Cost of Long-Term Care in California in 2025

America is older than ever. It’s true: Adults over 65 now outnumber teenagers! And the median age of the United States population is the highest it's ever been. People are living longer, and older adults make up a huge portion of the population.

The Golden State of California is leading this age-forward trend, boasting a median age of 39.5 — higher than the U.S. average of 38.2, according to the U.S. Census. With 16.2% of its populace over 65, just a tad above the national 16.1%, California stands on the brink of an era marked by long-term care needs and potential workforce gaps. These shifts could redefine the state's economic and health care landscapes.

As the country’s population ages, this has put an increasing focus on planning for long-term care. As the nation’s most populous state, California is affected by this as much as or more than anywhere else in the country.

If you’re in the state of California and are considering your options for long-term care or looking on behalf of a loved one, you’ve found the right place. At LTC News, we provide information and resources to help you make the best decisions for you and your loved ones concerning long-term health care.

In this article, we’ll cover:

• The cost of long-term care in California

• Types of care, and how this affects cost

• Payment methods and eligibility for assistance programs

• Programs and legislation specific to the state of California

• Resources and links to additional information

Note: Long-term health care costs vary dramatically in California. The information in this article is intended to provide a general outlook and considerations related to the cost of care. It should not be considered a replacement for speaking with long-term care and financial professionals.

Long-Term Care Eligibility in California

To qualify for Medi-Cal (California’s Medicaid program) long-term care benefits, one must meet the financial eligibility criteria and the functional eligibility criteria.

The financial eligibility criteria vary depending on the type of long-term care program and the marital status of the applicant, but are based loosely on the federally defined triggers that Long-Term Care Insurance requires.

The functional eligibility criteria are based on the level of care that the applicant needs. For nursing home care, the applicant must require a nursing facility level of care (NFLOC), which is defined by each state and may include factors such as activities of daily living (ADLs), instrumental ADLs (IADLs), health, and cognition. 

For Home and Community-Based Services Waivers, the applicant must also require a NFLOC or a similar level of care that would otherwise qualify them for institutional care.

Eligibility for Long-Term Care Insurance also relates to ADLs, or activities of daily living, so it’s useful to know what these are. If you need assistance with two or more of these ADLs, and the assistance is expected to last for 90+ days, you can qualify for long term care insurance assistance.

What are activities of daily living?

• Eating: The ability to feed oneself by getting food into the body from a receptacle such as a plate, cup, or table, by a feeding tube, or intravenously.

• Bathing: The ability to clean oneself, get in and out of the shower or bath, and perform other activities of personal hygiene such as shaving or brushing one’s teeth.

• Dressing: The ability to put on clothes, and not struggle significantly with common clothing accessories such as buttons or zippers. This also includes putting on and taking off all items of clothing and any necessary braces, fasteners, or artificial limbs.

• Transferring: The ability to walk and get in and out of bed, or chair.

• Continence: The ability to control one’s bladder and bowel functions, or, when unable to maintain control of bowel or bladder function, the ability to perform associated personal hygiene, including caring for a catheter or colostomy bag.

• Toileting: The ability to use and get on and off the toilet and perform associated personal hygiene.

Not all people have Long-Term Care Insurance. In fact, the majority of Americans don’t. However, the eligibility for it is a common trigger for long-term care assistance.

The federal government also differentiates between ADLs and IADLs, the latter of which stands for instrumental activities of daily living. These include more complicated activities related to community involvement and communicating with those around you.

Regardless, if a licensed clinical expert certifies that you need assistance with two or more ADLs and this assistance is expected to last 90+ days, you qualify as needing long-term care.

Types of Senior Care in California

When you think of long-term care, what comes to mind? For a lot of people, it’s nursing homes.

However, most long-term care doesn’t take place in nursing homes. In fact, you may never need to live in a nursing home, even if you or a loved one needs frequent long-term care assistance.

Far more care takes place in the home by a personal caregiver, or in other facility types. Long-term care is a spectrum, and below, we’ll discuss a few of the most popular options available: 

Adult Day Care

Adult day care centers can provide basic health services and an interactive, social environment for seniors without the permanent resident costs of other facility types. 

These centers provide valuable care and socialization benefits during the day and allow care recipients to go back to their homes each night instead of moving into the care facility. 

Home Health Aide

Home health aides, or personal care aides, assist with the activities of daily living (ADLs) we mentioned earlier. They may provide in-home assistance for eating, bathing, dressing, and other daily activities as needed.

Homemaker Services

Homemakers, much like a home health aide, provide in-home care, but homemakers have tasks unrelated to ADLs. These could include cleaning, meal preparation, laundry, and other basic household chores or errands that the care recipient is unable to accomplish on their own.

Continuing Care Retirement Communities

Continuing care retirement communities (CCRCs) are composed of multiple facility types, usually including independent living, assisted living, and skilled nursing facility care. 

These facility types are all within one community, and residents can move between the levels of care as needed, knowing they will remain in the same community.

Memory Care Facilities

Facilities specializing in those with Alzheimer’s disease, dementia, and other cognitive impairment issues. Some of the facility types listed here, such as assisted living centers or nursing homes, can have specialized memory care services.

Rehabilitation Facilities

Rehabilitation centers specialize in the rehabilitation of older adults after surgery, injury, or due to chronic or long-term conditions. 

Rehabs may provide a blend of medical care and custodial care, with the ultimate goal of returning the care recipient to a previous level of health or improving their condition enough to transition back home or to a different long-term care facility. 

Independent Living Facilities

Independent living facilities are communities for seniors who do not need assistance with basic living tasks.  

These facilities do not explicitly provide long-term care services. However, residents are free to hire their own private care provider if they need help but wish to remain in the same community. 

Besides the long-term care aspects, independent living facilities are very similar to assisted living facilities. Residents live in a community setting, with opportunities for recreation and socialization throughout their day. Many independent living communities also offer meal services or transportation services, though this varies depending on the community.

Assisted Living Facilities

Assisted living facilities (ALFs) These centers assist residents with ADLs but allow them to live as independently as possible. The care needs of those in assisted living centers are less acute than nursing homes, though some assisted living facilities can take care of those with mild cognitive decline. 

Assisted living facilities maintain a fully trained staff, 24/7, with a registered nurse on call. All assisted living facilities must provide residents with three meals a day and onsite assistance with medication management.

Nursing Home

Nursing homes offer more skilled medical care for those in greater need of health-related assistance. This is what makes them the most expensive long-term care option listed here. 

A nursing home must have trained staff, with a registered nurse (RN) or physician on site and awake, on duty 24 hours a day. A nursing home provides skilled, intermediate, and custodial services in addition to medication management and meals. Nursing homes can handle those with more advanced cognitive decline as well.

Care Type Influences the Cost

Below, we list median costs for long-term care, but it’s broken out by type of care since the cost differs significantly between types.

This is why it’s important to differentiate costs based on the type of care you or a loved one will be receiving. The most expensive caregiving types are more than double the cost of the least expensive types. Expecting them all to cost the same amount is a dangerous assumption and can lead to irresponsible financial decisions.

How To Pay for Long-Term Care in California

Just as important as what type of care you need is how you’ll fund the caregiving.

Below, we’ve listed some basic payment options. Each should be researched more fully before deciding on a solution.

Out-of-Pocket

Potentially expensive, but technically this is possible. However, this will not be viable for all but the wealthiest Americans, and even then, it will not be advisable for most, relative to other options.

California Medicaid Coverage (Medi-Cal)

Medicaid, known as Medi-Cal in California, can cover long-term care costs as long as the care recipient meets strict income requirements. 

In California, individuals must have an income under 138% above the poverty line in order to qualify for Medicaid. For a single adult, this limit would be $20,783. You can learn more about income requirements on California’s Medicaid eligibility page. 

As of January 1st, 2024, California no longer has asset requirements for older adults paying for long-term care with Medi-Cal. This includes spend-down, meaning seniors do not have to spend down their assets or income to a certain level in order to qualify. 

Long-Term Care Insurance

Long-Term Care Insurance can be a great decision for many. LTC Insurance covers all long-term care costs as long as you have money within your policy. 

The recommended age to apply for Long-Term Care Insurance is between your 40s, 50s, and 60s. In order to qualify for a Long-Term Care Insurance policy, you must be in relatively good health. 

Good health doesn’t mean the absence of health issues; it just means those health conditions are well-managed and that you don’t currently need long-term care. 

If you need long-term care or are receiving long-term care, you will not be able to qualify for an LTC Insurance policy. This is why the recommended age to purchase a policy and start long-term care planning is so low. However, those in their late 60s or early 70s who do not have long-term care needs may still be able to qualify at a higher rate. 

Standalone Long-Term Care Insurance policies are most common. Long-Term Care Insurance riders are also available for other policies, such as life insurance. Long-term care coverage add-ons can also be added to fixed or indexed annuities.

Riders are extra benefits available to add to multiple types of insurance policies. There are also riders available for LTC Insurance policies, such as inflation protection, which increases the amount of benefits within your policy to keep pace with the cost of living. 

Research from the National Bureau of Economic Research has shown that children of seniors with Long-Term Care Insurance are less likely to provide informal caregiving or reside with their parents and are more likely to work full-time. In short, it benefits entire families, not just the policyholder.

Short-Term Care Insurance

Short-term care insurance policies generally act as cash indemnity plans that cover one year of care or less, though some can extend to approximately two years. The major difference between short-term and Long-Term Care Insurance coverage is how long the benefits will last.

However, California is one of the few states where short-term care insurance is not offered. However, if you move to California and have a policy in place, you can still receive benefits.

California Long-Term Care & Financial Programs

Let’s take a quick look at programs and support that either only exist in California, or for which there are special considerations for Californians looking for long-term care financial options.

Federal Partnership Program

The California Partnership for Long-Term Care is an innovative program offered through the collaboration of the State of California Department of Health Care Services in cooperation with several private insurance companies. 

It was one of the four original partnership states. However, while most have reciprocity with other states' long-term care partnership programs, California does not.

This means if you move to California from another state, while you can receive benefits in California, the State of California will not honor the additional asset protection offered by the original state.

Currently, no insurance company offers a Partnership Long-Term Care Insurance policy due to state requirements that make them cost-prohibitive. However, there is a discussion in California that would make changes to the partnership program to make it much more affordable. 

Regular Long-Term Care Insurance is still available and provides substantial asset protection and access to quality care options.

For more on this program, check out our California Long-Term Care Resources page.

Medi-Cal Program

Medi-Cal is California’s Medicaid program. It will pay for long-term health care costs if an individual has little or no income and assets.

As stated earlier, there are no asset or spend-down requirements for Medi-Cal coverage. However, individuals may not have an income above 138% the poverty line in order to qualify. 

Before applying for Medicaid in California, you should confirm the latest rules and restrictions to understand what it will mean for your existing assets and those of your spouse.

California Medicaid Estate Recovery Program

When applying for Medicaid, your estate will be subject to the Medicaid Estate Recovery Program, or MERP.

Under this program in California, your assets can be subject to recovery, including your home, other real estate, bank accounts, motor vehicles, cash, and various other financial assets and even household goods.

The state will never require that a living spouse move out of their home, but otherwise, these are subject to recovery due to the asset and income limits imposed by Medicaid.

There is also a look-back period of up to 30 months in California, so income or asset reductions and restructuring during this period may still be subject to the asset recovery standards. This is different from the typical 60-day look-back period of other states.

This 30-month look-back immediately precedes the date a nursing home resident submits a Medi-Cal application or the date a Medi-Cal beneficiary is admitted to a nursing home.

During the look-back, Medi-Cal scrutinizes all asset transfers, looking for assets that were gifted. This includes assets that were sold for under fair market value. In 2023, California allows up to $11,576 / day to be gifted without violating the look-back period. This is called “strategic gifting.” 

However, if one gives more than this daily limit, one will be penalized with a penalty period of Medicaid ineligibility.

Other California Taxes, Incentives, Programs & Financial Vehicles

While we’re unable to cover all of California’s relevant programs, here are a few additional considerations that Californians should be aware of and discuss with a Long-Term Care Insurance specialist or other qualified financial advisor:

• Stability Rules: California has adopted Long-Term Care Insurance rate stability rules, which make it harder for an insurance company to get an approved rate increase.

• Income Tax: California is considering a tax on income for anyone who does not own a qualified Long-Term Care Insurance policy. The State of Washington already has this tax. However, details on the tax rollout are not currently known.

• Tax Deductions: California permits the same tax deduction as is allowed for federal income tax purposes for premiums paid for the purchase of qualified LTC insurance. The federal tax incentives also apply.

• Reverse Mortgages: Reverse mortgages are available in California. A reverse mortgage is a home equity loan where the borrower does not have to make payments. California law says you must be age 62 or over, occupy the property as a principal residence, own the home outright, or have significant equity in the home. In addition, there should not be any tax liens on the property. Many people in California have significant equity in their homes due to rising home values. This allows you to use that equity to benefit your retirement lifestyle and reduce stress and anxiety.

Cost of Long-Term Care in California

Below we’ve listed the median costs for long-term care in the state of California. It’s broken down by type of care, since different care types can come with wildly different expected charges.

Important Note: These are median expected prices for 2025 and won’t represent the full range of possible pricing. They’re based on LTC’s extensive data models and can help identify financial needs for you or a loved one.

Does Where You Live Matter?

Yes, and it can actually be a big deal. Costs vary dramatically depending on where you live, and in a large state like California, this is as true as ever. 

The northern parts of the state will tend to be less expensive, with higher costs in the southern parts of the state. Even these general tendencies can have exceptions, so it’s important to speak with a Long-Term Care Insurance specialist to drill down to an exact cost for care in your area.

How Much Does Long-Term Care Cost in California?

All prices listed below are based on annual medians but are listed both as annual and monthly charges. Your care provider or insurance policy may break down charges monthly or even daily.

Generally speaking, California median prices run higher than national medians do. Depending on the type of care, some sources estimate California costs to be as much as 35% higher than national medians.

If the charges for some of these seem high, remember that you have options to cover the cost of care. 

Payment and assistance options, both in the form of Long-Term Care Insurance that you can obtain through a Long-Term Care Insurance Specialist or via governmental assistance programs, can help significantly reduce your care costs and financial burden.

Your Long-Term Health, Covered in California

Regardless of where you are in your journey, it is worthwhile to look ahead and plan for the inevitable considerations of aging.

While some recommendations and options are true regardless of what state you live in, state-based legislation and restrictions can inform what options you have available to you.

If you’re interested in speaking with a Long-Term Care Insurance specialist, follow the link below or check out our additional resources on long-term care information for California.

NEXT UP: California Long-Term Care Resources

State Resources: California Department of Aging