TABLE OF CONTENTS
While home care and home health care are both available in your own home, there are some key differences between these options. Home care primarily provides basic services that you’d otherwise be able to perform yourself if age or impairment wasn’t an issue, including transportation for doctor’s appointments and errands, meal preparation and simple chores around the house. Home health care is specialized and is usually performed by licensed health professionals. This type of care may include catheter care, medication administration and physical or occupational therapy. Despite their difference, both care types cost approximately $6,101 per month in California.
Nationally, seniors pay $4,957 per month for home care and $5,148 for home health care, but in certain regions of the country where the cost of living is higher, care tends to cost more. In California, agencies charge over $1,000 more per month for services with fees for both levels of care coming in at $6,101. To the north in Oregon, home health care is the same at $6,101 and home care is a little cheaper at $6,006. In Arizona, home care and home health care costs average $5,339 and $5,434, and in Nevada, both types of care cost $5,148.
|Home Care||Home Health Care|
Home-based care is among the costlier long-term care options in California, with home care and home health care costing approximately $6,101 per month. Only nursing home care, which provides skilled nursing services in an institutional setting, is more expensive at $9,794. Assisted living features a similar scope of services as home-based care in a residential setting for $5,250 per month. Adult day care is the cheapest option at $1,842.
If your retirement income isn’t enough to cover home-based care, you may be able to pay for services through Medi-Cal, California’s Medicaid program. Medi-Cal provides coverage for essential health benefits such as outpatient care, emergency medical services and home health care. While it doesn’t have coverage for basic in-home services such as housekeeping and companion care, you may be eligible to sign up for one of several Medi-Cal programs and waivers to get this coverage. These programs include the In-Home Support Services Program, the Multipurpose Senior Services Program Waiver, the Home and Community-Based Alternatives Waiver and the Program of All-Inclusive Care for the Elderly.
If you need help covering in-home care expenses, you may qualify for one of Medi-Cal’s four programs or waivers. These programs are designed to help you remain in your own home by providing you with the services you’d typically otherwise receive in an assisted living or skilled nursing facility. Program rules and eligibility requirements vary from one program to another, but in general, you must qualify for Medi-Cal and be assessed by the Department of Health Care Services to need the services a given program provides.
|Contact||Area Served||Services Provided|
|In-Home Support Services Program||866-376-7066||Statewide||The IHSS waiver helps you avoid the transition to an assisted living facility or nursing home by paying for in-home care. Through this waiver, you can get services such as meal preparation, transportation, medication reminders, companionship, personal care and light housekeeping, depending on the needs assessment a county social worker conducts during an initial home visit. You may be eligible for this waiver if you’re at least 65 years old and enrolled in Medi-Cal. To begin the process, call or visit your local county’s IHSS office.|
|Multipurpose Senior Services Program Waiver||800-300-1506||46 counties||The MSSP Waiver is for older adults who need nursing home level care but want to stay in their own homes. This waiver provides services such as case management, personal care services, housekeeping and chore services, money management and home-delivered or congregate meals, keeping you safe and comfortable at home. You’re eligible for this program if you’re at least 65 years old, eligible for Medi-Cal and would require nursing home placement if not for these services. You also must live within an active MSSP Site. More information on this program is available through your local DHCS office.|
|Home and Community-Based Alternatives Waiver||833-388-4551
|Statewide||If you’re currently living in a nursing home but want to move back into your own home, you may qualify for the HCBA waiver. This waiver is similar to the MSSP waiver, providing the same services to those with the same scope of needs, but it focuses on shortening the duration of nursing home placement. There are nine waiver agencies throughout the state, and the one you obtain services from depends on your county or, if you live in Los Angeles or Orange Counties, your zip code. For information on qualifying and applying for this waiver, email [email protected].|
|Program of All-Inclusive Care for the Elderly||916-713-8444||33 service areas||PACE is a comprehensive program jointly administered by Medicare and Medi-Cal to provide a full spectrum of services to those who qualify for nursing home placement but want to remain in the community. Some services this program covers include inpatient and outpatient medical care, transportation, physical and occupational therapy, personal care and meal preparation. To get services, you must be at least 55 years old and live in your own home or that of a family member. You must also live within one of the 33 PACE services areas in the state. You can get more information on how to apply for services by calling the California Department of Health Care Services or emailing [email protected].|
To qualify for Medi-Cal, you must meet the program’s income and asset limits. If you’re single, you may have an annual income of up to $18,768 and up to $2,000 in countable assets. Certain assets, including your primary dwelling, one vehicle and your personal belongings don’t count toward this limit. If you’re married, you and your spouse may have a joint income of up to $25,272 and up to $3,000 in countable assets.
|Income Limits*||Asset Limits|
Along with financial criteria, you must meet a few other eligibility requirements to qualify for Medi-Cal. These include:
For many people, the simplest way to apply for Medi-Cal is to submit an online application through www.CoveredCA.com. If you want help with the process, you can call or visit your local social services office. You may also print off, fill out and mail a completed Single Streamlined Application to the office
What Information You Will Need
Before submitting an application, it’s helpful to compile necessary documents that support your need and eligibility for Medi-Cal. These include:
How to Get Help Applying for Medicaid
Several agencies and helplines provide support for Medi-Cal beneficiaries, ensuring you get the information and guidance you need through the application process and as a policyholder.
|Contact||Area Served||Services Provided|
|Certified Enrollment Counselor||855-324-3147||Statewide||You can contact your local Certified Enrollment Counselor for free personalized help with signing up for Medicaid and its waiver programs. CECs answer any questions you have about eligibility requirements and coverage and can provide more information on supporting documents you should submit along with your application.|
|Medi-Cal Managed Care Ombudsman||888-452-8609||Statewide||If you run into problems with your Medi-Cal coverage, such as denied coverage for services or canceled policies, you can reach out to the program’s dedicated ombudsman for free and impartial information and assistance.|
|Medi-Cal State Fair Hearing||800-952-5253||Statewide||If Medi-Cal denies or changes coverage for a service, you have the right to a fair hearing. To have your case considered, file a hearing request with the California Department of Social Services, State Hearings Division, within 90 days.|
Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.
Below is an overview of some of the services typically covered by Medicare for those who are eligible:
As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.
Read our guide to Medicare and Home Care Coverage for more information.
While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for Home Care in this guide.
Whether you’re seeking home-based care to remain in your own home or transition out of a nursing home, California has several programs and agencies to help you navigate the system and get the support you need. Through the following resources, you can find free and low-cost services such as meal deliveries, weatherization services, property tax assistance and friendly phone calls.
|Contact||Area Served||Services Provided|
|Area Agencies on Aging||800-510-2020||Statewide||Your local Area Agency on Aging is a vital resource that serves as a single point of entry to numerous statewide and regional programs that help you maintain your safety and independence at home. Through the AAA, you can find social and recreational programs, congregate meals and transportation services. Agencies also provide low-cost in-home and home health care services, which may help reduce the overall monthly cost of your care.|
|California Department of Veterans Affairs||800-952-5626||Statewide||If you or your spouse is a U.S. veteran, the California Department of Veterans Affairs is here to help you access the benefits and services you’re eligible for. Through one of the department’s county offices, you can obtain benefits counseling and assistance with applying for programs such as Aid and Attendance, veterans’ and survivors’ pensions and disability compensation, which can help offset home-based care costs.|
|California Community Action Partnership Association||916-443-1721||Statewide||CalCAPA oversees and supports Community Action Agencies throughout the state, promoting access to members of the community with financial and functional needs. Services vary depending on the local CAA but typically include weatherization services, home modifications, home-delivered and congregate meals and bill assistance programs.|
|Meals on Wheels California||[email protected]||Statewide||Meals on Wheels provides home-delivered meals to those unable to obtain meals themselves because of age or disability. Your local Meals and Wheels provider may provide daily noontime and evening meals, as well as frozen meals for weekends. Rules regarding eligibility and cost-sharing responsibilities vary from one provider to another.|
|Legal Aid Foundation of Los Angeles||800-399-4529||Los Angeles County||If you’re in the Los Angeles region and you need help with applying for public benefits such as Social Security, Supplemental Security Income and Medicaid, the Legal Aid Foundation of Los Angeles may be able to help. This nonprofit agency is staffed with legal professionals who specialize in age-related issues and benefits assistance. To find help outside Los Angeles County, contact the State Bar of California.|
|Property Tax Postponement||800-952-5661||Statewide||The statewide property tax postponement program can help you afford living expenses by postponing the current year’s property taxes. This is done through a secured loan that isn’t repaid until certain qualifications are met, such as selling your residence. To qualify, you must have an adequate amount of equity in your home.|
|California 2-1-1||2-1-1||Statewide||California 2-1-1 provides over-the-phone information and referrals for community-based programs and services. You can call this helpline for free assistance with locating wellness services, social and recreational programming, durable medical equipment loans and in-home care.|
As of April 2022, home care and home health care agencies are required to ensure caregivers are fully vaccinated against COVID-19. If a caregiver contracts the virus, they must receive a booster shot within 90 days of the infection. As new variants of the virus are introduced to the population or if infection rates spike, these guidelines may change. Your county’s health department or the local Area Agency on Aging may have updated information.
In some cases, home care agencies have rules above and beyond what the state or federal government requires, and staff members may abide by increased guidelines for masking and vaccinations. If you have questions or concerns about COVID policies, it may be a good idea to contact the home care provider directly.
The California Department of Social Services, Home Care Services Bureau, oversees and licenses home care agencies in the state. It enforces rules regarding the scope of care these agencies provide, training requirements and how to report abuse.
|What Types of Care Can Be Provided?||Home care aides provide non-medical assistance with daily living activities such as bathing, dressing, meal preparation and transportation, as well as companionship services and basic housekeeping and chores.|
|Are Care Plans Required?||Before administering care, home care agencies provide in-home assessments to determine what services you need and to create a care plan based on your needs and goals. Your care plan contains details on who provides your care and when as well as how much services cost. You have the right to be involved in this process and to request changes to your care plan as needed.|
|Can Home Care Providers Assist with Medication Management?||Home care providers can assist you with self-administered medication. This may include removing it from its packaging, letting you know when it’s time to take the medication or reminding you to fill your pillbox. They’re not permitted to administer the medication to you.|
|Are There Special Requirements for Screening Home Care Aides?||Whether home care aides undergo screening prior to being placed in your home depends on whether they work for a licensed or unlicensed home care agency. Licensed care providers are cleared of tuberculosis and undergo criminal background checks. Unlicensed care providers aren’t subject to this requirement.|
|Are Home Care Aides Required to Undergo Special Training?||Home care aides who work for licensed home care agencies are required to meet minimum training requirements. However, those who don’t work for licensed agencies aren’t required to undergo any training.|
|Does Medicaid Cover Home Care in California?||Medi-Cal, California’s Medicaid program, doesn’t pay for home care directly, but it pays for services under four waivers and programs including the In-Home Support Services Program, the Multipurpose Senior Services Program Waiver, the Home and Community-Based Alternatives Waiver and the Program of All-Inclusive Care for the Elderly.|
|How Do I Report Abuse of Myself or a Loved One?||To report abuse, individuals should call Adult Protective Services, which investigates complaints made by or on behalf of those aged 60 and over or those with disabilities aged 18-59. Call 833-401-0832 and when prompted, enter your zip code to be connected with your county’s APS. This service is available 24 hours per day, seven days per week.|
Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, 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 be the best fit for you and your family.