In-Home Care for OIder Adults in California: Cost & Payment Options

October 22, 2024

California is seeing a growing need for in-home senior care to address the aging population and the desire for seniors to age in place in an in-home setting. In-home care can sometimes be a less expensive option than in-facility care, depending on the level of care needed. It also provides seniors with comfort, social independence, and dignity in a familiar setting.

We’ll cover the costs of in-home care in California, the factors that influence these costs, and available resources and payment options for families considering in-home senior care.

Understanding In-Home Care Costs in California

The cost of living in California is one of the highest in the United States, and in-home healthcare costs reflect this reality. Higher wages are necessary to support the cost of living for caregivers, and services like transportation and meal delivery come at a premium compared to other states.

Factors Influencing Costs

In-home care costs in California vary widely due to several key factors:

  • Type of Care Needed: Medical care often requires licensed professionals, like nurses, which is more costly than non-medical care, such as assistance with daily grooming and home care activities.
  • Geographic Location: Urban areas, such as Los Angeles and San Francisco, generally have higher rates than rural areas due to the overall cost of living.
  • Level of Care: Full-time care incurs higher costs than part-time or intermittent care.
  • Additional Services: Specialized care, such as memory care for Alzheimer’s patients, or extra services, like housekeeping, meal provision, or transportation, can also increase costs.

Understanding these factors is essential when planning for in-home care.

Average Costs Across California

According to Genworth Financial's most recent data, the average cost of hiring a Home Health Aide in California is $37.00 an hour. 

However, these rates fluctuate depending on the region. For example, in the San Francisco Bay Area, rates average $45.00 an hour, while in Los Angeles, they are slightly lower, averaging $35.00 an hour.

After reviewing estimates from tools like Genworth, it’s a good idea to reach out to a few in-home care providers, such as Clara Home Care, to get a clear picture of actual costs in your specific area.

Payment Options for In-Home Care

There are several ways to cover the costs of in-home care, including out-of-pocket payments, insurance coverage, and government support programs. Families can often combine these payment methods to ease the financial burden.

Clara Home Care provides flexible payment options, working with various insurance programs and out-of-pocket solutions to ensure families can manage the cost of care.

Out-of-Pocket Payment

Some seniors may be able to manage in-home care costs using retirement savings or by having budgeted for long-term care in advance. However, those who haven't planned or who face unexpected medical challenges may need to explore other funding options.

Ways to access funds for in-home care include:

  • Personal savings
  • A pension or other retirement fund
  • Income from investments
  • Proceeds from the sale or refinancing of a home
  • Reverse mortgages, annuities, and trusts
  • Family members who contribute to their loved one’s financial needs
  • Certain life insurance policies

Some life insurance policies offer an accelerated death benefit, which provides tax-free cash advances while the insured person is still alive. Patients qualify for these benefits if they live in nursing care permanently, need long-term care for an extended time, or have a life-threatening diagnosis. It’s important to check each policy to understand what benefits are available and when they can be accessed.

Additionally, selling a life insurance policy through a life settlement or viatical settlement could provide funds to cover long-term care costs. Checking with your employer-sponsored plan or your insurance provider can help you determine eligibility for this option.

Insurance Coverage

Long-term care expenses may be covered by Medicaid and long-term care insurance policies, but Medicare and standard private health insurance typically do not cover these costs.

Types of services that may be covered by insurance include:

  • Housecleaning
  • Meal preparation/delivery
  • Grocery shopping or food delivery services
  • Personal care, such as bathing, personal care, and paramedical services
  • Accompaniment to doctor appointments‍

Government Programs

California’s state healthcare benefits program, Medi-Cal, covers many in-home healthcare services. 

The In-Home Support Services (IHSS) program, designed for individuals with disabilities and seniors over 65, allows eligible residents to remain in their homes safely as an alternative to out-of-home care. Medi-Cal determines eligibility for this program based on factors such as income, household size, age, disability status, and residency in California.

Financial Assistance and Community Resources

When in-home care is required, community resources can provide critical support. One of the best resources available to Californians is the Aging and Disability Resource Connection, which coordinates many services for seniors and disabled adults.

This organization works in partnership with the Area Agencies on Aging (AAA), making it an excellent starting point for those seeking assistance.

Steps to Plan and Budget for In-Home Care

Budgeting is a vital step in managing the costs of in-home care. Start by assessing your loved one’s care needs. Consider the level of care required—whether it’s housework, daily grooming, or specialized medical care—and determine the duration of care needed.

Planning for long-term care is also essential as you or your loved one ages. It may be helpful to consult professionals who specialize in financial planning and elder law to ensure your budget covers future needs.

Assessing Care Needs

A professional needs assessment is necessary to determine what services are required and how many hours of care will be authorized by your insurance plan.

This assessment may involve input from family, friends, a physician, or other licensed healthcare professionals who can advocate for your loved one’s best interests.

Creating a Budget

Managing the costs of in-home care requires careful financial planning. Start by estimating monthly expenses based on the type and level of care required. If care is only needed temporarily, such as for recovery from surgery, the costs may be lower than for long-term care for chronic illnesses. Consider long-term financial planning that accounts for potential future care needs and cost increases.

When planning for in-home care, it's helpful to consult with providers like Clara Home Care, who offer tailored in-home care support based on your specific budget and care requirements.

Seeking Professional Advice

While online resources are a good starting point for planning in-home care, consulting financial planners, estate planners, and elder law attorneys can provide valuable insight into managing long-term care costs. Additionally, caseworkers from Medicare, Medicaid, or local community resources can help guide you in setting up care and accessing financial support.

You can also work directly with agencies or service providers, like Clara Home Care, who offer tailored in-home care support based on your budget and needs.

Putting it All Together: Next Steps for Paying for In-Home Care in California

Here’s a quick checklist to help you take the next steps in planning and paying for in-home care in California.

  1. Assess Care Needs: Determine the level of care required, from daily living assistance to medical support. Schedule an assessment: Aging and Disability Resource Connection.
  2. Explore Payment Options: Look into payment methods like out-of-pocket, Medicaid, long-term care insurance, and Medi-Cal’s IHSS. Check Medi-Cal eligibility: Medi-Cal Eligibility.
  3. Apply for Government Assistance: Eligible individuals can apply for Medi-Cal’s IHSS for in-home services. Learn more: IHSS Program Information.
  4. Create a Budget: Estimate monthly care costs and plan for long-term expenses. Get help with budgeting: California Department of Aging Resources.
  5. Consult a Professional: Speak with financial or legal experts for advice on managing care costs. Find legal support: California Advocates for Nursing Home Reform.
  6. Consider a Caregiver Service: Services like Clara Home Care offer personalized care options to fit your budget. Contact Clara Home Care: Clara Home Care.

While it’s best to plan ahead for in-home senior care, that’s not always possible when a sudden illness or injury occurs. Fortunately, many resources are available in California, both at the state and community levels, to help families set up care and manage the associated costs.

This article was reviewed and fact-checked by Megan Jones, MSW, LSWAIC

Sources

“Benefits & Services.” In Home Supportive Services, www.cdss.ca.gov/in-home-supportive-services.

“Cost of Long Term Care by State: Cost of Care Report.” Genworth Financial, 2023, www.genworth.com/aging-and-you/finances/cost-of-care.

Paying for Long-Term Care | National Institute on Aging, www.nia.nih.gov/health/long-term-care/paying-long-term-care.

State of California. “Aging and Disability Resource Connection.” California Aging and Disability Resource Connection, aging.ca.gov/Programs_and_Services/Aging_and_Disability_Resource_Connection/.

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