Page Reviewed / Updated - February 11, 2021
This webpage will help Californians understand assisted living, home care, and adult day care costs throughout the state. It also explores payment options and financial assistance programs available to assist in caring for the elderly, be that in residential care or for aging in place at home.
The programs outlined here are comprehensive of what is available from the state of California. But it is not comprehensive of what is available at a national level. To search for assistance nationwide, and the program that best fits your needs and circumstances, make sure to use our Resource Locator Tool.
Cost of Care Calculator
According to Genworth’s Cost of Care Survey 2019, the average cost of assisted living in California in 2020 is $4,500 / month. However, based on the geographic region of the state, the average monthly cost ranges from $3,175 to $5,853. Marin County, which includes San Jose, San Luis Obispo, Santa Cruz, and Napa, is the most expensive area of the state. Here the monthly cost ranges from $5,250 - $5,853. Please note that while San Francisco is also in Marin County, the average cost of assisted living is lower in this area with an approximate cost of $4,750 / month. In the areas of Sacramento and Los Angeles, the average cost of assisted living is on par with the statewide average of $4,500 / month. The least expensive assisted living can be found inland, in the cities of Bakersfield, Madera, Merced, Stockton, and Riverside. In these areas, the average monthly cost is between $3,175 and $3,650.
Alzheimer's residential care, also called Memory Care, is on average 20% to 30% more costly. This type of care can add as much as approximately $993 to $1,463 to the monthly cost of assisted living.
In 2020, per Genworth’s 2019 Cost of Care Survey, the average hourly rate for home care across California is $27.98. As with the cost of assisted living, the average range across the state is large. On the low end, in-home care can be found at $22.98 / hour, and on the high end, in-home care can be as much as $33.00 / hour. The least expensive areas of the state for home care are Chico, Visalia, Bakersfield, and Riverside, where the average cost is closer to $22.88 - $24.50 / hour. On par with the statewide average, the areas of San Diego and El Centro have average hourly costs of approximately $28.00. The costliest home care can be found in Napa, San Jose, Santa Rosa, and San Francisco, where the cost is approximately $30.00 - $33.00 / hour.
Home health care, which is provided by a health professional, is also available and is essentially the same average hourly cost statewide as is home care at $28.00 / hour. However, in some areas of the state, the cost of home health care does have a higher average hourly cost. In the areas of Santa Maria and Santa Cruz, the average cost is approximately $1.00 more per hour, and in Vallejo, it is $2.50 / hour more on average.
Adult day care is the most affordable care option for seniors. Genworth’s Cost of Care Survey 2019 shows the average daily cost in 2020 to be $77. In Chico, Santa Cruz, San Luis Obispo, and Santa Rosa, it is more expensive, ranging from $107 - $153 / day. The least expensive areas of the state for adult day care are Hanford, Salinas, and Visalia. Here, the average cost of adult day care is $40 - $61 / day. Several areas have costs slightly below the state’s average daily cost. They include the following: Los Angeles, Bakersfield, Oxnard, Vallejo, Stockton, and Fresno. In these areas, the average daily cost for adult day care is between $68 and $76.
Medicaid in California is called Medi-Cal. It is a program for disabled and elderly individuals and persons with limited income and resources. Through Medi-Cal, some personal care, as well as nursing home care is provided.
As part of Medi-Cal, there is an In-Home Supportive Services (IHSS) Program. Via this state Medicaid program, non-medical care is provided for eligible elderly individuals to prevent or delay nursing home placement. Services and benefits may include assistance with daily living activities, housecleaning, meal preparation, and grocery shopping, to name a few. This program is an entitlement, meaning if one meets the eligibility requirements, services will be received. This program allows individuals to choose the provider of their choosing, including family members and even spouses.
In addition to the state Medicaid plan, four programs (or Medicaid "waivers"), also referred to as Home and Community Based Services (HCBS) waivers, are available that provide assistance for home care, adult day care, home modifications, and assisted living. These programs are also in place to help prevent nursing home placements. Unlike the state Medicaid plan, Medicaid waivers are not entitlement programs. This means there are enrollment caps for program participation, and if the cap has been reached, a wait list for services will exist.
1) In some areas of California, Medi-Cal offers the Assisted Living Waiver Program (ALWP). It helps individuals who are eligible for nursing home care, but would prefer to live in an assisted living community. While room and board are not covered, several supportive services are available. These can include personal care assistance, medication administration, and prepared meals. Read about the Assisted Living Waiver eligibility, benefits, and locations.
2) The Multipurpose Senior Services Program (MSSP) Waiver helps nursing home eligible individuals who prefer to stay in their homes continue to do so. It covers care management and supportive services, such as adult day care, personal emergency response systems, and home modifications. But it doesn't pay for medical care. This program, unfortunately, is not available in every county of California. Read about Medi-Cal MSSP Waiver eligibility requirements and benefits.
3) The Home and Community-Based Alternatives (HCBA) Waiver, previously called the Medi-Cal Nursing Facility / Acute Hospital (NF/AH) Waiver, is a combination of several former waivers that helps nursing home eligible individuals receive care services, including medical care in their homes. This program also offers assistance to individuals currently residing in nursing facilities who wish to move back to their home. Read about HCBA Waiver eligibility and benefits.
4) Medi-Cal's Adult Day Health Care program has transitioned into the newly created Community Based Adult Services (CBAS) program. This program provides daytime care, meals, social activities, therapies, and skilled nursing. Functional needs must be met.
In order to qualify for the state Medicaid plan or one of the waivers, Medi-Cal has both income and asset qualifications. These limits depend on one's age and marital status. As of 2020, a single elderly individual's monthly income cannot exceed approximately $1,294, or $1,747 as a married couple. An individual can qualify for Medi-Cal if the total value of their assets does not exceed $2,000, and for a married couple, $3,000. One's home, household furnishings, burial plots, personal effects and a vehicle, are not included in the asset calculation. CA is unique in that there is no equity interest limit for one’s home to be exempt.
Persons with income and assets over these limits can still become eligible for Medi-Cal assistance. Individuals whose income exceeds the limit(s), but who have high medical expenses may qualify through a Medi-Cal spenddown program called Share of Cost. Persons with assets valued over the limit might become eligible by working with a Medi-Cal planner to restructure their resources appropriately. If there is some question about qualification, it is strongly recommended individuals contact a Medi-Cal Planner prior to application. This especially holds true if one is over the income and / or asset limit(s).
California also offers assistance programs for the elderly that do not require an individual to qualify for Medicaid (Medi-Cal). Unfortunately, in 2012, the budget for Alzheimer's Day Care Resource Centers (ADCRC) was cut by the state. However, some Area Agency on Aging offices may have funding to assist with the cost of adult day care.
Another option for working families caring for a loved one is California Paid Family Leave. This program provides up to six weeks paid time off for working professionals, specifically to care for a family member.
Finally, for San Francisco residents, there is a local, pilot program called Support at Home. It provides financial assistance for elderly individuals or disabled persons to help them remain living in their homes. Read more.
In addition to these state specific options that help pay for care, there are many non-profit and federal options. Use our Resource Locator Tool to find other programs that help pay for or reduce the cost of care. There are also programs that help veterans with assisted living, and there are eldercare loans available in California.
While reverse mortgages are available nationwide, California's real estate values have resulted in a unique financial product. This is an alternative to a reverse mortgage and can be used to pay for elder care for some families. This is the Unison HomeOwner Agreement.
Given the broad range of elder care pricing throughout the state of California, there is good reason to contact multiple providers to find the most affordable care. When considering assisted living in particular, one should consider communities away from the densely populated coastal areas if price is of concern. To help families with this process, our organization provides a free service that matches an individual's specific care needs with care providers in their price range in their preferred geographic area. Click here for assistance finding affordable care.
For more information about the costs and resources available in California cities, click on the links below.