Home Care in Iowa

Seniors who wish to age in place in Iowa have two options for their care. In-home care involves basic help with daily living tasks and housekeeping, while home health care adds some minor medical care. In Iowa, the average cost for in-home care is $5,529 a month, according to the 2021 Genworth Cost of Care Survey. This price increases just a little to $5,577 a month for home health care.

Though its average costs for in-home care and home health care are higher than national averages by about $500 a month each, Iowa has a fairly moderate price compared to nearby states. For example, in Illinois, both types of care cost $5,339 a month, about $200 less than in Iowa, while in Wisconsin, the cost is almost the same at $5,529 and $5,720 a month. Missouri has the lowest price among the neighboring states, at $4,767 a month for both care types. Minnesota has the highest average at $6,673 for in-home care and $6,912 for home health care.

Seniors in Iowa can choose to age at home or select another type of senior care available in the state. Nursing home care is the most costly care type, averaging $6,874 a month for a semiprivate room. For assisted living, seniors pay an average of $4,367, more than $1,000 less than in-home care. Adult day care is the most affordable, with an average cost of $1,353 a month.

In some cases, Iowa Medicaid can cover home care expenses for adults disabled or aged 65 and over. Standard Medicaid coverage will pay for home health care through Home Health Services, but not in-home care that is not health-related. This program covers care through Medicare-certified home health agencies, even if you are not homebound.

Other home care services fall under the Home- and Community-Based Services (HCBS) program. This program offers the Consumer Choices Option waiver, which allows you to control some of your Medicaid dollars to hire home care providers. The other HCBS waiver program is Consumer Directed Attendant Care, which lets you use Medicaid dollars to pay for in-home care and homemaker services.

Iowa has three waiver programs that allow people to use Medicare funds to pay for home care services, part of the Home- and Community-Based Services Waiver Program. To qualify for these programs, you must be Medicaid-eligible and require care that necessitates moving into an institution, but you are able to stay at home.

To receive Medicaid in Iowa, you must fit the state’s income guidelines and asset limitations. Regular Medicaid in Iowa limits income for single applicants to $10,092 a year. If a married couple applies, the total income limit is $15,132 a year. Iowa’s asset limitations are $2,000 for single applicants and $3,000 for married applicants.

To apply for Medicaid in Iowa, visit the Online Department of Human Services (DHS) Portal and complete the prescreening process to determine eligibility. Then, apply for assistance directly online. Create your account to fill in the application. If you prefer to mail in your application, download it online and then mail it to:

Imaging Center 4
P.O. Box 2027
Cedar Rapids, Iowa 52406

What Information You Will Need

Medicaid requires proper financial documents and proofs as part of the application process. You’ll need to supply the following:

• Proof of citizenship
• ID card or driver’s license
• Proof of any incomes
• Health insurance policy numbers
• Proof of state residency

How to Get Help Applying for Medicaid

Iowa’s Medicaid application is quite detailed. It may be overwhelming to answer the questions thoroughly and truthfully. There are several resources available in Iowa to help you apply and use your coverage appropriately once you’re approved.

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:

• Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
• Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
• Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
• Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

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 this guide.

Throughout Iowa, you’ll find several services available to help you stay comfortable and safe at home if you wish to age in place. These programs may provide food, home modifications and repairs, or financial assistance to help seniors with their personal needs, and all are available at little to no cost.

Iowa Home health care workers in Iowa employed by agencies using Medicaid and Medicare funds must have full vaccination against SARS-CoV-2 to serve. This ruling is from the Centers for Medicare & Medicaid Services and comes from the federal level. Though states took the matter to court, on January 20, 2022, a district court dismissed the case. Iowa does not have a specific law that requires home health care providers in other settings to have the COVID-19 vaccine, but it does allow for more generous exemptions than federal regulations. Home care agencies not under the federal requirement can establish their own rules.

These rules are current as of April 2022. The guidelines surrounding COVID-19 regularly change, so the local Area Agency on Aging is the best resource to check to learn more about the current regulations.

Home health agencies must follow the rules and regulations of Rule 441-78.9 of the Iowa Administrative Code. The Department of Human Services also provides a Home Health Services Provider Manual, and these rules are a requirement for agencies that accept Medicaid funds.

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.

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