Paying for care
What home care costs and how families pay for it
Home care is billed by the hour and usually paid privately. Long-term care insurance and VA benefits can help. Medicare doesn’t pay for ongoing non-medical care. Here’s how each one works.
Licensing and caregiver screening
Licensed Home Care OrganizationCDSS license #374700397
Caregivers on the state registryLive Scan fingerprint check (CA DOJ and FBI) and TB test
Owned by a registered nurseMildred Kiminyei, RN
How home care is billed
Home care agencies charge by the hour. Many have a minimum visit length, and some charge more for nights, weekends, or holidays. Ask about all of these before you sign anything, with any agency.
Our rates run from $40 to $48 an hour, depending on the care and the schedule. We’ll give you your exact rate on the first call. It goes into your written service agreement before care starts, so the first bill isn’t a surprise.
A quick way to estimate a monthly cost
Multiply the hourly rate by the hours of care per week, then by 4.3, the average number of weeks in a month. At our rates, 20 hours a week (about 86 hours a month) comes to about $3,440 to $4,128 a month.
Hourly, 24-hour, and live-in care
Hourly visits
A caregiver comes for a set block of hours, a few days a week or every day. This fits someone who is safe alone part of the day but needs help with bathing, meals, or errands.
24-hour care in shifts
Two or three caregivers split the day into shifts, so someone is always awake. This fits someone who needs help at night or can’t be left alone. It costs the most, because every hour is paid.
Live-in care
One caregiver stays in the home for several days in a row, with a private place to sleep and scheduled breaks. It usually costs less than 24-hour shifts, but it only works if your parent sleeps through most nights.
More detail on round-the-clock options is on our 24-hour and live-in care page.
Our rates and policies
The details that show up on your bill.
- Hourly rate
- $40 to $48 an hour, depending on the care and the schedule. Your exact rate is quoted on the first call and written into your service agreement before care starts.
- Minimum visit length
- 4 hours
- How often we bill
- Every two weeks
- Ways to pay
- TODO: Accepted payment methods
- Deposit
- $500
- Cancelling a visit
- 12 hours’ notice
- Holidays
- Billed at 1.5 times the hourly rate
- Long-term care insurance
- We give you an invoice to submit to your insurer
Long-term care insurance
Many long-term care insurance policies pay for care from a licensed home care agency. Find the policy and check four things before care starts:
- Benefit trigger. Most policies pay when a person needs help with at least two of six daily activities (bathing, dressing, eating, using the toilet, continence, and moving between bed and chair) or has a severe cognitive impairment, such as dementia.
- Elimination period. A waiting period, often 30, 60, or 90 days, when you pay before the policy starts paying. Some policies count calendar days. Others count only days you received paid care.
- Daily or monthly benefit. The most the policy pays. If care costs more, you pay the difference.
- Plan of care. Most policies require a plan of care from a licensed health care practitioner, such as a doctor or nurse, before they pay.
Call the insurance company to start a claim as soon as you know care is needed. On some policies, the waiting period doesn’t start until you do.
VA Aid and Attendance
Aid and Attendance is an extra monthly amount added to a VA pension. It’s for veterans and surviving spouses who need another person’s help with daily activities like bathing and dressing, are bedridden, live in a nursing home because of a disability, or have very limited eyesight.
- Who can qualify. Veterans who served during a wartime period and meet the VA’s service, income, and net worth rules, and their surviving spouses.
- How to apply. Veterans apply for a VA pension with VA Form 21-527EZ. Surviving spouses use VA Form 21P-534EZ. To add Aid and Attendance, include VA Form 21-2680, which a doctor fills out.
- Free help. Accredited veterans service officers help with VA claims at no charge, including at the County of San Diego’s veterans services office. Be careful with anyone who wants to charge you to file a claim.
- Holding your start date. Filing an “intent to file” with the VA can hold your start date for up to a year while you gather paperwork.
The VA explains the rules on its Aid and Attendance page.
Medicare
Medicare doesn’t pay for help with bathing, dressing, or using the bathroom when that is the only care someone needs. That kind of help is called custodial care, and it’s what most home care is.
Medicare does pay for home health care: part-time skilled nursing or therapy, when a doctor certifies that a person is homebound and needs it. It’s usually short-term, often after a hospital stay. Many families use both at once. A home health nurse visits a few times a week, and a caregiver from an agency like ours helps with daily life.
Some Medicare Advantage plans include a small in-home support benefit. Check your plan’s Evidence of Coverage, or call the number on the member card. Medicare’s own summary is on its home health services page.
Medi-Cal and IHSS
Medi-Cal’s In-Home Supportive Services program (IHSS) pays for in-home help for people with low income who qualify. In IHSS, the person receiving care chooses their own caregiver, often a family member, and the program pays that caregiver. IHSS doesn’t pay private agencies like ours. In San Diego County, IHSS is run by Aging & Independence Services.
Other ways families pay
- Tax deduction. Care for someone who is chronically ill, given under a plan of care from a licensed health care practitioner, can count as a deductible medical expense. Ask your tax preparer.
- Life insurance. Some policies let you use part of the death benefit for long-term care. Ask the insurance company what the policy allows.
- Home equity. Some families use a reverse mortgage or a home equity line of credit to pay for care at home. These carry real costs, so get independent advice first.
This page is general information, not financial or legal advice. If you’re not sure what applies to your family, call us at (858) 380-9599 and we’ll talk it through.
Common questions
How much does home care cost in San Diego?
Rates differ between agencies. Ours run from $40 to $48 an hour, depending on the care and the schedule, and we’ll quote your exact rate on the first call. To estimate a month, multiply the hourly rate by the hours per week, then by 4.3.
Will Medicare pay for a caregiver after my mother’s hospital stay?
Medicare may pay for home health visits from a nurse or therapist if her doctor certifies she’s homebound and needs skilled care. It won’t pay for a caregiver whose only job is helping with bathing, meals, or supervision.
Does long-term care insurance pay for home care?
Many policies do, once the benefit trigger is met and the elimination period has passed. Check the daily benefit and whether the policy requires a plan of care from a doctor or nurse.
Can VA benefits pay for home care?
Yes. Aid and Attendance adds a monthly amount to a VA pension for eligible veterans and surviving spouses, and it can be used for home care. Veterans enrolled in VA health care can also ask their VA care team about the VA’s homemaker and home health aide program.
Request a free in-home consultation
Tell us what’s going on and we’ll call you back to talk it through and set up a visit at the home. The consultation is free.
If it’s urgent, call instead of using the form.
- (858) 380-9599
- love@pendaseniorhomecare.com
- Office hours: Monday to Friday, 9 a.m. to 5 p.m.
- Care available 24 hours a day, 7 days a week