Approximately 17.5% of Iowa’s 3,155,070 residents are aged 65 and older, while nationwide, seniors make up 16.5% of the population. Older adults in Iowa are supported through a number of federal and state programs administered by the Iowa Department of Human Services and the Iowa Department on Aging, making Iowa a great place for seniors to spend their retirement years. For those who wish to remain in their own homes, the statewide average cost of in-home care is $4,767, which is higher than the national average of $4,290.

Keep reading to learn about the cost of in-home care in Iowa, financial assistance programs to help seniors cover in-home care costs and free and low-cost resources for seniors in the state.

The Cost of In-Home Care in Iowa

In-Home Care Costs in Nearby States

The Genworth 2019 Cost of Care Survey shows that the average cost of in-home care in Iowa is $4,767 per month, based on 44 hours of service per week. Average care costs in Iowa are $477 above the national average of $4,290 and notably lower than in the neighboring states of Minnesota and South Dakota. Costs are the same in Wisconsin and somewhat more affordable than Illinois and Missouri.

$4767

Iowa

$4290

United States Average

$4195

Missouri

$4481

Illinois

$4767

Wisconsin

$5339

South Dakota

$5529

Minnesota

Cost of Other Types of Care in Iowa

At a monthly average cost of $4,767, in-home care costs in Iowa are the same as home health care services, and more expensive than adult day care ($1,376) or an assisted living facility ($4,078). As is common nationwide, nursing home care is the costliest care option in Iowa at an average of $6,342 per month.

$4767

In-Home Care

$4767

Home Health Care

$1376

Adult Day Care

$4078

Assisted Living Facility

$6342

Nursing Home Care

The Cost of In-Home Care in Iowa’s Top Cities

Although the statewide average cost of in-home care is $4,767, actual costs vary depending on the location. The most expensive city for in-home care is Sioux City along Iowa’s western border, where 44 hours of in-home care per week costs an average of $5,529. Des Moines is tied as the second-most expensive city with average in-home care costs of $4,957 per month, while costs are below the state average in Iowa City ($4,385) and Davenport ($4,290). The lowest cost statewide is in Cedar Rapids at $4,195 per month.

$4767

Iowa

$4195

Cedar Rapids

$4290

Davenport

$4385

Iowa City

$4957

Des Moines

$5529

Sioux City

Financial Assistance for In-Home Care in Iowa

Iowa Medicaid Home and Community-Based Services Elderly Waiver

Iowa’s Home and Community-Based Services Elderly Waiver is a Medicaid HCBS Waiver designed to help seniors age in place in their own homes or another non-institutional community-based setting. The goal of the waiver is to reduce the rate of nursing home placement among seniors who are able to safely remain in the community with the appropriate services and supports.

Waiver benefits are assigned on a case-by-case basis depending on the needs of each participant. Benefits include chore services, case management, assistive devices, adult day care services and consumer-directed attendant care (CDAC).

Who Is Eligible?
To qualify for enrollment in the Elderly Waiver, seniors must be Iowa residents, be aged 65 or older, and meet the financial criteria for Medicaid coverage in the state. Applicants must also be assessed by an approved medical team as needing the level of care normally provided in a nursing home setting. This waiver is available statewide, but as waivers are not entitlement programs, waiting lists may be in place in some areas. Adults under the age of 65 who are Medicaid-eligible and meet the functional criteria for the Elderly Waiver can apply for the Health and Disability Waiver, which provides benefits that are comparable to coverage through the Elderly Waiver.

How to Apply
Seniors can apply for the Elderly Waiver by calling Iowa’s Medicaid Member Services at 1-800-338-8366 or by contacting the nearest Department of Human Services office.

Program of All-Inclusive Care for the Elderly

Iowa seniors aged 55 and older who meet Iowa’s criteria for requiring nursing facility level of care may be eligible for enrollment in the Program of All-Inclusive Care for the Elderly, a nationwide nursing home diversion program. The goal of PACE is to delay or prevent nursing home placement among frail and disabled seniors by providing comprehensive, community-based medical and nonmedical support such as in-home care, day programming, meal delivery and transportation to the regional PACE center.

PACE services include all Medicare and Medicaid benefits, plus additional services required to help keep participants safe and supported in their own homes such as meal delivery, recreational therapy and personal care. PACE participants who wish to seek medical care from providers outside of the PACE network can either seek prior approval from the PACE team or pay out-of-pocket for non-PACE services.

Who Is Eligible?
To qualify for PACE, seniors must be 55 or older, meet the functional criteria for nursing home placement, and be either Medicaid-eligible or dual-eligible (Medicaid and Medicare). Some PACE programs also accept private-pay participants. PACE participants must also live in one of the counties where PACE is available, as the program is not currently offered throughout Iowa.

How to Apply
To apply, seniors can contact their regional PACE program found online at https://dhs.iowa.gov/ime/members/medicaid-a-to-z/hcbs/pace.

More Ways to Pay for In-Home Care

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 In-Home Care Resources in Iowa

Iowa seniors can access a number of free and low-cost programs and services designed to help keep older adults as independent as possible within the community. These programs include congregate dining and meal delivery services, assistance with chores and barrier-free transportation to medical appointments and community events.

ContactServices Provided
Iowa Department on Aging1-800-532-3213The Iowa Department on Aging provides seniors with a number of services and programs designed to promote healthy aging, including case management, elder abuse prevention workshops and fall prevention programs.
LifeLong Links Program866-468-7887 or contact your local Area Agency on AgingLifeLong Links provides seniors aged 60 and older with free information about local services and resources, and Options Counseling to help seniors plan for their long-term needs.
Home-Delivered MealsContact your local Area Agency on AgingLow and moderate-income seniors can have prepared fresh and frozen meals delivered directly to their homes free of cost.
Congregate MealsContact your local Area Agency on AgingSeniors can access daily free or low-cost hot lunches at congregate nutrition sites statewide.
Long-Term Care Ombudsman515-725-3308 or 866- 236-1430The Office of the State Long-Term Care Ombudsman (OSLTCO) advocates for the rights of Iowa residents living in long-term care facilities by investigating complaints, providing public information and promoting residents’ rights.
Legal Assistance Program515-282-8161 or 1-800- 992-8161The Legal Assistance Program helps seniors 60 and older who need advice and representation related to civil matters related to health insurance, housing, consumer fraud and elder abuse.

In-Home Care Laws and Regulations in Iowa

Iowa is one of the few states where private nonmedical home care providers are exempt from state licensing, although home care agencies usually need to have a valid business license in the county where they provide services. Staff who provide in-home care services must comply with all state and federal laws around elder abuse prevention, medication administration and reporting of suspected elder abuse. Providers that deliver services funded by Iowa Medicaid need to comply with the Iowa Department of Human Services guidelines outlined on the following table.

Scope of CareNonmedical home care providers, also known as homemakers, can provide nonmedical care such as assistance with personal hygiene, housekeeping and meal preparation, companionship and help with grocery shopping, errands and scheduling medical appointments. Some home care providers are also able to transport clients to social and recreational engagements.
Care Plan RequirementsHomemakers are not required to provide care plans for their clients, but private-pay clients may want to obtain a service agreement prior to retaining a caregiver. Medicaid-funded programs that provide in-home care must develop and maintain care plans for beneficiaries.
Medication Management RequirementsNonmedical caregivers are prohibited from administering any type of prescription or over-the-counter medications. Homemakers may provide medication reminders and assist with self-administration.
Staff Screening RequirementsIn accordance with Iowa Code section 135C.33, in-home care staff who deliver direct services to consumers, as well as those who provide in-home services under a Home and Community-Based Services Waiver, must complete a criminal record check prior to commencing work as a homemaker.
Staff Training RequirementsThere are no state-mandated training requirements for nonmedical in-home caregivers in Iowa, although agencies that employ homemakers often require that staff has basic first aid training.
Medicaid CoverageIowa Medicaid funds in-home care services through a number of programs, including the Home and Community-Based Services Health and Disability Waiver, and the Program of All-Inclusive Care for the Elderly.
Reporting AbuseConcerns regarding the abuse, neglect or exploitation of any senior living in the community in Iowa should be reported to Iowa’s 24/7 Abuse Hotline at (800) 362-2178. Emergency and/or life-threatening situations should be reported to local law enforcement officials.

Frequently Asked Questions

How Much Does In-Home Care Cost in Iowa?

According to the Genworth 2019 Cost of Care Survey, the average cost of 44 hours per week of in-home care is $4,767. Actual costs vary depending on location and can be higher or lower than the state average. For example, costs in Sioux City along Iowa’s western border are well above the state average at $5,529 per month, while along the eastern border, costs are below the state average in Dubuque at $4,195 per month.

Are There Programs to Cover Home Modifications in Iowa?

Iowa’s Home and Community-Based Elderly Waiver, a Medicaid waiver, includes benefits that cover specific modifications to member’s homes and vehicles. These modifications are approved on a case-by-case basis and may include the installation of grab bars and handrails, ramps and lifts, voice-activated devices and low-pile carpeting or slip-resistant flooring. Air conditioning, telecommunications devices, keyless entry systems and modifications to kitchen counters, bathtubs and toilets are also covered.

Does Iowa Medicaid Pay for In-Home Care?

Iowa seniors aged 65 and older who meet the financial and medical criteria for enrollment in the Home and Community Based Services Elderly Waiver, may qualify for benefits that include in-home care. This Medicaid nursing home diversion program assigns benefits based on what each senior needs in order to safely remain in their own home, so long as the cost of in-home care is less than the cost of nursing home care.

What Does It Mean to Age in Place?

Aging in place simply means that seniors are able to safely remain in their own home or community as they age, rather than moving into an institution such as a nursing facility. Services such as in-home care help seniors stay as independent as possible, which is a key part of aging in place.

What Are “Activities of Daily Living”?

Activities of daily living are the basic tasks everyone needs to perform each day in order to maintain their health, wellness and independence. Also called self-care tasks, ADLs include using the toilet, eating, moving around your home, bathing, grooming and getting dressed.

Home Care Services in Iowa (208)