Seniors aged 65 and over account for 14.3% of California’s vast population of over 39.5 million. The state departments of Health Care Services, Social Services and Aging provide a wealth of beneficial programs and resources that help make California an idyllic environment for older adults. Seniors who wish to retain their independence can expect to pay $5,335 per month on average for in-home care services, and they can have peace of mind knowing that the state strictly regulates home care providers.
The following guide offers more detailed information about in-home care costs in California, financial assistance options in the state and free and low-cost resources available to seniors living at home.
In-Home Care Costs in Nearby States
According to Genworth’s 2019 Cost of Care Survey, in-home care services in California cost $5,335 per month on average. While this is more expensive than the national monthly average of $4,290, it is in between the costs paid in neighboring Oregon and Washington. Prices are considerably lower in adjacent Arizona and match the U.S. median in Nevada.
Cost of Other Types of Care in California
Senior care costs span a wide range in California, and rates are directly influenced by the type of care and setting. At $5,335, in-home care is on par with the cost of home health care services, which average $5,339 per month. The most expensive option is nursing home care, which at $8,760 costs about $3,400 more on a monthly basis. Assisted living is somewhat less expensive at an average of $4,500, whereas adult day care is the most affordable type of care available in California at just $1,668 per month.
The Cost of In-Home Care in California’s Top Cities
Monthly in-home care costs in California’s 10 most populous cities vary by over $1,900. The highest monthly average of $6,292 is paid in San Francisco, while the lowest rate of $4,362 is found in Bakersfield. The average price in the state’s largest city, Los Angeles, is slightly lower than the California median at $5,243 per month, as are rates in Sacramento ($5,434), Stockton ($5,005) and Fresno, where the monthly cost is $4,862. Prices for in-home care services in Riverside and Modesto are identical at $4,671 per month, while San Diego shares the statewide average of $5,335.
In-Home Supportive Services Program
The In-Home Supportive Services program is available to all eligible California seniors who wish to remain living at home and avoid or delay entering a nursing home. The IHSS covers the cost of various supportive services, such as assistance with personal care and activities of daily living, meal preparation, housecleaning, laundry, grocery shopping and escorts to medical appointments. Seniors may choose their own care provider, including a spouse or family member.
Who Is Eligible?
To be eligible for services through the IHSS program, seniors must be aged 65 or older, or blind or disabled, and have received an eligibility determination for full-scope or share-of-cost Medi-Cal. They also must live in their own home, rather than in a hospital, long-term care or licensed community care facility.
How to Apply
Interested individuals should complete an application and submit it to the IHSS office in their county.
Multipurpose Senior Services Program
The Multipurpose Senior Services program is a Medi-Cal Home and Community-Based Services waiver that provides eligible seniors with the means to continue living independently at home. The MSSP covers the cost of case management and a wide range of benefits and services that are tailored to meet a person’s needs. Provided services may include personal care, housekeeping and chore assistance, respite care and therapeutic counseling. The waiver may also cover minor home repairs and accessibility adaptations, transportation and money-management assistance.
Who is Eligible?
Individuals aged 65 or older who qualify for Medi-Cal coverage and will require nursing facility care without the services provided under the MSSP program can apply.
How to Apply
Interested seniors must apply for Medi-Cal and indicate on the application that they wish to apply for long-term care services and supports through the MSSP waiver. To learn more about the program, seniors should contact their county’s Social Services office.
Home and Community-Based Alternatives Waiver
The Home and Community-Based Alternatives waiver is available to Medi-Cal-eligible seniors who are at risk of admission to a nursing home or are currently living in a nursing facility and wish to move back to their own home or a family member’s home. The program provides care management by a nurse and social worker along with various benefits, such as in-home medical and supportive services, home modifications, medical equipment expenses and training for family caregivers.
Who Is Eligible?
Applicants of any age may qualify for the HCBA program if they meet Medi-Cal’s eligibility guidelines and need a nursing home level of care or are already living in a nursing facility.
How to Apply
Interested individuals may contact the HCBA waiver agency listed for their county to request an application, or call 833-388-4551 to learn more about the program and application process.
Program of All-Inclusive Care for the Elderly
California’s Program of All-Inclusive Care for the Elderly provides eligible seniors with a personalized care plan for comprehensive medical and support services. The program’s goal is to help seniors remain independent and living at home for as long as possible. PACE services are coordinated through 48 care centers and alternative sites in 14 California counties. Applicants who qualify for Medicaid and Medicare may have no out-of-pocket costs for PACE services.
Who Is Eligible?
Individuals must be aged 55 or older and live in a PACE service area based on their zip code to be eligible for the program. They also must meet the program’s financial guidelines and be assessed as needing a nursing home level of care but able to safely live at home.
How to Apply
Interested individuals may locate a PACE center in their zip code and contact the provider directly. Alternatively, they may call the California Department of Health Care Services, Integrated Systems of Care Division at 916-552-9105 to schedule an eligibility assessment.
More Ways to Pay for In-Home CareWhile 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.
There are a number of free and reduced-cost resources available to help California seniors age in place in their own homes. These include personal and respite care assistance, home-delivered meals, home modifications and weatherization, transportation and more. An individual may need to meet certain function and/or financial guidelines to qualify, depending on the program.
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.
Does California Medicaid Pay for In-Home Care?
The Medicaid program in California, Medi-Cal, currently has three programs in effect that cover the cost of in-home care and various related services for those who qualify. Seniors seeking assistance through these programs must meet specific financial and functional eligibility guidelines. While one, the In-Home Supportive Services program, is a Medi-Cal entitlement and available to all who apply, the Multipurpose Senior Services and Home and Community-Based Alternatives programs are waivers that limit the number of participants, so seniors may be placed on a waiting list after applying.
Are There Programs to Cover Home Modifications in California?
The Home and Community Services program is available to eligible California seniors who need help paying for home modifications that can allow them to age in place. Along with accessibility upgrades, this program offers a number of other services that may help seniors maintain their independence. The services available vary by area, so interested individuals should contact the Area Agency on Aging in their locale to learn if home modification assistance is offered and how to apply.
Are There Transportation Assistance Programs in California?
The California Department of Aging funds transportation programs throughout the state. The services are implemented at the county level through local Area Agencies on Aging, and generally offer nonemergency medical transportation to doctor appointments, health care and social service agencies, as well as for necessities, such as grocery shopping. Seniors may call 800-510-2020 to contact their Area Agency on Aging to learn about eligibility, the application process and scheduling service.
Does Medicare Pay for In-Home Care?
Medicare pays for care at home for eligible beneficiaries who are under a doctor’s care while recovering from surgery, hospital stay, injury or illness. Services, such as periodic skilled nursing care, short-term home health aide assistance and intermittent physical or occupational therapy sessions, are covered. Medicare does not pay for around-the-clock at-home care, daily help with personal care needs, such as bathing or dressing, homemaker services or home-delivered meals.
What Types of Services Does a Home Care Aide Provide?
Registered home care aides in California provide a wide range of nonmedical services that may help a senior remain living independently at home. These services may include assisting with activities of daily living and personal care, planning meals, cooking, cleaning, doing laundry, providing companionship and helping with grocery shopping or running errands. Home care aides may also remind a senior about taking medication, but they cannot administer medication or provide medical or nursing care.
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