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Financial Assistance, Costs and Payment Options for Eldercare in Iowa

Page Reviewed / Updated - May 2019

Introduction:
This webpage is intended to assist Iowa residents in understanding the costs associated with long-term elderly care. Average costs for assisted living, home care and home health care, and adult day care throughout the state and various geographic locations will be explored. Financial assistance programs and programs providing senior care and services, whether it be in the home or in an assisted living facility, will also be covered.

While the programs outlined on this page are comprehensive of what the state of Iowa has to offer, it is not comprehensive of what is available nationally. In order to find the best care for your needs and budget, it is important to consider all of your options. To assist in your search for nationwide assistance, make sure to use our Resource Locator Tool

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Iowa Elder Care Costs

Assisted Living / Memory Care

As of 2019, the average statewide cost of assisted living in Iowa is $3,847 / month. The most affordable assisted living can be found in Sioux City ($3,050 / month). In the areas of Davenport, Cedar Rapids, and Des Moines, the average monthly cost of assisted living is just over the statewide average at $3,865 - $3,950. The areas of the state where assisted living is the costliest are Dubuque ($4,100 / month) and Iowa City ($4,175 / month).

For seniors that need a higher level of supervision and assistance due to Alzheimer’s or a related condition, Memory Care assisted living is available at an additional $780 to $1,154 / month.

Home Care

The average hourly cost of non-medical home care statewide in Iowa in 2019 is $24.00. However, cost can vary quite dramatically based on one’s geographic location within the state, currently ranging from $21.00 to $27.50 / hour. In Cedar Rapids and Davenport, the average rate is $21.00 to $22.00 / hour. In Dubuque, Iowa City, and Waterloo, the hourly rate ranges from $23.00 to $23.25. The most expensive hourly rates for home care are in Ames and Des Moines at $25.00 and Sioux City at $27.50.

Home health care, provided by health care professionals, is also available in Iowa. On average, this type of in-home care costs $1.00 more an hour.

Adult Day Care

In Iowa, in 2019, the most affordable mode of care is adult day care, with the average daily cost throughout the state being $62 / day. This rate can vary significantly depending on one’s geographic location within Iowa. Sioux City, by far, has the most inexpensive adult day care with a daily average of $35. That said, the following areas all have average daily rates between $58 and $69: Des Moines, Waterloo, Davenport, Cedar Rapids, Iowa City, and Dubuque. The costliest day care is found in Ames with an average rate of $80 /day, which is just above the national daily average of $72 / day.

Iowa Financial Assistance Programs

Medicaid Programs for the Elderly

Medicaid Background
Medicaid is a nationwide program that offers health insurance to low-income residents of the United States. While the federal government sets the parameters of this program forth, each state can operate its program as they see fit within the given parameters. In Iowa, like each of the other states, Medicaid will cover the cost of nursing home care, in addition to limited home and community based services. Medicaid in Iowa also offers Medicaid Waivers, intended to provide long-term care for those who are elderly and / or disabled. These waivers are meant to provide these individuals support and services to assist them in aging in their homes and communities, rather than be placed in nursing homes. Please note: Medicaid waivers are not entitlement programs. This means that there is limited capacity for participants, and once the enrollment cap is met, there will be a waitlist for services. 

Medicaid Waivers
The Home and Community Based Services Elderly Waiver provides in-home care and support for Iowa residents who require care equivalent to that which is provided in a nursing home. This program allows for consumer direction, meaning eligible applicants are able to choose which services best benefit them and who to hire, including some family members. Other benefits may include attendant care, home health aide, nursing care, chore services, and home and vehicle modifications.

The Health and Disability Waiver is intended for physically disabled individuals under the age of 65. Those enrolled in this program are able to choose their own attendant care worker, regardless of whether they live at home or in an assisted living facility. Other benefits of this program include adult day care, homemaker services, meal delivery, personal emergency response systems, and nutritional counseling.

Eligibility Requirements
An individual’s functional ability, income, and assets are all taken into consideration when applying for long-term care Medicaid in Iowa. To be financially eligible in 2019, Iowa residents must have a monthly income that does not exceed $2,313. This amount is equivalent to 300% of the Federal Benefit Rate (FBR). A single applicant’s assets cannot be greater than $2,000, but does exclude certain items, such as an individual’s home, if not valued over $585,000, and the applicant, or their spouse, lives in the home. Household items and personal effects are also exempt.

If income and assets are over the allowable amounts, this does not automatically call for Medicaid disqualification. For instance, if a married applicant’s spouse is not applying for Medicaid, a certain portion of the applicant’s income and joint assets can be given to the non-applicant (community) spouse. These rules are in place to prevent spousal impoverishment, but also effectively lower an applicant’s income and assets for qualification purposes. As of 2019, up to $3,160.50 / month in income can be transferred to the community spouse, and up to $126,420 in assets can be retained by the non-applicant spouse. However, it is highly suggested one seek assistance from a Medicaid Planning Professional prior to applying for Medicaid in order to reallocate income and assets. Learn more.

State (Non-Medicaid) Assistance Programs

The Iowa Able Foundation Loan Program provides low interest loans to elderly and disabled individuals so they can buy assistive technology or make modifications to their home, improving their independence. Eligible purchases and projects include motorized wheelchairs, wheelchair ramps, and walk-in bathtubs. One must have the resources to be able to repay the loan.

The Senior Living Program - Case Management Program for Frail Elders provides a number of services and supports to enable seniors to continue to live in their home, as opposed to a nursing home facility. Benefits may include home health aide, homemaker services, nursing care, adult day care, respite care, and personal emergency response systems. This program allows for self-direction of some services, including hiring relatives to provide personal care.

Other Financial Options for Care

In addition to the state specific programs that assist in covering the cost of elderly care in Iowa, there are also federal and non-profit programs available. In order to find other programs that assist in paying for care or reduce your out-of-pocket cost, make sure to use our Resource Locator Tool.  This tool makes it easy to locate and consider all of your options and choose the program that best fits the circumstances. Eldercare loans and programs that aid veterans with assisted living are other available options.

Finding Affordable Care in Iowa

As determined by the numbers above, the cost of senior care can vary a great deal across the state of Iowa, particularly when it comes to assisted living and home care. The best way to manage the cost of care is to appropriately assess needs and then opt for a high quality provider at an affordable rate. To aid in this search, our organization has partnered with several organizations that maintain large databases of care providers. Via this free service, care needs are matched with qualified providers within the preferred geographic location, while also taking budget into account. Click here to find affordable care.

Top Cities for Senior Care in Iowa

For more information about the costs and resources available in Pennsylvania cities, click on the links below.