California sits above the national line for senior care in nearly every setting. In the CareScout 2025 Cost of Care Survey, assisted living in California runs about $7,000 a month, a semi-private nursing-home room about $12,167, and non-medical in-home care about $40 an hour. Which setting a family chooses can swing the yearly bill by tens of thousands of dollars, from about $84,000 for assisted living to about $146,000 for a semi-private nursing-home room.

This guide lays out what every senior-care setting in California costs in 2026, what pushes the price up or down, and how families actually pay, from private savings to Medi-Cal for those who qualify after the state's 2026 asset-test changes.

In This Guide

What Each Senior Care Setting Costs in California

The figures below come from the CareScout 2025 Cost of Care Survey for California, released in March 2026. These are industry-survey medians, not government rates and not maximums, so the cost at any one provider can land higher or lower.

Read across the settings and California's pattern is consistent: care here costs more than the national benchmark in nearly every category. Assisted living has a median of about $7,000 a month against $6,200 nationally, and a private nursing-home room about $182,135 a year against $129,575 nationally. That doesn't make the choices any easier, but knowing the real numbers up front is what keeps the money picture from holding surprises later.

Care setting California National
Assisted living (month) about $7,000 about $6,200
Assisted living (year) about $84,000 about $74,400
Nursing home, semi-private room (month) about $12,167 about $9,581
Nursing home, private room (month) about $15,178 about $10,798
Nursing home, semi-private room (year) about $146,000 about $114,975
Nursing home, private room (year) about $182,135 about $129,575
Non-medical in-home care (hour) about $40 about $35

The in-home figure is an hourly rate, so the monthly bill depends entirely on the schedule. Beginning with its 2025 survey, CareScout reports an hourly "non-medical caregiver" rate. In California that non-medical caregiver rate runs about $40 an hour, or about $91,520 a year on CareScout's basis of 44 hours a week. Skilled home health care, the medical kind a doctor orders, is a different service: Medicare covers it for people who are homebound and need part-time or intermittent skilled care, but it does not pay for 24-hour care at home or for personal care when that is the only care a person needs. Low-income Californians may instead get in-home help through In-Home Supportive Services (IHSS), which requires a Medi-Cal eligibility determination. For the difference between the two, see our home care vs. home health guide.

What Drives the Cost of Senior Care in California

The setting sets the range. A nursing home sits at the top of it, at about $12,167 a month for a semi-private room and $15,178 for a private one. Assisted living, which California calls a Residential Care Facility, has a median of about $7,000 a month. Memory care is not a separate line in the figures above: in California it is regulated as care in a Residential Care Facility for the Elderly (RCFE), which the California Department of Social Services licenses, and CANHR reports that specialized services like dementia care are more costly.

The figures in this guide are statewide medians, so an individual provider can price well above or below them. A family comparing facilities in different parts of the state should get local quotes rather than assume the statewide number.

The rate can also change after move-in. In a California RCFE, an increase tied to a change in the resident's level of care requires written notice within two business days after the facility first provides the new level of care, with an itemization of the charges, while other rate increases require at least 90 days' written notice. When you compare quotes, ask what the base rate includes and what moves a resident to a higher level of care.

How Families Pay

Each payer covers different settings and different parts of the bill. Here is how the main options work in California.

Private pay is savings, income, the proceeds of a home sale, and long-term care insurance if a person bought it. It is the most flexible option, since it covers any setting, but it is also the one that runs out, and at about $12,167 a month for a semi-private nursing-home room, it can run out faster than families expect. Long-term care insurance pays according to the terms of each policy, so check what a policy covers and for how long.

Medi-Cal, California's Medicaid program, pays for long-term care, including nursing-facility care and home- and community-based services, for people who meet both a level-of-care test and the financial rules. A change worth knowing for 2026: under AB 116, California reinstated the asset test for most non-MAGI Medi-Cal programs effective January 1, 2026, ending the 2024-2025 window when there was no asset limit. The asset limit is now $130,000 for one person, plus $65,000 for each additional household member. Medi-Cal's long-term-care rules are tied to nursing-facility-level need: the Assisted Living Waiver, for example, requires care needs equal to those of Medi-Cal-funded nursing-facility residents. Confirm the income rules that apply to your situation with your county Medi-Cal office. When one spouse needs care, spousal-impoverishment rules protect part of the couple's assets for the at-home spouse. For 2026, federal rules set the range a state works within at $32,532 to $162,660, and that top figure is not automatically what a spouse keeps, so confirm California's amount with the county.

One gap matters for anyone weighing assisted living: Medi-Cal does not pay the room-and-board cost of assisted living. In the 15 counties where it currently operates, Medi-Cal can cover the care services in an RCFE through the Assisted Living Waiver, but the resident still pays room and board out of pocket, from their own funds and with enough left over for personal and incidental needs. Waiver slots are limited, so qualifying does not guarantee a place. A family choosing assisted living should plan to cover room and board privately, even where the waiver helps pay for the care services themselves. A nursing home is a separate question with separate rules: Medi-Cal's long-term-care coverage is tied to nursing-facility-level need, and the California Department of Health Care Services is the place to confirm what a skilled nursing stay pays for.

A note on the 2026 transfer rules, because they shape planning. California's look-back period is 30 months, phasing in month by month from July 1, 2026 until the full 30-month review applies to long-term-care applications on or after July 1, 2028. And a note on Medicare, because the assumption is common: Medicare covers skilled care, nursing and therapy care that can only be safely and effectively performed by or under the supervision of professionals or technical personnel, in settings such as a Medicare-certified skilled nursing facility or through its home health benefit, but not custodial care, the help with bathing, dressing and other daily activities, when that is the only care a person needs. That is why Medicare does not pay for a long-term stay in a nursing home or assisted living. That long-term care falls to private pay and, for those who qualify, Medi-Cal.

How to Plan and Budget

Start by matching the setting to the actual need, not the other way around. A candid assessment of how much help a person truly needs is worth more than a default assumption. The gap between settings is wide, from a median of about $7,000 a month for assisted living to about $12,167 for a semi-private nursing-home room, so the match matters. Our assisted living vs. nursing home guide walks through that threshold.

Then build a realistic timeline. Estimate the monthly cost of the right setting, list the resources available to pay for it, and work out how long private funds will last before Medi-Cal would come into play. If Medi-Cal is likely to be part of the plan, the new asset test and the phasing-in look-back reward starting early and getting advice, because a disqualifying transfer within the look-back can bring a period of ineligibility for nursing-facility care. Two Brevy guides go deeper here: Medicaid Planning Strategies walks through how to position assets and income within the rules, and Medicaid Personal Needs Allowance, Explained covers the small monthly amount a nursing-home resident keeps.

Finally, budget for more than the base rate. Ask each provider what its quoted rate leaves out, and leave room in the plan for a level-of-care increase.

Frequently Asked Questions

How much does senior care cost in California?

It depends heavily on the setting. In the CareScout 2025 Cost of Care Survey, assisted living has a median of about $7,000 a month ($84,000 a year), a semi-private nursing-home room about $12,167 a month ($146,000 a year), a private room about $15,178 a month ($182,135 a year), and non-medical in-home care about $40 an hour. These are statewide medians, not maximums, so an individual provider can cost more or less.

Is senior care more expensive in California than the national average?

Yes, in nearly every setting. In the CareScout 2025 survey, assisted living has a median of about $7,000 a month against $6,200 nationally, and both nursing-home room types sit well above the national figures. Non-medical in-home care runs about $40 an hour against $35 nationally.

Does Medi-Cal pay for senior care in California?

For nursing-facility care and home- and community-based services, yes, if a person meets a level-of-care test and the financial rules. As of January 1, 2026, California again applies a Medi-Cal asset test under AB 116: $130,000 for one person plus $65,000 for each additional household member. Do not rely on older guidance that says Medi-Cal has no asset limit; for most programs that was true only during the 2024-2025 window.

Does Medi-Cal cover assisted living in California?

Not the room-and-board cost. In the 15 counties where the Assisted Living Waiver currently operates, Medi-Cal can cover the care services in a Residential Care Facility for the Elderly, but the resident still pays room and board out of pocket, from their own funds and with enough left over for personal and incidental needs, and waiver slots are limited. A skilled nursing facility is a different benefit with different rules, so confirm that one with DHCS rather than assuming it follows the assisted-living answer.

How do families pay for senior care in California?

Through private pay (savings, income, home-sale proceeds, and long-term care insurance if they have it) and through Medi-Cal once a person meets the level-of-care and financial rules. Medicare does not pay for custodial care, such as help with bathing and dressing, when that is the only care a person needs. Because California reinstated the asset test in 2026 and is phasing in a 30-month look-back on transferred assets, planning early and getting professional advice usually pays off.

Learn More

Care TypesCost of Senior Care by State: Assisted Living, Nursing Home, and Home CareThe 2026 national median cost of assisted living, memory care, nursing homes, and in-home care, why your state differs, and your state's own cost guide. Care TypesAssisted Living in CaliforniaAssisted living in California means an RCFE, licensed by CDSS. What it costs in 2026, and what Medi-Cal and the Assisted Living Waiver will and won't cover. Care TypesNursing Homes in CaliforniaNursing homes in California in 2026: what a skilled nursing facility costs, how to check a facility's quality, and how Medi-Cal pays for nursing-home care. Care TypesMemory Care in CaliforniaMemory care in California: how dementia care works inside an RCFE, staff training rules, what it costs, and whether Medi-Cal's ALW helps pay. Care TypesHome Care vs. Home Health in CaliforniaHome care vs. home health in California: home health is skilled care Medicare covers; home care is non-medical help families pay for privately or get via IHSS. Care TypesAssisted Living vs. Nursing Home in CaliforniaAssisted living vs. a nursing home in California: care level and who pays. About $7,000 a month private-pay vs. roughly $12,167 for a nursing home.
MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house. MedicaidMedicaid Personal Needs Allowance, ExplainedHow the Medicaid Personal Needs Allowance works in 2026: the $30 federal floor, what the states set, and how patient liability is calculated.

Find personalized help building a realistic senior-care budget for California at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.