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.

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.

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.

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. 

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.

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 

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.