In-home care (non-medical caregiver) costs in California
Here is the middle of the price range in California, and then — because it is the question that actually follows — who pays for it. The short answer on that second one surprises most people: Medicare does not.
The California median
$40.00 an hour
- Works out to, monthly
- $7,627
- Works out to, yearly
- $91,520
Our arithmetic, not the survey's. The survey reports this one by the hour, so the monthly and yearly figures assume a schedule: $40.00 an hour × 44 hours a week × 52 weeks ÷ 12 months. Fewer hours, smaller bill — the schedule is the biggest lever you have.
That is about 14% higher than the national median of $35.00 an hour. Within California the spread is usually wider still: a city costs more than a rural county, often by a great deal.
A caregiver who comes to the house to help with bathing, dressing, transferring and toileting, and who may also do light housekeeping and meal preparation.
What this number is, and what it is not.
It comes from an industry cost-of-care survey — providers reporting their prices — not from a government rate table. There is no federal agency that publishes what assisted living costs, which is why the survey is the source of record here and why we label it plainly rather than dressing it up as official.
A median means half charged more and half charged less. It is not a quote for any particular home, agency or facility, and no provider is bound by it. Prices collected for the 2025 survey.
Where California sits
$40.00 an hour ranks California 10th of the 50 states priced for in-home care (non-medical caregiver): 9 charge more, 36 charge less. Massachusetts, New Hampshire, Oregon and Rhode Island report the same figure.
Iowa is the next state up, at $41.00; Idaho the next down, at $39.00.
The national median is $35.00, so California runs $5.00 above it — 14% more, or $11,440 a year ($5.00 × 44 hours a week × 52 weeks).
The column runs $24.00 (Mississippi) to $46.00 (Wyoming). California sits 73% up it, 1.67× the lowest, with 20 other within a tenth of it.
Of the 6 kinds of care California was priced for, this is its 2nd dearest standing: at best 8th of 49 for nursing home, private room, at worst 25th of 45 for adult day health care.
What $7,627 a month becomes
Our multiplication, holding the California median flat — no real bill does — with the same span of the state's least costly priced care beside it:
Six months
$45,760
$12,220 of adult day health care
One year
$91,520
$24,440 of adult day health care
Two years
$183,040
$48,880 of adult day health care
Three years
$274,560
$73,320 of adult day health care
Five years
$457,600
$122,200 of adult day health care
Care is bought in years, not months, and $7,627 a month is $91,520 a year.
Five years at the national median would be $400,400: $57,200 less than five years in California.
Inside California, five years of adult day health care runs $122,200 and five of skilled nursing at home (private duty nurse) $1,258,400; this page's $457,600 sits 30% between them. Most families pay for more than one of these in sequence.
Against other care in California
Converted to a month on our schedule, set beside this page's $7,627:
Skilled nursing at home (private duty nurse)
$20,973 a month
$13,347 a month more, $160,160 a year, 2.75× this page. California places 15th of 46 for it, 5 below its 10th here.
Nursing home, private room
$15,178 a month
$7,551 a month more, $90,616 a year, 1.99× this page. California places 8th of 49 for it, 2 above its 10th here.
Nursing home, semi-private room
$12,167 a month
$4,540 a month more, $54,484 a year, 1.60× this page. California places 15th of 50 for it, 5 below its 10th here.
Assisted living community
$7,000 a month
$627 a month less, $7,520 a year, 0.92× this page. California places 14th of 50 for it, 4 below its 10th here.
Adult day health care
$2,037 a month
$5,590 a month less, $67,080 a year, 0.27× this page. California places 25th of 45 for it, 15 below its 10th here.
On the same monthly footing, in-home care (non-medical caregiver) is the 4th costliest of the 6 kinds of care priced in California, at $7,627. The conversions are ours; the medians are the survey's.
44 hours a week of in-home care in California is $7,627 a month against $7,000 for assisted living — 8% less. The first buys 44 hours and nothing else; the second includes the room, the meals, and someone awake overnight.
Who actually pays for this
This is the part most cost pages leave out, and it is the part that changes what a family does next.
Medicare does not pay for long-term care
Medicare pays for short stretches of skilled care — a limited stay in a skilled nursing facility after a qualifying hospital admission, or skilled home health under specific conditions. It does not pay for custodial care: help with bathing, dressing, meals, medication reminders and supervision. That is what most people need, and for years at a time.
Medicare's own page on long-term care ↗ says the same thing in its own words. It is worth reading once, because almost everyone assumes the opposite.
Medicaid may pay — after a spend-down
Medicaid is the largest payer of long-term care in the country, but it is needs-based: it begins once income and countable savings are inside the limits California sets. Getting there by spending savings on care is what people mean by a spend-down. There is also a look-back period, so gifts and transfers made in the years beforehand matter.
Veterans: Aid and Attendance may help
A wartime veteran, or a surviving spouse, who needs help with daily activities may qualify for an addition to the VA pension called Aid and Attendance. It is an income-and-net-worth benefit, it is paid monthly, and a great many families who qualify have never heard of it. Accredited veterans service organizations help with the claim for free.
Otherwise: savings, family, and long-term care insurance
Most families pay out of pocket first — from savings, a pension, the sale of a house, or several relatives contributing. A long-term care insurance policy bought years ago pays a daily or monthly amount if the policy's conditions are met; if there is a policy in the family, find it and read what triggers it before you need it.
Working out which of these applies to one particular family is exactly what a free California counselor does all day. They are paid by a federal grant, not by commission, and they have nothing to sell you. The Eldercare Locator (ACL): 1-800-677-1116 ↗ will connect you to the area agency on aging for your county.
Who to ask in California
California's free counseling program is California Health Insurance Counseling and Advocacy Program (HICAP), on 1-800-434-0222. It is grant-funded and sells nothing.
No California Medicaid limits sit beside this $7,627-a-month figure yet: the California pack is pending because this year's limits could not be read in the state's own document, and an unverified limit is worse than none.
Verified 2026-08-02 against CareScout (formerly Genworth) Cost of Care Survey 2025, fielded July-November 2025 (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against SHIP National Technical Assistance Center (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Common questions
- Does Medicare pay for in-home care (non-medical caregiver) in California?
- No. Medicare pays for short stretches of skilled care after a qualifying hospital stay, and for skilled home health in limited circumstances. It does not pay for long-term custodial care — help with bathing, dressing, meals and supervision — which is what most families are actually paying for.
- Is in-home care (non-medical caregiver) dearer in California than in other states?
- $40.00 an hour places California 10th of the 50 states the survey priced for it: 9 charge more and 36 charge less. The national median is $35.00. That ranking is our arithmetic on the survey's published medians, not a ranking the survey itself publishes.
- Is this the price I will be quoted in California?
- No. It is the middle of a range from an industry cost-of-care survey: half of the providers surveyed charged more, half charged less. Prices vary a great deal between a city and a rural county in the same state, and no facility is bound by this figure.
- Who can help me work out how to pay for it?
- California runs its free counseling program as California Health Insurance Counseling and Advocacy Program (HICAP), on 1-800-434-0222. It is paid for by a federal grant, sells nothing, and the Eldercare Locator (1-800-677-1116) will connect you to the area agency on aging that covers your county.