Working it out
Keeping her at home sounds cheaper
For a few hours a day it genuinely is. The trouble is that nobody needs a few hours a day forever, and the point where it stops being cheaper arrives sooner than families expect — usually around five or six hours of paid help a day.
The number that surprises people
Around here, in-home care is priced above assisted living
Same survey, same year, same region. In-home care comes out at $7,245 a month and assisted living at $6,600 — about $645 a month more for the care at home.
And look at what each buys. The in-home figure is 44 hours a week, which is six hours and seventeen minutes a day. The assisted living figure is somewhere to live, every hour of every day. The other seventeen and a half hours at home are unpaid, and in practice that means you.
Both figures are from CareScout's 2025 Cost of Care Survey for the Los Angeles–Long Beach–Anaheim region. Putting them side by side is our comparison, not something the survey says.
Do it with your own numbers
The arithmetic takes about a minute
Ours are regional medians and yours will differ, so use the rate an agency has actually quoted you and the rate a home has actually quoted you.
hours a day × the hourly rate × 30.44 = what a month costs
30.44 is the average number of days in a month. Use four weeks instead and you will understate it badly — at six hours a day and $35 an hour, a 28-day month hides about $500.
Where the two meet
Paid hours a day at which home care costs the same as a home at that monthly rate. Below the figure, home is cheaper. Above it, the home is.
| Hourly rate | $4,000 a month | $5,500 a month | $7,000 a month |
|---|---|---|---|
| $30 | 4h 23m | 6h 01m | 7h 40m |
| $35 | 3h 45m | 5h 10m | 6h 34m |
| $38the regional median | 3h 27m | 4h 45m | 6h 03m |
| $40 | 3h 17m | 4h 31m | 5h 45m |
At the region's own published figures — $38 an hour against $6,600 a month — the two meet at five hours and forty-two minutes a day.
And then there is the night
Most families do not arrive at this decision because of the days. They arrive because of the nights — the falls, the wandering, the two in the morning telephone calls. Daytime help does not touch any of that.
Round-the-clock cover bought by the hour, at the region's $38 an hour, is about $27,761 a month. That is roughly four times the assisted living median and more than twice a private room in a nursing home. At $30 an hour it is still $21,917.
Some agencies price a live-in arrangement differently from hourly cover, and it is worth asking. We cannot tell you what that costs here, because the survey does not publish a live-in rate at all and we would rather say so than invent one.
Two things to hold on to when you compare. The hourly figure is what an agency bills, not what a caregiver is paid, so it is not the number for hiring somebody privately. And a care home's monthly rate includes her rent, her food and her utilities, while the cost of keeping the house going carries on underneath the cost of the care.
If she is on Medi-Cal
The programme nobody mentions
In-Home Supportive Services is California's publicly funded in-home care, and it changes this entire comparison for a family that qualifies. A county social worker assesses what she needs and authorises a number of hours a month.
Two things about it that families almost never know. You can usually be the paid provider yourself — a family member can be hired. And her “own home” is defined as the place she chooses to live, so moving in with you does not end it.
What it will not do is pay for a care home. The help has to be where she lives, and a licensed facility is specifically excluded. So IHSS is the thing that makes home viable for longer; it is not an alternative way to fund a placement.
It runs through Medi-Cal, and California reinstated the Medi-Cal asset test on 1 January 2026 after two years without one, so the financial picture is not what it was in 2025. Orange County's social services agency is the place to start, and there is a health care certification form a doctor has to complete before the county can authorise anything — worth starting early for the same reason it is worth starting early with a care home.
Before you hire anybody
How to check an agency, in about five minutes
California licenses in-home care agencies and background-checks their caregivers, and both records are public. It is the same kind of check we tell families to run on a care home.
The agency needs a licence
A business sending caregivers into a home for non-medical help must hold a Home Care Organization licence from the Department of Social Services. Operating without one carries a $900 a day penalty. Search the state's care facility search, which lists home care organizations alongside care homes — and read the status field, because "Pending" is not "Licensed".
The record shows more than the licence
An agency's page carries what a care home's does: how many times the state has visited, the dates, Type A and Type B citations, and how many complaint investigations were completed and what they found. It is the most useful five minutes available to you, and almost nobody spends it.
The caregiver should be registered
A licensed agency must list each caregiver on the state's Home Care Aide Registry and have them cleared before they are in contact with clients — fingerprints to the Department of Justice and the FBI. You can check an individual, but only if you have their personnel ID as well as their name, so ask the agency for it.
What the agency carries that you would not
A licensed agency has to hold workers' compensation on its aides, an employee dishonesty bond, and a million dollars of liability cover. Its aides must do five hours of training before they start and five hours a year after. Hiring privately is lawful and sometimes right, but all of that becomes yours.
What Medicare will and will not do
This is where families lose the most time, so it is worth being plain. Original Medicare does not pay for the kind of help most people mean when they say home care — bathing, dressing, meals, somebody there. That exclusion is written into the statute, not decided by an insurer.
What it does cover is home health: if she is homebound and needs intermittent skilled nursing, or physical or speech therapy, Medicare pays for that, and a home health aide can help with personal care alongside it. Two things follow that catch people out. The aide hours end when the skilled service ends. And nursing and aide time together have to stay under eight hours a day and twenty-eight hours a week, so this is not a route to all-day cover.
Homebound does not mean bedbound — she can leave for medical appointments, church and the occasional outing. And Medicare does not pay for assisted living either, though it keeps paying her doctor visits and therapy after she moves in.
A Medicare Advantage plan may offer in-home support as a supplemental benefit. Few do, and the ones that do gate it, so the only reliable answer is to ring the plan and ask what it covers this year.
Common questions
Home or a home, answered
- Is it cheaper to keep my mother at home?
- For a few hours a day, yes, comfortably. Past about five or six hours a day of paid help it usually stops being cheaper, and round-the-clock cover is not close. Work it out with the rate you have actually been quoted: hours a day, times the hourly rate, times 30.44 — the average number of days in a month. Compare that with a home's monthly rate and you have your answer in about a minute.
- What does in-home care cost around Anaheim?
- The CareScout 2025 Cost of Care Survey puts the median non-medical caregiver rate at $38 an hour for the Los Angeles–Long Beach–Anaheim region. That is a two-county regional figure covering about thirteen million people, not an Anaheim figure — every Anaheim and Orange ZIP returns the same number — and it is the rate agencies bill, not what a caregiver is paid. Ring three agencies and you will get three different numbers; use yours, not ours.
- So in-home care costs more than assisted living?
- At the hours the survey assumes, in this region, yes — and that surprises most people. The same survey, the same year, the same region prices in-home care at $7,245 a month and assisted living at $6,600. But read what each buys. The in-home figure is 44 hours a week, about six hours and seventeen minutes a day. The assisted living figure is somewhere to live, every hour of every day. That comparison is ours, drawn from two of the survey's published figures, not something the survey says.
- What would twenty-four hour care at home actually cost?
- At the region's published $38 an hour, round-the-clock cover is about $27,761 a month — roughly four times the assisted living median and more than twice a private room in a nursing home. Some agencies price live-in arrangements differently from hourly cover, and the survey publishes no live-in rate at all, so ask specifically. But if anyone quotes you 24-hour hourly care as the affordable option, the arithmetic is not on their side.
- Will Medicare pay for a caregiver at home?
- Not for the kind of help most families mean. Original Medicare does not pay for custodial care — bathing, dressing, meals, supervision — when that is all somebody needs; the exclusion is in the statute itself. It does cover home health for someone who is homebound and needs intermittent skilled nursing or physical or speech therapy, and a home health aide can help with personal care alongside that skilled service. But the aide hours stop when the skilled service stops, and nursing and aide time together are capped under eight hours a day and twenty-eight a week. A Medicare Advantage plan may offer in-home support as an extra benefit; few do, so ask the specific plan.
- What is IHSS and could my mother get it?
- In-Home Supportive Services is California's publicly funded in-home care programme, and it is the single most under-known thing in this whole comparison. It pays for help at home for people who qualify for Medi-Cal, assessed by a county social worker, and she can usually hire a family member as the paid provider. It does not pay for a care home — the help has to be in her own home — but her own home includes moving in with you, because the regulation defines it as the place she chooses to reside. Note that California reinstated the Medi-Cal asset test on 1 January 2026.
- How do I check an in-home care agency is legitimate?
- California licenses them. A business that sends caregivers into a home for non-medical help must hold a Home Care Organization licence from the Department of Social Services, and its caregivers must be background-checked and listed on the state's Home Care Aide Registry. Both are publicly searchable, and the agency's record shows its citations and complaint history in the same way a care home's does. Read the status field — "Pending" is not "Licensed".
- Can I just hire somebody directly?
- Yes, lawfully — the Act expressly does not stop a family employing someone itself. Go in with your eyes open, though. There is no state background check, you become an employer with the obligations that carries, and the Department of Social Services does not investigate complaints against an individual caregiver. A licensed agency has to carry workers' compensation on its aides, a dishonesty bond and liability cover; hiring privately, that is all you.
Cost figures from the CareScout 2025 Cost of Care Survey, released 2 March 2026 with fieldwork between July and November 2025, for the Los Angeles–Long Beach–Anaheim region — two counties, not Anaheim. Monthly conversions use 30.44 days and are ours. Medicare coverage read at medicare.gov and in the governing statute; IHSS and home care licensing read at the California Department of Social Services. General information for families, not legal, medical or financial advice.
Every regulation quoted on this page is listed with a link to its full published text on California care home rules. Please check us rather than take our word for it.
If the question is really what a home costs, what care actually costs here goes further. If you are not sure it is time at all, the signs that matter is the more useful page.
Last reviewed . Figures are re-checked against their sources whenever this page is revised.
Tell us the hours and we will do the sum with you
If you have a quote from a home care agency and a quote from a care home, we will tell you plainly which is cheaper at the hours she actually needs — and if the answer is to stay at home a while longer, we will say that too.
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