How do families pay for a care home in California?
Mostly privately: across the US, only about 17% of assisted living residents had any care paid by Medicaid in 2022. Medicare does not pay to live in a care home.
Checked against Medicare.gov, DHCS, CDSS, VA and California lawHow we check
- Paying privately
- Income, savings, the sale of a home, family help or insurance. California’s median for assisted living: $7,000 a month (2025).
- Medi-Cal
- The Assisted Living Waiver may pay for care, not room and board, in participating homes in 15 counties.
- SSI/SSP
- $1,626.07 a month in 2026. A home that accepts it may charge $1,444.07 of it.
Sources: CDC, 2022 · CareScout survey, 2025 · DHCS · CDSS notice, Dec 2025
Find homes and their listed prices near you
This guide covers licensed care homes for older adults: assisted living and board and care (the state calls them RCFEs). Nursing homes are paid for differently, mostly by Medicare for short stays and by Medi-Cal for long ones.
Checked against Medicare.gov, DHCS, CDSS, VA and California lawHow we check
Most residents pay privately, and some also get help from a program. Answer five questions to see which ways to pay may apply to your family member.
Check which ways to pay may apply
Each way that may apply comes with its first step. The county is optional.
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The rules this check uses
The law’s own words, with the day we last checked each one.
If the resident is an SSI/SSP recipient, then the basic services shall be provided and/or made available at the basic rate at no additional charge to the resident.
(1) This shall not preclude the acceptance by the facility of voluntary contributions from relatives or others on behalf of an SSI/SSP recipient.
(2) An extra charge to the resident shall be allowed for a private room if a double room is made available but the resident prefers a private room, provided the arrangement is documented in the admissions agreement and the charge is limited to 10% of the Board and Room portion of the SSI/SSP grant.
(3) An extra charge to the resident shall be allowed for provision of special food services or products beyond that specified in (f)(2) below, when the resident wishes to purchase the services and agrees to the extra charge in the admission agreement.
A facility need not accept a particular resident for care. However, if a facility chooses to accept a particular resident for care, the facility shall be responsible for meeting the resident's needs as identified in the pre-admission appraisal specified in Section 87457, Pre-admission Appraisal and providing the other basic services specified below, either directly or through outside resources.
The term "chronically ill individual" means any individual who has been certified by a licensed health care practitioner as—
(i) being unable to perform (without substantial assistance from another individual) at least 2 activities of daily living for a period of at least 90 days due to a loss of functional capacity,
(ii) having a level of disability similar (as determined under regulations prescribed by the Secretary in consultation with the Secretary of Health and Human Services) to the level of disability described in clause (i), or
(iii) requiring substantial supervision to protect such individual from threats to health and safety due to severe cognitive impairment.
Such term shall not include any individual otherwise meeting the requirements of the preceding sentence unless within the preceding 12-month period a licensed health care practitioner has certified that such individual meets such requirements.
For purposes of subparagraph (A), each of the following is an activity of daily living:
(i) Eating.
(ii) Toileting.
(iii) Transferring.
(iv) Bathing.
(v) Dressing.
(vi) Continence.
The beneficiary must—
(1) Have been hospitalized in a participating or qualified hospital or participating CAH, for medically necessary inpatient hospital or inpatient CAH care, for at least 3 consecutive calendar days, not counting the date of discharge; and
How do most people pay?
Privately. Across the US in 2022, about 17% of people in assisted living and similar homes had any of their care paid by Medicaid; the rest paid another way. (CDC, 2022) Medicare does not pay to live in a care home.
The money comes from:
- monthly income, such as Social Security and pensions;
- savings and investments;
- the sale of a home;
- family members sharing the cost;
- long-term care insurance, and VA benefits for a veteran or surviving spouse (both below).
To see how long the money lasts, take the home’s all-in monthly rate and subtract the income that will go to it each month. Divide the savings by what is left: that is about how many months they cover at today’s rate. A rate increase or more care shortens it.
Before you sell a home, give money to family or move savings, ask the county or a qualified adviser. It can affect taxes, and Medi-Cal later.
“If we pay privately now, will you accept the SSI rate or the Assisted Living Waiver later, if the money runs out?”
What does a care home cost in California?
Each home sets its own price. California’s median for assisted living was $7,000 a month for a private one-bedroom. That is from CareScout’s Cost of Care Survey, taken July to November 2025. (CareScout survey, 2025)
A median is the middle price, not a quote. Ask each home for its all-in monthly rate, in writing, for the same room and the same care needs.
- Assisted living, private one-bedroom
- $7,000CareScout survey, 2025
- Nursing home, shared room
- $12,167CareScout survey, 2025
- Nursing home, private room
- $15,178CareScout survey, 2025
- Home care, 44 hours a week
- $7,627CareScout survey, 2025
- Adult day health care
- $2,037CareScout survey, 2025
No survey we found gives a California figure for board and care or for memory care, so we give none.
The admission agreement must say what the monthly fee covers and list every other fee with its price. Health and Safety Code §1569.884 It must also say the resident gets a monthly statement of every separate charge. Health and Safety Code §1569.884
“What is the full monthly cost for the care needed, in writing, and what would make it go up?”
Licensed care homes near you
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What can make the bill go up?
A home must give at least 90 days’ written notice of a rate increase, with the amount and the reasons. Health and Safety Code §1569.655(a) That notice is not needed when the rate rises because the resident’s level of care changed. Health and Safety Code §1569.655(a)
A home may not send a one-time bill for its own rising costs. It must spread an increase over 12 months of the monthly rate. Health and Safety Code §1569.655(b)
Before you sign, ask each home for its average rate increases over the last three years. The home must give that disclosure to anyone thinking of moving in. Health and Safety Code §1569.658(c)
Does Medicare pay?
No, not to live in a care home. Medicare does not pay for long-term care. (Medicare.gov)
After at least 3 days as a hospital inpatient, Medicare can pay for up to 100 days in a skilled nursing facility. 42 CFR §409.30(a)(1) (Medicare.gov, 2026) Days under observation do not count toward the 3 days.
- Days 1–20
- $0, after the $1,736 deductibleMedicare.gov, 2026
- Days 21–100
- $217 a dayMedicare.gov, 2026
- Day 101 on
- All costsMedicare.gov, 2026
Medicare also pays for hospice care where they live, including a care home. It does not pay the home’s monthly rate. (Medicare.gov)
Can Medi-Cal pay?
Medi-Cal can pay for care in a care home through the Assisted Living Waiver, in participating homes in 15 counties. The waiver pays for care services, not room and board. (DHCS)
Medi-Cal alone does not make someone eligible for the waiver. DHCS reports limited enrollment slots and a waitlist. In March 2026, 14,831 people were enrolled and 15,910 were waiting. (DHCS waitlist, Mar 2026) How the Assisted Living Waiver works ›
If their county has no waiver homes, ask their Medi-Cal plan about Assisted Living Facility Transitions. It may pay for care in a care home that works with the plan. It does not pay room and board. (DHCS, Apr 2025)
Savings. Medi-Cal for people 65 and older, or with a disability, counts savings. In 2026 the limit is $130,000 for one person and $65,000 more for each other person in the household. W&I Code §14005.62(a)(1), to July 2027
A 2026 law lowers it to $21,000 for one person and $31,000 for two, no sooner than July 1, 2027. W&I Code §14005.62(a)(1), from July 2027 W&I Code §14005.62(a)(2), from July 2027 People already on Medi-Cal meet the new limit at their first renewal after that date. W&I Code §14005.62(b), from July 2027 (SB 164, Jun 2026)
When one spouse needs long-term care, the spouse at home can keep up to $162,660 of the couple’s savings in 2026. (CMS bulletin, Dec 2025) The county works out the exact amount, and how much income the spouse at home keeps.
Giving money or property away can delay Medi-Cal’s long-term care coverage. The Health Consumer Alliance says gifts made on or after January 1, 2026 may bring up to 30 months without it. (Health Consumer Alliance, Nov 2025) Ask the county before moving money.
Will SSI pay, and does every home take it?
SSI/SSP pays $1,626.07 a month in 2026 to a person who lives in a licensed care home. (CDSS notice, Dec 2025) A home that accepts it may charge $1,444.07 for basic services: room, board, care and supervision. Title 22 §87101(b)(1) The resident keeps at least $182 for personal needs. (CDSS notice, Dec 2025)
No law we read makes a home accept SSI residents. Title 22 §87464(d) Ask each home before the move, and get the answer in writing.
A home may not ask an SSI applicant for a deposit or an admission fee. Health and Safety Code §1569.651(a)
SSI is for people 65 or older, blind or disabled, with little income and savings. In 2026, savings may be no more than $2,000 for one person. (CMS bulletin, Dec 2025) Social Security decides who gets it.
Can a veteran or surviving spouse get help?
A VA pension with Aid and Attendance may add to their income. It is for a veteran who served in wartime, or a surviving spouse, who needs help with daily activities. VA decides. (VA)
- Veteran, no dependents
- $29,093 a year at mostVA, Dec 2025
- Veteran with one dependent
- $34,488 a year at mostVA, Dec 2025
- Surviving spouse
- $18,697 a year at mostVA, Dec 2025
- Net worth limit
- $163,699VA, Dec 2025
VA subtracts countable income from these amounts, which run from December 1, 2025 to November 30, 2026.
A VA-accredited representative helps with the claim for free. (VA)
Will long-term care insurance pay?
A policy may pay once its benefit trigger is met. For a tax-qualified policy, a licensed health care practitioner must certify it. The person cannot do 2 of 6 daily activities without substantial help, for at least 90 days. 26 U.S.C. §7702B(c)(2)(A) 26 U.S.C. §7702B(c)(2)(B) Needing substantial supervision because of severe memory loss or confusion also counts. 26 U.S.C. §7702B(c)(2)(A)
Ask the insurer about the waiting period, and whether the policy pays a licensed care home. (Dept. of Insurance) HICAP gives free, confidential counseling on long-term care insurance: 1-800-434-0222. (Dept. of Aging)
What if the money runs out?
Ask each home, before the move, what happens if the savings run out. Ask whether it accepts the SSI rate or the Assisted Living Waiver, and keep the answer in writing.
A home may give 30 days’ written notice when the basic rate is unpaid 10 days after it is due. Title 22 §87224(a) Apply for Medi-Cal well before the money runs out: the waiver has a waitlist.
Who helps for free?
- HICAP: Medicare and insurance questions, 1-800-434-0222. (Dept. of Aging)
- Your Area Agency on Aging: local help, found by county (Department of Aging).
- A VA-accredited representative: VA claims (VA).
- The long-term care ombudsman: problems with a home, 1-800-231-4024, 24 hours a day, 7 days a week. (Dept. of Aging)
Questions families ask · 6
How do most people pay for assisted living?
Privately, from their own income and savings, the sale of a home, family help or insurance. Across the US in 2022, about 17% of residents had any of their care paid by Medicaid.
Does Medicare pay for assisted living?
No. Medicare does not pay to live in a care home. After a hospital stay it can pay for a short stay in a skilled nursing facility.
Does Medi-Cal pay for assisted living in California?
In part. The Assisted Living Waiver pays a participating home for care, not room and board, in 15 counties, and people wait for a place.
How much is assisted living in California?
The median was $7,000 a month for a private one-bedroom in 2025, in CareScout’s survey. Each home sets its own price.
Can a home charge an SSI resident more than the SSI rate?
For basic services, no: the basic rate is payment in full. The state allows a few written extras, such as a private room. Read SSI in a care home.
What happens when the money runs out?
A home may give notice when the basic rate goes unpaid. Ask before moving in whether the home accepts SSI or the waiver, and apply for Medi-Cal early.
You do not need every answer about money before you start looking.
Next, step 3 of 6: Find homes and check them
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