Paying for Elder Care
This informational page is intended to explain the costs, payment options and financial assistance programs available to Californians seeking elderly care services both in residential and home environments.
The information below reflects the current data related to the state of California and not necessarily that of other states.
California Assisted Living Costs
The cost of assisted living in California varies depending on the city or county you live in. The average cost of assisted living across California in 2020 was $4,500/month (Genworth’s 2019 Cost of Care Survey). The range of monthly cost throughout California was lowest in inland cities such as Bakersfield, Madera, Merced, Stockton, and Riverside ($3,175 – $3,650) and highest in areas such as Marin County which includes San Jose, San Luis Obispo, Santa Cruz, and Napa ($5,250 – $5,853).
Assisted living residential services specializing in Alzheimer’s/Memory care increase the average monthly cost by 20-30%, or by approximately $993-$1,463.
California Home Care Costs
According to Genworth’s 2019 Cost of Care Survey, home care in California cost an average of $27.98/hour. The range of hourly cost throughout the state ranked lowest in Chico, Visalia, Bakersfield, and Riverside ($22.88 – $24.50/hour) and highest in Napa, San Jose, Santa Rosa, and San Francisco ($30 – $33/hour). The data also displays that areas such as San Diego and El Centro fall within the statewide average of approximately $28/hour.
Home health care is similar to home care, however the aid is conducted by a health care professional. Due to the level of expertise, this form of assistance is slightly more expensive in some areas of California, however, data regarding home health care shows the average hourly rate matches home care at roughly $28/hour.
California Adult Day Care Costs
At a daily average of $77, adult day care ranked as the most cost effective option for seniors in 2020 (Genworth’s Cost of Care Survey 2019). Statewide, the lowest daily costs were found in areas such as Hanford, Salinas, and Visalia ($40-$60/day) while the highest daily costs were in cities such as Chico, Santa Cruz, San Luis Obispo, and Santa Rosa ($107-$153/day). Locations such as Los Angeles, Bakersfield, Oxnard, Vallejo, Stockton, and Fresno offered services close to the statewide average.
CA Financial Assistance Programs
Medi-Cal Programs for the Elderly
Financial assistance in California is primarily allocated by Medi-Cal (also known as Medicaid nationwide). This program is designed to provide financial support for individuals who are elderly, disabled, and/or have limited income and resources.
Medi-Cal provides some personal and nursing home care. One such extension of Medi-Cal called In-Home Supportive Services (IHSS) Program helps assist eligible elderly persons with non-medical needs in order to prolong or prevent the need to be transferred into a nursing home. Services administered within this program include, but are not limited to, daily living activities, house cleaning, meal preparation, grocery shopping, etc. Individuals who meet the eligibility requirements will be granted these services and in addition are able to select their own provider for themselves and others within their immediate family.
Other programs designed to prolong or prevent nursing home admissions within the state Medicaid plan are called Home and Community Based Services (HCBS) waivers. These programs supply services such as home care, adult day care, home modifications, and assisted living.
Unlike the In-Home Supportive Services (IHSS) program, these waiver programs maintain an enrollment cap that, when reached, will cause the applicant to be placed on a waiting list.
The following are descriptions of the four (4) Home and Community Based Services (HCBS) Waiver programs:
1) The Assisted Living Waiver Program (ALWP) provides assisted living opportunities to some areas of California when nursing home placement is necessary but not desired. Room and board are not covered within the framework of the program, however services such as personal care assistance, administration of medication, and meal preparation are offered.
2) The Multipurpose Senior Services Program (MSSP) Waiver supplies in-home supportive services such as adult day care, personal emergency response systems, and personalized home medications. This program does not include medical care and is also limited to some but not all California counties.
3) The Home and Community-Based Alternatives (HCBA) Waiver can provide in-home medical care services to elderly individuals who are eligible for nursing home placement. This program can also help transfer current nursing home residents back into their homes with the proper supportive care and resources.
4) The Community Based Adult Services (CBAS) program supplies adult day care services such as, but not limited to, daytime care, meals, social activities, various therapies, and skilled nursing. Click the program name link for extended information.
Certain income and asset qualifications dependent on age and marital status must be met in order to be eligible for the state Medicaid plan and/or waiver programs. In 2020, the monthly income cap for a single/married elderly individual was approximately $1,294/$1,747 respectively. Assets can not exceed roughly $2000 for a single senior or $3000 for someone who is married. Calculation of assets does not include an individual’s house, home furnishings, burial plots, personal effects and vehicles.
Elderly individuals who exceed the qualification boundaries for income and assets may still be eligible. In the case of high medical expenses, those who exceed the income cap can apply to the Medi-Cal spend down program called Share of Cost to gain access to the above mentioned programs. Persons with assets outside of the range of eligible can work with a Medi-Cal planner to reconstruct their resources in order to qualify. If you know your income or assets exceed the qualifications for acceptance, contact a Medi-Cal Planner before submission of your application.
State (Non-Medicaid) Assistance Programs
Elderly individuals who do not require Medi-Cal services still have options for financial assistance by the state of California. Although the budget for Alzheimer’s-related care programs has been cut in recent years, some Area Agency on Aging offices can still provide adult day care funding.
In support of family members caring for their elderly loved ones, California Paid Family Leave provides up to six weeks of paid time off for those who work.
One program called Support at Home offered exclusively to San Francisco residents supplies financial assistance for elderly and disabled individuals who wish to remain at home.
Additional Financial Options for Care
In addition to state-funded programs for financial assistance, other non-profit and federal options exist as well.
Also consider programs that help veterans with assisted living as well as eldercare loans available in California.
An alternative to a reverse mortgage is something called Unison HomeOwner Agreement which can also be used to cover elder care costs for some families.
Finding Affordable Care in California
It is a good idea to contact multiple providers to find the most affordable elder care in your area. In regards to assisted living, communities more inland are less populated and thereby have cheaper care expenses.
Free assistance is available for determining the most cost-effective service for you and your loved ones in relation to your geographic location and specific elder care needs.