In-Home Dementia Care in California

Paying for care in California: In-Home Supportive Services

Medicare does not pay for the long-term help dementia requires. In California the programme that can is IHSS, administered by individual county Departments of Social Services under state Medi-Cal oversight.

Who qualifies

California's In-Home Supportive Services programme assesses the specific tasks a person needs help with and authorises hours accordingly. The cited page does not publish the assessment thresholds or the maximum authorised hours, so confirm both with the county IHSS office.

The financial limits

Single applicant

No current asset limit - California eliminated the Medi-Cal/IHSS asset test entirely effective January 1, 2024. A reduced asset limit is planned to be reinstated in 2027, but has not yet taken effect.

Married couple

No current asset limit - same elimination applies regardless of household size. A reduced asset limit is planned to be reinstated in 2027, but has not yet taken effect.

Look-back period

No asset transfer look-back period applies specifically to IHSS (unlike nursing home Medicaid)

How to apply

Application is made through the county IHSS office or California Department of Social Services, followed by an in-home assessment from a county social worker to determine authorized hours.

What is unusual about California

IHSS lets the recipient choose and direct their own provider, including hiring a family member in many cases, rather than being assigned a worker by an agency.

Rules and figures change. Confirm the current position with the programme itself before making a financial decision.