I. What You Should Expect to Pay for 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.

The Cost of Home Care and Home Health Care in Nearby States

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.

Home Care Home Health Care
Iowa $5,529 $5,577
National $4,957 $5,148
Illinois $5,339 $5,339
Wisconsin $5,529 $5,720
Missouri $4,767 $4,767
Minnesota $6,673 $6,912

The Cost of Home Care vs. Other Types of 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.

II. Can Medicaid Help You Pay for Home Care in Iowa?

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.

Home Care Waiver Programs in Iowa

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.

Program Contact What Is Covered
Home Health Services (HHS) (800) 338-8366 HHS lets seniors use Medicare funds to pay for home health agencies to take care of medical needs in their homes. To qualify, you must be Medicaid-approved and have a documented need for service. You don’t have to be homebound but need a physician’s certification, noting you need HHS to meet a medical need. These services must be health care needs that an unpaid caregiver, such as a family member or friend, can’t provide.
Consumer Choices Option (CCO) (800) 338-8366 CCO allows seniors to directly hire employees to take care of their home care needs. This program lets you employ your own support people, so you select the care provider you want. You work with Independent Support Brokers and Financial Management Service to manage your budget from the allocated Medicaid funding for your home care needs.
Consumer Directed Attendant Care (CDAC) (800) 338-8366 The CDAC program allows you to hire an attendant to help with daily living activities. The CDAC’s goal is to help seniors or disabled adults remain in their homes while recovering. Attendants can also help with some medical care needs, such as colostomy care or medication monitoring. This program is available to seniors on the HCBS waiver program. Seniors meet with their case managers to determine if CDAC would help them stay comfortably and safely at home.

How to Know if You're Eligible for Medicaid in Iowa

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.

2022 Medicaid Income Limits for Seniors in Iowa
Income Limits* Asset Limits
Single Person $10,092 $2,000
Two-Person Household $15,132 $3,000

*Per year

In addition, to qualify for Iowa Medicaid, you must meet these criteria:

  • U.S. citizenship or qualified legal residency
  • Iowa residency
  • Need help obtaining medical care or medical coverage

How to Apply for Medicaid in Iowa

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.

Contact Area Served Services Provided
Legal Hotline for Older Iowans (800) 992-8161 Entire State The Legal Hotline for Older Iowans is a free phone-based legal advice provider for Iowa residents ages 60 and older. If you’re having trouble with your Medicaid approval, you can call the number to get legal advice and learn more about your options.
Iowa Department of Human Services (855) 889-7985 Entire State The Help Center, through the IDHS, provides help with Medicaid applications over the phone. They can also connect you with counselors in your area who can provide support as you get through your application.
Iowa Medicaid Member Services Hotline (800) 338-8366 Entire State Iowa operates a Medicaid Member Services Hotline available to those approved for Medicaid but need help using their coverage well. You can call the hotline to verify if you have Medicaid coverage or ask for your coverage certification.

III. Can You Use Medicare to Pay for Home Care in Iowa?

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.

IV. Other Financial Assistance Options for Home Care in Iowa

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.

V. Free Resources for Aging in Place in Iowa

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.

Contact Area Served Services Provided
Medicaid Home Delivered Meals Managed Care Organization Referral Entire State Seniors who qualify for full Medicaid benefits may also be eligible to receive home-delivered meals. This service is in addition to the Meals on Wheels programs available through the Area Agencies on Aging.
Home Repairs and Modifications (800) 432-9209 Western, Southwestern and South Central Iowa Connection Area Agency on Aging offers a Home Repairs and Modification program for older Iowans living in the agency’s service area. This program provides help with making a home safe for seniors aging in place. The program is based on financial need, not income. It also covers vehicle modifications for seniors who need accessible vehicles.
Area Agencies on Aging (AAA) Online Statewide Iowa has six Area Agencies on Aging. These agencies provide services to assist seniors with aging in place. The AAA is the contact point for most home-delivered meal and transportation services available to seniors within their local communities.
Iowa Aging and Disability Resource Center (ADRC) (866) 468-7887 Entire State The Iowa Aging and Disability Resource Center connects older Iowans with the resources they need to age at home with dignity and safety. Seniors can access the ADRC and its services through their local AAA.
Iowa Weatherization Assistance Program (515) 242-5655 Entire State The Weatherization Assistance Program helps elderly or disabled Iowa residents make their homes more energy-efficient to reduce their utility bills. This program gives seniors a computerized energy audit to determine areas where they could benefit from more energy efficiency. The program will then pay for some of these energy-efficient and indoor air quality additions.


VI. Vaccination Requirements & COVID-19 Rules for Home Care Aides in Iowa

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.

VII. Rules and Regulations for Home Care Providers in Iowa

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.

What Types of Care Can Be Provided? Home care providers assist with daily living activities, including nonmedical care with hygiene and housekeeping. They may also provide companionship and help with running errands. Home health care providers can administer some health care needs at home, including occupational and physical therapy, skilled nursing care and other services outlined by the senior’s doctor.
Are Care Plans Required? Home care does not require care plans, but home health care does. The care plan must be in place when home health care services begin, and it must be reviewed every 60 days.
Can Home Care Providers Assist with Medication Management? Yes, home care providers and home health care providers can administer medications as outlined by the senior’s doctor.
Are There Special Requirements for Screening Home Care Aides? Under Iowa Code section 135C.33, those who will be providing in-home care for seniors under any of the Home- and Community-Based Services waiver programs must have a criminal background check.
Are Home Care Aides Required to Undergo Special Training? In-home caregivers do not have to follow any specific training requirements based on state law. However, if they are certified nurse aides, they must fulfill the state certification requirements. Also, specific home health agencies can set training mandates for their staff based on their individual goals and needs.
Does Medicaid Cover Home Care in Iowa? Yes, Medicaid covers home care under the Home- and Community-Based Services waiver programs. It covers home health care under the Home Health Services program.
How Do I Report Abuse of Myself or a Loved One? Contact Dependent Adult Protective Services at (800) 362-2178.

VIII. How to Find a Home Care Provider in Iowa

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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