Financial Assistance, Costs and Payment Options for Eldercare in California

Introduction:

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 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.

Did You Know?  The cost of assisted living in inland California can be 25% - 35% less expensive than assisted living on the coast. 

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California Elder Care Costs for 2018

California Assisted Living Costs:

The average cost of assisted living in California in 2018 is $4,070 / month. However, based on the geographic region of the state, the average monthly cost ranges from $1,020 to $10,720. In the most expensive areas of the state; Marin County, which includes the San Francisco area, San Mateo, San Luis Obispo, Santa Cruz, and Napa, the monthly cost ranges from $4,870 - $6,020. The least expensive assisted living can be found inland, in the cities of Madera, Merced, Stockton, and Modesto. In these areas, the average monthly cost is between $2,770 and $2,995. Alzheimer's residential care, also called Memory Care, can add as much as $1,170 to the monthly cost of assisted living.

California Home Care Costs:

In 2018, the average hourly rate for home care across California is $23.75. 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 $12.75 / hour, and on the high end, in-home care can be as much as $35.75 / hour.

The least expensive areas of the state for home care are Madera, Vallejo, and Riverside, where the average cost is closer to $17.25 / hour. In Napa, San Jose, Santa Rosa, and San Mateo, the cost is approximately $27.25 / hour.

California Adult Day Care Costs:

Adult day care is the most affordable care option for seniors. In 2018, the average daily cost is $80. In Chico, San Jose, and Santa Rosa, it is more expensive, ranging from $93 - $128 / day. The least expensive areas of the state for adult day care are Hanford, Stockton, Vallejo, and Visalia. Here, the average cost of adult day care is $43 - $61 / day. Several areas have costs slightly below the state’s average daily cost and include the following: Los Angeles, Madera, Redding, Salinas, Santa Cruz, and Santa Maria. In these areas, the average daily cost for adult day care is between $63 and $76.

 

 

CA Financial Assistance Programs

Medi-Cal Programs for the Elderly

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 and 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.

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), which helps individuals who are eligible for nursing home care, but would prefer to live in an assisted living community. While room and board is not covered, several supportive services are available, such as 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 that prefer to stay in their homes continue to do so. It covers care management and supportive services, such as adult day care, assistive technology, and home modifications, but 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 2018, a single elderly individual's monthly income cannot exceed approximately $1,235, or $1,664 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 (up to an equity value of $858,000 if a single applicant), household furnishings, burial plots, personal effects, and a vehicle are not included in the asset calculation.

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 structure their resources appropriately. If there is some question regarding 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).

 

State (Non-Medicaid) Assistance Programs

California also offers assistance programs for the elderly that do not require an individual to qualify for Medicaid (Medi-Cal). Unfortunately, as of 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.

The In-Home Supportive Services (IHSS) program, also mentioned above under Medicaid programs, is open to both Medicaid eligible and non-eligible persons and provides a variety of personal care supports to participants in their homes. This includes assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), such as bathing, eating, dressing, meal preparation, housekeeping, and transportation assistance. This program allows individuals to choose the provider of their choosing, including family members and even spouses. 

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, which provides financial assistance for elderly individuals or disabled persons to help them remain living in their homes.  Read more.

 

Other Financial Options for Care

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.

 

Finding Affordable Care in California

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.