Which setting is cheapest in California?

It depends on hours, acuity, and whether IHSS can authorize in-home tasks. A few weekly private-pay visits can cost less than a community fee. Around-the-clock private staffing can cost more than a facility. This table is a planning snapshot, not a recommendation.

Why doesn’t the IHSS row show a monthly dollar amount?

County IHSS staff set hours. The county sets the hourly wage. Publishing a fake statewide paycheck would be misleading. Use the CDSS county wage-rate page and the local IHSS office.

Who typically pays for each row?

Private home care and most assisted living or memory care are family-paid or insurance. Nursing homes may be private pay, a limited Medicare skilled stay, or Medi-Cal long-term care. IHSS is Medi-Cal funded after authorization.

When the person lives in their own home, has a Medi-Cal determination, and the county authorizes listed tasks. It does not pay an RCFE or nursing-facility rent.

How is this different from the compare-care tool?

The compare-care tool walks parent notes and timelines. This page is the dollar matrix. Use both. Neither one admits someone to a community or authorizes hours.

Are city pages using different rates?

No. Metro and county cost pages use the same statewide CareScout medians. Local copy is geography, filing, and official links, not an invented city rate table.

Cost of careSetting comparison

Setting comparison

Compare California care costs side by side

Updated September 16, 2026. Reviewed September 16, 2026 against public CDSS, DHCS, Medicare.gov, VA, and CareScout 2025 California tables. County wages, hours, and wait times still change. Official .gov pages decide.

Put the settings next to each other before you call an admissions desk. Dollar rows use CareScout 2025 California medians and labeled planning bands. The IHSS row does not invent a wage. Hours and who can be paid stay with the county.

Planning estimate only. Figures use CareScout 2025 California statewide medians plus labeled planning bands. They are not a quote, not a facility admission, not a Medi-Cal or IHSS eligibility result, and not an hours authorization. Agency and community prices vary by county and by acuity. IHSS hours and provider pay are county and Medi-Cal decisions. This site does not calculate an IHSS paycheck. Licensed home care organizations and residential communities set their own private-pay terms. County IHSS staff authorize tasks. County Medi-Cal staff decide coverage and any share of cost. Ask those offices and providers for the number that counts.

Skip to the live calculator Full cost calculator Compare care options Ask for help lining up paperwork

Short answer

Private home care is hourly. Assisted living, memory care, and nursing homes are monthly community or facility fees. IHSS is a Medi-Cal in-home program whose wage is set by county. Medicare does not pay for ongoing custodial care.

Hours, monthly planning dollars, who pays, and IHSS

Monthly figures are midpoints at 20 hours/week for hourly rows, and published or labeled medians for facility rows. Move the live calculator below to change hours. Facility fees do not change with the slider.

Setting	How billed	Hours	Monthly midpoint	Who typically pays	When IHSS may apply
Private home care (licensed HCO)	Hourly	20 hrs/week	$3,467$3,033 to $3,900	Usually the family or another private payer. Medicare home health is a different skilled benefit.	IHSS may cover authorized tasks in the same house on a separate calendar. It does not pay the agency invoice.
Live-in home care (hourly framing)	Modeled as 12 billed hours/day	84 hrs/week	$14,560$12,740 to $16,380	Private pay. Agencies often quote a daily package instead of 24 times the hourly rate.	IHSS is not a live-in staffing pattern. Authorized tasks may still run in the home. The county sets those hours.
Assisted living (RCFE)	Monthly community fee	Facility staffing, not hourly	$7,000$5,600 to $8,400	Usually private pay or long-term care insurance. Medi-Cal rarely pays the room.	IHSS does not follow someone into a licensed residential care facility. Own-home rules still apply.
Memory care	Monthly community fee	Secured unit staffing	$9,100$8,400 to $9,800	Usually private pay. CareScout does not publish a separate California memory-care median.	A licensed memory-care unit is not the IHSS own-home setting. Ask the county before assuming hours continue.
Nursing home / SNF	Monthly room and board	Facility nursing roster	$13,673$12,167 to $15,178	Private pay or Medi-Cal long-term care after a stay qualifies. Medicare may cover a limited skilled stay, not custodial long-stay care.	A nursing facility is not own home. IHSS stops while someone lives there. A return-home plan can restart the county file.
IHSS / Medi-Cal path	County-authorized tasks	Set on the Notice of Action	Not estimatedCounty wage page	Medi-Cal funds authorized tasks. The recipient is generally the employer of an enrolled individual provider. The State issues the warrant.	May apply when the person lives in their own home, has a Medi-Cal determination, and the county authorizes listed tasks.

Related tools and resources

Official sources

Official California sources

Official program pages: CDSS: In-Home Supportive Services, CDSS: IHSS for children, County IHSS offices, CDSS: IHSS providers, CDSS: county IHSS wage rates, CDSS: provider orientation, CDSS: Electronic Visit Verification, CDSS: Electronic Services Portal, DHCS: Medi-Cal, Apply for Medi-Cal, BenefitsCal, CDSS: hearing requests, CDSS: forms catalog, CDSS: IHSS overtime and workweek, DDS: regional centers.

Planning estimate only. Not a quote, not a facility admission, not a Medi-Cal or IHSS eligibility result, and not an hours authorization. Rates vary by county, agency, and facility. IHSS hours and provider pay are county and Medi-Cal decisions. We do not calculate IHSS paycheck amounts. Licensed agencies and facilities set their own private-pay terms. County IHSS staff authorize tasks. County Medi-Cal staff decide coverage and any share of cost. Ask those offices and providers for the number that counts.

Illustrative cost planner

Live dollar totals for private-pay settings, using CareScout 2025 California medians. IHSS is shown as a program path, not as a household paycheck.

Hours of help per week

Private home care is billed by the hour. CareScout publishes its California home-care median on a 44 hour/week basis. Facility rows stay monthly fees even if you change hours.

20 hours/week

About 2.9 hours/day across 7 days

Exact hours

Days per week (optional)

Used to show hours/day and to model live-in framing as 12 billed hours times the days you choose. Facility fees do not change with this number.

Which setting are you pricing?

Private home care (licensed HCO)An agency sends aides to the house and bills by the hour. Compare this private-pay total to IHSS for the same hours.Live-in home care (hourly framing)Modeled as 12 billed hours per day, not 24 times the hourly rate. Agencies often quote a daily live-in package instead. CareScout does not publish a California live-in daily median.Assisted living (RCFE)A licensed residential care facility for the elderly. Billed as a monthly community fee, not by the hour.Memory careUsually a secured assisted-living unit for dementia. CareScout does not publish a separate California memory-care median.Nursing homeA skilled nursing facility. Semi-private and private-room medians are both published. Long-stay custodial care is typically private pay or Medi-Cal, not Medicare.IHSS / Medi-Cal pathThe program may cover authorized services in the home. A family member may be paid as the provider after enrollment. Hours and the hourly wage are county and Medi-Cal decisions. This planner does not estimate an IHSS paycheck.

Estimated private-pay cost

Private home care (licensed HCO)

$3,033 to $3,900monthly

Low: $3,033
Midpoint: $3,467
High: $3,900

Annual: $36,400 to $46,800Midpoint $41,600 per year

How this number was calculated

20 hours/week × $40/hour × (52 ÷ 12) weeks = $3,467/month at the midpoint. Low uses $35/hour. High uses $45/hour. 52 ÷ 12 is about 4.33 weeks.

Compare settings at these hours

Private home care (licensed HCO)

$3,467/month mid

$3,033 to $3,900 monthly · $41,600 per year at midpoint · 20 hours/week

Live-in home care (hourly framing)

$14,560/month mid

$12,740 to $16,380 monthly · $174,720 per year at midpoint · 84 hours/week

Assisted living (RCFE)

$7,000/month mid

$5,600 to $8,400 monthly · $84,000 per year at midpoint

Memory care

$9,100/month mid

$8,400 to $9,800 monthly · $109,200 per year at midpoint

Nursing home

$13,673/month mid

$12,167 to $15,178 monthly · $164,076 per year at midpoint

IHSS / Medi-Cal path

Wage set by county

Private-pay alternative: $3,033 to $3,900 per month for the same hours.

Assumptions and sources

CareScout Cost of Care Survey 2025, July through November 2025. California statewide median. Published 2025 by CareScout.

Private home care midpoint uses the CareScout 2025 California non-medical caregiver median of $40 per hour.
Assisted living midpoint uses the CareScout 2025 California median of $7,000 per month for a private one-bedroom residential care facility.
Memory care is a 20% / 30% / 40% planning premium on that assisted living median. CareScout does not publish a separate memory-care row.
Nursing home low and high are the published semi-private and private-room medians.
Live-in framing bills 12 hours/day, not 24 times the hourly rate.
If a county authorizes in-home help, the program may cover those authorized services. A family member may be paid as the provider after enrollment. Hours and the hourly wage are county and Medi-Cal decisions. This planner does not calculate an IHSS paycheck and does not say anyone will receive a set amount.

Paying for care and official pages

Questions people ask

Which setting is cheapest in California?: It depends on hours, acuity, and whether IHSS can authorize in-home tasks. A few weekly private-pay visits can cost less than a community fee. Around-the-clock private staffing can cost more than a facility. This table is a planning snapshot, not a recommendation.
Why doesn’t the IHSS row show a monthly dollar amount?: County IHSS staff set hours. The county sets the hourly wage. Publishing a fake statewide paycheck would be misleading. Use the CDSS county wage-rate page and the local IHSS office.
Who typically pays for each row?: Private home care and most assisted living or memory care are family-paid or insurance. Nursing homes may be private pay, a limited Medicare skilled stay, or Medi-Cal long-term care. IHSS is Medi-Cal funded after authorization.
When can IHSS apply?: When the person lives in their own home, has a Medi-Cal determination, and the county authorizes listed tasks. It does not pay an RCFE or nursing-facility rent.
How is this different from the compare-care tool?: The compare-care tool walks parent notes and timelines. This page is the dollar matrix. Use both. Neither one admits someone to a community or authorizes hours.
Are city pages using different rates?: No. Metro and county cost pages use the same statewide CareScout medians. Local copy is geography, filing, and official links, not an invented city rate table.

See if IHSS may apply

A coordinator can walk through Medi-Cal, county forms, and the home visit with you. The county still decides eligibility and hours.

Your name

Email address

Where are you in the process?

California county (optional)

What should we help with? (optional)

For example: starting an IHSS application, provider enrollment, or county forms. Keep medical records and diagnoses for the county packet.