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 Cost of In-Home Care in Iowa

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. 

$5529

Iowa

$4957

The United States

$4508

Minnesota

$5911

South Dakota

$5148

Nebraska

$4767

Missouri

$5339

Illinois

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. 

$5529

Cedar Rapids

$5148

Davenport

$5815

Des Moines

$5291

Dubuque

$5339

Sioux City

$4767

Waterloo

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. 

$5529

In-Home Care

$5577

Home Health Care

$6874

Nursing Home Care

$4367

Assisted Living

$1353

Adult Day Health Care

Does Medicaid Cover Home Care in Iowa?

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.  

Home Care Waiver Programs in Iowa 

Elderly Waiver 

The Elderly Waiver is a Home and Community-Based Services Waiver that expands Medicaid’s coverage to pay for supportive services in the individual’s own home. The services you receive under this waiver are customized to your needs, as determined by an interdisciplinary team. Services may include: 

  • Adult day care 
  • Assistive devices 
  • Case management 
  • Chore services 
  • Consumer-directed attendant care 
  • Emergency response systems 
  • Home and vehicle modifications 
  • Homemaker services 
  • Home-delivered meals 
  • Respite services 
  • Companion services 
  • Transportation  

All these services must be provided in a community setting, whether it’s the individual’s home, a residential care facility or an adult day health care facility. The total cost of the services for an individual must be cheaper than what they would pay for nursing home care.  

To qualify for the Elderly Waiver, applicants must be at least 65 years old, and they must require a nursing home or skilled nursing level of care. They must also be permanent Iowa residents and legal U.S. citizens or residents. Applicants must also meet financial eligibility criteria. Single applicants may have an annual income of no more than $30,276, and they may have up to $2,000 in countable assets.

Seniors must apply for the Elderly Waiver through their Iowa Department of Human Services county office. After they apply, the department will contact them to schedule an assessment.  

How to Know If You’re Eligible for Medicaid in Iowa 

To qualify for Medicaid, your income and assets must fall within certain limits. Single applicants can have up to $10,092 in annual income. This includes income from all sources, including wages, veterans’ and public benefits, pensions and withdrawals from savings accounts. Single applicants may also have up to $2,000 in countable assets. This limit applies to money in checking and savings accounts, stocks, investment and vacation properties and bonds. Many assets are exempt, including personal belongings, the applicant’s primary residence, irrevocable funeral contracts, burial space and their vehicle. Married applicants can have a joint income of up to $15,132 and up to $3,000 in countable assets. 

2022 Medicaid Income Limits for Seniors in Iowa 

Income Limits* 
Asset Limits 

Single Person 

$10,092 

$2,000 

Two-Person Household 

$15,132 

$3,000 

*Per year 

Iowa Medicaid has other eligibility criteria applicants must meet to qualify for coverage. Along with meeting financial criteria, seniors must meet these requirements

  • Resident of Iowa 
  • Citizen or legal U.S. resident 
  • Aged 65 or over or disabled according to Social Security standards 

How to Apply for Medicaid in Iowa 

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 

How to Get Help Applying for Medicaid 

Several agencies, programs and helplines provide personalized assistance to help you navigate the Medicaid process. The following table highlights statewide resources that provide application assistance and information on beneficiaries’ rights and options if coverage is denied.  

Resource
Contact
Description

(800) 338-8366

Iowa Medicaid Member Services has a toll-free number you can call on weekdays between 8 a.m. and 5 p.m. for help with understanding what Medicaid covers, how to apply and where to obtain services. Its representatives can also provide more information on the Elderly Waiver, including whether there is a current wait list.

(866) 236-1430

The Managed Care Ombudsman Program provides advocacy, information and assistance to those receiving long-term care services through Medicaid, whether through the regular program or one of the HCBS waivers. You can contact the ombudsman for help with understanding your benefits, finding providers who accept payment from Medicaid and understanding how to get in-home care services paid for. The ombudsman can also help you file a complaint if you feel that your case is being treated unfairly.

The American Council on Aging has contact information for Medicaid planners throughout the state who help seniors use strategies to meet the program’s financial limits if their income or assets exceed what’s permitted. The organization also publishes easy-to-read information on Iowa Medicaid’s waiver programs, details on spousal impoverishment rules and how to apply for coverage. 

(515) 281-3094

The Department of Human Services oversees Iowa Medicaid and ensures fair claims practices for members. If you feel that coverage or a claim is unfairly denied, you can file an appeal with this department to have it thoroughly investigated. To file an appeal, you can submit a request in person, over the phone or in writing.

(800) 532-1275

Iowa Legal Aid has licensed legal professionals who specialize in helping older adults apply for public benefits, including Medicaid and the Elderly Waiver. You can contact this agency over the phone or visit a local office to speak with a specialist and get help with the application process, gathering supporting documents and resolving issues, such as denied claims or canceled policies.

Does Medicare Cover In-Home Care in Iowa?

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 Iowa

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 Iowa

Iowa has numerous resources that can help you find the services you need at home, access public benefits to pay for care and connect with community-based services that may save you money. The following table lists top resources available to seniors statewide.

Contact 
Area Served
Services Provided 

2-1-1 

Statewide 

211 Iowa is a free information and referral service that can help you connect with community-based programs in your area. You can call this toll-free helpline to find local senior centers, home-delivered and congregate meals, transportation and home modifications and repairs. The service can also help you obtain low-cost housing and provide information on local, state and federal benefits that may help you afford long-term care. This service is free and confidential.

(515) 729-8846 

Statewide 

Iowa Association of Area Agencies on Aging oversees local AAAs throughout the state. Services vary slightly by region, but all AAAs provide basic services, such as financial and legal counseling, help with accessing public benefits, home-delivered and congregate meals, transportation and in-home care services. Your AAA may also provide companion services that include daily phone calls or weekly home visits. These services are available to those aged 60 and over. 

(515) 252-4698 

Statewide 

The Iowa Department of Veterans Affairs serves older veterans in Iowa through county offices. At these locations, veterans and their families obtain benefits counseling and assistance with enrolling in programs that may help pay for in-home care. Local offices can also connect qualifying individuals with community-based services, such as transportation, counseling and medical care. 

(800) 351-4664 

Statewide 

The Senior Health Insurance Information Program provides free over-the-phone health insurance options counseling for Medicare beneficiaries. You can contact the program’s toll-free number for help with understanding your Medicare and long-term care benefits, finding prescription drug coverage and comparing private Medicare options. SHIP counselors can also help you determine whether you’re eligible for Medicaid and Medicare Savings Programs.

(800) 989-8137 

Statewide 

The Iowa Care Planning Council has an online database where you can access information on ways to pay for long-term care, including reverse mortgages, veterans benefits and Medicaid. It also lists local providers that offer non-medical home care services, as well as those that provide repairs, modifications, durable medical equipment loans and financial planning.

Statewide 

The Iowa Community Action Association oversees Community Action Agencies throughout the state. These agencies provide a range of services to qualifying individuals, including home-delivered and congregate meals, long-term care options counseling, utility assistance and emergency financial assistance. In some cases, individuals are required to pay for a portion of the services they receive.

(800) 367-3388 

Statewide 

The Iowa Property Tax Credit for Senior and Disabled Citizens provides tax relief for those aged 65 and over and those who are completely disabled, reducing their living expenses. To obtain this credit, the property owner must file their claim by June 1 of the year before property taxes are due. In addition to age or functional criteria, applicants must also meet financial eligibility requirements.

COVID-19 Rules for In-Home Care Providers in Iowa

In Iowa, agencies that provide skilled home health care services are required to ensure all caregivers are fully vaccinated against COVID-19, unless they have an exemption. Currently, there is no vaccine mandate in place for agencies that provide non-medical in-home care. 

This rule is valid as of April 2022, but due to the evolving nature of the virus, guidelines may be periodically updated. To get up-to-date information on vaccine requirements for home care and home health care agencies, seniors can contact their local Area Agency on Aging or their county’s health department. Additionally, some agencies have rules above and beyond what’s required by federal law to keep their caregivers and clients safe. If you have questions about safety measures, you can direct questions to your home care agency.

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.

In-Home Care Laws and Regulations in Iowa
Scope of Care
Nonmedical 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 Requirements
Homemakers 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 Requirements
Nonmedical 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 Requirements
In 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 Requirements
There 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 Coverage
Iowa 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 Abuse
Concerns 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.

How to Find an In-Home Care Provider in Iowa

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.

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.

2019, 2020, 2021, 2022

Right at Home Des Moines

2600 University Ave., Suite 210, West Des Moines, IA, 50266

The staff has been good about letting me know when they are not coming. They could have the same person come every time. The girls that have come have been great but it has not been on a regular basi … (read more)
The staff has been good about letting me know when they are not coming. They could have the same person come every time. The girls that have come have been great but it has not been on a regular basi … (read more)

2017

Home Instead – Des Moines, IA

414 61st St, Suite B, Urbandale, IA, 50322

The majority of the caregivers are experienced and personable. Unfortunately , you may not have the samecare provider consistently. Which requires you as th client to retrain a new provider often abo … (read more)
The majority of the caregivers are experienced and personable. Unfortunately , you may not have the samecare provider consistently. Which requires you as th client to retrain a new provider often abo … (read more)

2021

Home Care Assistance

9250 University Avenue, West Des Moines, IA, 50266

It was enjoyable and helpful to have someone come in. I really didn’t need that much assistance. She was bright, perceptive, picked up on little details and she followed through on things.
It was enjoyable and helpful to have someone come in. I really didn’t need that much assistance. She was bright, perceptive, picked up on little details and she followed through on things.

Sunlight Senior Care – Des Moines, IA

699 Walnut St., Unit 400, FL4 , Des Moines, IA, 50309

In-home care is one of the fastest growing services that makes staying in your own home a reality. Whether you’re looking for someone to help you or your loved one with daily tasks, companionship, h … (read more)
In-home care is one of the fastest growing services that makes staying in your own home a reality. Whether you’re looking for someone to help you or your loved one with daily tasks, companionship, h … (read more)

Sunlight Senior Care – Council Bluffs, IA

1200 N St, Lincoln, NE, 68508

In-home care is one of the fastest growing services that makes staying in your own home a reality. Whether you’re looking for someone to help you or your loved one with daily tasks, companionship, h … (read more)
In-home care is one of the fastest growing services that makes staying in your own home a reality. Whether you’re looking for someone to help you or your loved one with daily tasks, companionship, h … (read more)

Interim HealthCare – West Des Moines

2455 106th Street , Urbandale, IA, 50322

Interim HealthCare of Des Moines has more than 35 combined years of healthcare management, clinical, and staffing experience. We are locally owned and operated and we are deeply connected to Iowa’s He … (read more)
Interim HealthCare of Des Moines has more than 35 combined years of healthcare management, clinical, and staffing experience. We are locally owned and operated and we are deeply connected to Iowa’s He … (read more)

Care by April

2348 Northwest 75th Avenue, Ankeny, IA, 50023

Tina & the rest of the crew that has helped with Grandma (whom is 95) are so caring, passionate and have a Great way of dealing with elderly that have dementia, they are so patient with Gramms an … (read more)
Tina & the rest of the crew that has helped with Grandma (whom is 95) are so caring, passionate and have a Great way of dealing with elderly that have dementia, they are so patient with Gramms an … (read more)

A Plus Home Care Services and Supplies

2301 West First Street, Ankeny, IA, 50023

I was very disappointed with A+ home care services. My father had a stroke and as I am in my mid-20’s and his next of kin and power of attorney I was in charge of taking care of his care after he lef … (read more)
I was very disappointed with A+ home care services. My father had a stroke and as I am in my mid-20’s and his next of kin and power of attorney I was in charge of taking care of his care after he lef … (read more)

Comfort Keepers of Urbandale

1300 Metro East Drive, Pleasant Hill, IA, 50327

We appreciate your loving care for my dad before he passed away. That is the most important thanks we want to extend. You were truly caregivers-it never seemed like it was work for you. Thank you f … (read more)
We appreciate your loving care for my dad before he passed away. That is the most important thanks we want to extend. You were truly caregivers-it never seemed like it was work for you. Thank you f … (read more)

HCI ExtraCare Services

2910 Westown Parkway, Suite 200, West Des Moines, IA, 50266


Cerro Gordo County Dept. of Public Health – Mason City

Mohawk Square, 3rd Fl, 22 N Georgia Av, Suite 300, Mason City, IA, 50401


Senior Helpers

2951 86th Street, Urbandale, IA, 50322


BrightStar Care of Des Moines

1001 Office Park Rd, Ste 107, West Des Moines, IA, 50265


Care Builders at Home – West Des Moines, IA

3408 Woodland Avenue Suite 209, West Des Moines, IA, 50266



Home Care Services in Iowa (191)