ihss website In-Home Supportive Services (IHSS) Program

IHSS-Care givers Stay At Homemedi cal can pay for you to have a caregiver at home ihss

Can California Medi-Cal Help Pay for Care at Home IHSS?

 What Are You Trying To Do?

  • Care for a Parent or Spouse at Home
    • Many families are looking for programs that may help pay for caregivers, supervision, meal preparation, transportation, or assistance with activities of daily living.  Scroll down to learn more about IHSS.
  • Reduce Medi-Cal Share of Cost
  • Avoid a Nursing Home
    • California has several home and community-based care programs intended to help certain seniors and disabled individuals remain safely at home instead of entering institutional care.   Learn about HCBS Waivers →
  • Understand Estate Recovery Rules
  • Pay for Assisted Living or Board & Care
    • Scroll down

Common Questions

  • Can family members get paid to provide care?
    • Sometimes yes. California IHSS rules may allow certain relatives to serve as caregivers.
  • Does IHSS affect Medi-Cal Share of Cost?
    • Potentially. Different Medi-Cal eligibility categories and deductions can interact with Share of Cost rules.
  • Can IHSS help someone avoid a nursing home?
    • In some cases, yes. IHSS and related programs are often intended to help individuals remain safely at home.
  • Does Medicare pay for long-term caregiving?
    • Usually not in the way most people expect. Medicare generally focuses on medically necessary skilled care, not ongoing custodial care.
  • Can Medi-Cal help pay for assisted living?
    • Sometimes, through specific waiver or community-based programs, depending on eligibility and availability.

California Health Care Foundation
In Home Supportive Services IHSS

Federal Funding Deferrals

What Is IHSS?

IHSS stands for In-Home Supportive Services. The program may help certain elderly, blind, or disabled California residents remain safely in their homes by providing support services such as:

  • Meal preparation
  • Bathing and dressing assistance
  • Housekeeping
  • Transportation
  • Protective supervision
  • Help with medications
  • Personal care services

In some situations, family members may be eligible to serve as paid caregivers under IHSS rules.

 cdss.ca.gov/in-home-supportive-services

However, eligibility rules, assessments, hours authorized, and interactions with Medi-Cal Share of Cost can become complicated very quickly.

 

How Can Medi-Cal Help Pay for Assisted Living or

Board & Care in California?

What Is the Difference Between Assisted Living,
Board & Care, and Nursing Homes?

People often use these terms interchangeably, but they are not the same:

  • Board & Care:
    • Usually smaller residential homes with assistance for meals, medications, supervision, and daily living.
  • Assisted Living:
    • Larger facilities that may provide meals, activities, medication management, and help with daily activities.
  • Memory Care:
  • Skilled Nursing Facilities (SNF):
    • Nursing homes providing higher medical levels of care.

Important: Medicare may help temporarily after a hospitalization for skilled nursing or rehabilitation, but Medicare generally does not pay for ongoing custodial long-term care simply because someone needs supervision or assistance with daily living.


Long-Term Care vs Medicare

Can Medi-Cal Help Pay for Assisted Living?

  • Possibly — but the answer depends on the person’s medical condition, income, assets, county availability, and whether appropriate programs or waivers are available.

California Medi-Cal may help with:

One program families sometimes hear about is the:

Assisted Living Waiver (ALW).

The  assisted-living-waiver  may help certain Medi-Cal beneficiaries receive care in assisted living settings instead of nursing homes, but:

  • Availability can be limited
  • Not all facilities participate
  • There may be waiting lists
  • Not every county participates equally
  • Medical eligibility requirements apply
  •  dhcs.ca.gov/assisted-living-waiver/

Where Does CalAIM Fit Into This?

CalAIM is California’s large Medi-Cal reform initiative that expanded care coordination and certain community support services through Medi-Cal managed care plans.

 

CalAIM may help support:

  • Care coordination
  • Housing navigation
  • Transitions from facilities back into the community
  • Community-based supports
  • Behavioral health coordination

However, CalAIM does not mean Medi-Cal automatically pays for all assisted living or board & care facilities.

Home Care Alternatives

Many families prefer to keep loved ones at home as long as possible instead of moving into a facility. Depending on the situation, alternatives may include:


IHSS In-Home Supportive Services


Medicare Home Health Coverage

Estate Recovery Questions

  • Families are often concerned about what happens to a home or estate after Medi-Cal benefits are paid.
  • Estate recovery rules can be complicated and may depend on the type of Medi-Cal benefits received and when services were provided.
  • Our webpage on Estate Recovery Rules
  • Bottom line:
    • Long-term care planning in California may involve Medicare,
    • Medi-Cal,
    • IHSS,
    • assisted living waivers,
    • estate recovery rules,
    • home care alternatives, and
    • private insurance planning.
    • The rules are often confusing because different programs cover different levels of care.

Questions or Long-Term Care Insurance Quotes?

  • You can contact me if you would like information about
    • long-term care insurance,
    • Medi-Cal planning questions,
    • home care alternatives, or
    • California long-term care issues.


Email Steve


Schedule a Zoom Meeting

Resources, Citations & Links

  • Freedom Blue – Pays for Caregivers, if you buy coverage BEFORE you need it

Related Child & Sibling Pages

Site Map 

email us Steve@SteveShorr.com

Optional Deeper Details Below
The practical explanation is above. The section below includes supporting documents, background material, citations, examples, and technical details for readers who want more.

What are HCBS Home and Community-Based Services?

Medicaid- Medi Cal covered HCBS are services that support older adults and people with disabilities with activities of daily living in settings of their choice, including their homes, assisted living facilities, and adult day health centers. Supports include, for example, personal care assistance, care coordination, medically-tailored nutrition, transportation, medication management, home modifications, and, for individuals with high care needs, 24-hour nursing and supervision. California’s HCBS programs include:

Can Medi Cal Recover for IHSS?

 

Yes, Medi-Cal can seek recovery from a deceased person’s estate for In-Home Supportive Services (IHSS) and other long-term care costs if they received those benefits after age 55, though there are specific exemptions for surviving family members and certain services, so it’s crucial to check specific case details and consult an estate planning attorney. While some sources mention IHSS payments are exempt, newer guidance and practice confirm they are generally subject to recovery unless specific exemptions apply, like care for a surviving spouse or minor/disabled child. [1, 2, 3, 4, 5, 6]

 

When Medi-Cal Can Recover (Estate Recovery Program):
  • Age 55+: For individuals who received long-term care services, including IHSS, after age 55.
  • Institutionalization: For anyone, regardless of age, who was permanently institutionalized.
  • Services Covered: Nursing facility care, home and community-based services (like IHSS), and related hospital/prescription drug costs. [2, 5, 6, 7]
  • Post-2017 Changes: For deaths on or after January 1, 2017, recovery is limited to nursing facility services and HCBS, including IHSS, but only for payments made for those specific services.  dhcs.gov * dhcs.gov pdg *  CANHR.org FAQ’s *
When Recovery is Exempt (No Recovery):
  • Surviving Spouse/Minor/Disabled Child: If a surviving spouse, minor child, or disabled dependent lives in the home.
  • No Probate Assets: If the estate has no assets subject to probate (e.g., held in a properly structured trust).
  • Specific Service Exclusions: Costs for Medicare premiums/co-pays for certain low-income beneficiaries are exempt, and some Personal Care Services (PCS) under specific waivers might also be excluded. [1, 2, 4, 8]
Key Considerations:
  • Estate Planning: Tools like irrevocable trusts can help protect assets from recovery claims.
  • Notification: The state sends a notice (itemized bill) to heirs after the recipient dies.
  • Professional Advice: Because rules are complex, consulting a California estate planning attorney experienced with Medi-Cal is highly recommended. [2, 7, 8, 9, 10]
In Summary: Don’t assume IHSS payments are automatically exempt; they are generally recoverable from the estate unless specific exemptions for family or asset structure apply. [1, 2, 3, 5, 11]

AI responses may include mistakes.

FAQ’s

Can IHSS Providers – Care Workers – Get Medi Cal regardless of their income?

Here’s what the PASC-SEIU Homecare Workers  website says –

As long as you are authorized  work 74 hours or more per month for two consecutive months.  You will continue to be eligible as long as you continue to be authorized to work at least 74 hours per month. View actual wording

On the other hand:

IHSS workers would be presumptively eligible, for 6 months  – you can get temporary coverage until official eligibility is determined Law Insider *  for full [Medi Cal] benefits and there would be no means test – they won’t look at your income, resources – assets or your ability to pay for health insurance. Sooner or later though, A Medi Cal application would eventually have to be completed.    Investopedia *  Dhcs *  Report to CA Health Care Foundation by USC  June 2000    

On the other hand:

Here’s an optometrist making $200k that was the IHSS caretaker for his mother.  He states:

i was never asked about income if i remember correctly email dated 5.9.2022

On the other hand:

I don’t do phone calls – especially when I don’t get compensated to help people with IHSS – here’s a number to call

Providers who are eligible for the plan will automatically be sent an enrollment packet that describes what the PASC- SEIU Homecare Workers Health Care Plan provides. If you are eligible for the health plan, you may contact the PASC Health Plan Call Center at 1-855-PASC-PLN, (1-855-727-2756), to request an enrollment form.

If you are already enrolled in L.A. Care plan and have additional questions about specific benefits provided by the Plan, please call L.A. Care at 1-844-854-7272, or go to their website at www.lacare.org/members/ihss.

 

 

What is the

CA Assisted Living Waiver?

 

The California Assisted Living Waiver (ALW) is a Medi-Cal program that helps low-income, eligible seniors and persons with disabilities move into or remain in assisted living facilities instead of a nursing home. It covers the cost of care services in a Residential Care Facility for the Elderly (RCFE) or subsidized housing, but participants must pay their own room and board. [1, 2, 3]

 

Key Aspects of the ALW Program
  • Eligibility: Must be full-scope Medi-Cal eligible with zero share of cost, require a nursing facility level of care, and be able to pay for room and board.
  • Coverage & Availability: The program is authorized in 15 California counties (including Los Angeles, San Diego, and San Francisco) through February 28, 2029.
  • Services Provided: Includes care coordination, personalized care plans, 24-hour care, and routine, scheduled nursing visits.
  • Goal: To provide a less restrictive, home-like environment, avoiding unnecessary institutionalization.
  • Waitlist/Limitations: It is not an entitlement program, and spots are limited, often leading to waitlists. [1, 2, 3, 4, 5]
How to ApplyInterested individuals must work with a Care Coordination Agency (CCA) to conduct a nurse assessment and complete an application. A list of participating RCFEs and CCAs can be found on the California Department of Health Care Services (DHCS) website. [2, 6, 7, 8, 9]

 

 

AI responses may include mistakes.

Participants in the ALW have access to the following services:

  • Assisted Living Services: The following is a list of some of the services that must be provided to ALW participants.  These services may be provided in an RCFE, or by a licensed Home Health Agency to residents in public housing.
    • Assisting in developing and updating an individualized care plan for each resident
    • Personal care and assistance with activities of daily living
    • Laundry
    • Housekeeping
    • Maintenance of the facility
    • Providing intermittent skilled nursing care
    • Meals and snacks
    • Providing assistance with self-administration of medications
    • Providing or coordinating transportation
    • Providing recreational activities
    • Providing social services
  • Care Coordination: These services include identifying, organizing, coordinating and monitoring services needed by participants .
  • Nursing Facility Transition Care Coordination: These services help transition participants from a nursing home to the community.  CA Assisted Living Waiver

Resources & Links

    • DHCS.CA.Gov – CA Department of Health Care Services
    • Assisted Living Waiver dchs.gov
    • Elder Options – Private Website – DHCS subcontractor that can help people in Sacramento Area
    •  nolo.com when-californias-medi-cal-will-pay-nursing-home-assisted-living-home-health-care.