalCAPA supports Community Action Agencies throughout California, providing access to services and programs that help older adults maintain their independence at home. Through your local CAA, you can access programs and services such as home modifications, weatherization services, emergency utility bill assistance and home-delivered meals.
Meals on Wheels Californiainfo@mowca.orgStatewideThe Meals on Wheels program supports the nutritional needs of those who are housebound due to age or disability by providing fresh and frozen meals. Generally speaking, this service is available to those unable to shop for or prepare meals themselves. Your local provider may have additional eligibility requirements.
Legal Aid Foundation of Los Angeles800-399-4529Los Angeles CountyThose in the Los Angeles region may obtain free legal assistance, advice and representation through the Legal Aid Foundation of Los Angeles. This nonprofit agency has legal professionals who help older adults apply for public benefits that may help offset home-based care expenses, as well as resolve issues such as Social Security overpayment. Those outside the Los Angeles area may contact the State Bar of California to find services in their areas.
Property Tax Postponement800-952-5661StatewideThe California Property Tax Postponement Program enables older adults to delay payment on their property taxes, which may help them afford living and long-term care expenses. Through the program, participants with sufficient equity in their homes can delay paying property taxes until certain conditions are met, such as taking out a reverse mortgage or selling the property.
California 2-1-12-1-1StatewideCalifornia 2-1-1 is a statewide information and referral service available to all state residents. Through this free service, you can connect with providers in your area that offer free and low-cost programs such as emergency bill pay, prescription drug assistance, chore services and volunteer-based transportation.

In-Home Care Laws and Regulations in California

Home care organizations in the state of California are regulated by the Department of Social Services’ Home Care Services Bureau. The HCSB oversees the licensing of HCOs and maintains an online registry of home care aides. Bureau staff also carry out unannounced on-site visits to ensure regulation compliance and investigate complaints. The following table provides an overview of home care rules and regulations in California.

TopicRule
Scope of CareHCOs may provide nonmedical, in-home care services, including personal care, assistance with daily living activities, housekeeping, meal planning/preparation, transportation and companionship.
Care Plan RequirementsHCOs work with clients to define their care needs. An organization will also develop a home care aide schedule to meet those needs that includes provisions for replacement staff when necessary.
Medication Management RequirementsHome care aides may assist clients with self-administration of medications that do not require oversight, handling or administration by a licensed medical professional.
Staff Screening RequirementsAll HCO staff must submit fingerprints, undergo criminal background checks and be screened for tuberculosis. Direct care workers must also register as home care aides with the HCSB.
Staff Training RequirementsNewly hired home care aides must complete two hours of orientation and three hours of initial training. Once on staff, aides must complete five hours of verified continuing training through a state-approved organization on an annual basis.
Medicaid CoverageCalifornia offers the In-Home Supportive Services entitlement program, as well as the Multipurpose Senior Services and Home and Community-Based Alternatives waiver programs that pay for various in-home care and supportive services for those who qualify.
Reporting AbuseTo report abuse, neglect or exploitation of a senior who lives in their own home or apartment, concerned individuals should contact the Adult Protective Services office serving that county.

Frequently Asked Questions

How to Find an In-Home Care Provider in California

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. When you hire an in-home care aide you’re placing a lot of trust in the hands of the person by inviting them into your home, so you’ll want to be diligent in your search. At Caring.com, we’re here to help – we’ve created a helpful checklist below that can help guide you through the process of both determining your needs and finding a home care agency that will provide the best care possible.

Download
Finding a Home Care Provider Checklist
Finding a Home Care Provider Checklist

Find Home Care Agencies Near You

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.

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Caring.com

Caring.com is a leading online destination for caregivers seeking information and support as they care for aging parents, spouses, and other loved ones. We offer thousands of original articles, helpful tools, advice from more than 50 leading experts, a community of caregivers, and a comprehensive directory of caregiving services.

 

The material on this site is for informational purposes only and is not a substitute for legal, financial, professional, or medical advice or diagnosis or treatment. By using our website, you agree to the Terms of Use and Privacy Policy

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