How to Pay for Assisted Living in California

The short answer

Most families pay for assisted living with private money first: the parent’s income, savings, or the sale of a home. Medicare does not pay for it. In California, Medi-Cal can help through the Assisted Living Waiver, but only in some counties, only for people who qualify, and usually after a wait. SSI, and VA benefits for veterans and surviving spouses, can help too.

This guide covers each route and what your family would still owe. It is written for families in Sacramento and Placer counties, but the state programs apply across California.

What assisted living costs here

The median is the middle price across the homes CareScout surveyed in the region. Our range comes from monthly rates that more than 50 licensed care homes in the area quoted us by phone in September 2026. The range covers both shared and private rooms. Care needs change the price too, so ask each home what its rate includes.

Does Medicare pay?

No. Medicare does not pay for long-term care, which Medicare also calls custodial care: help with everyday tasks like bathing, dressing and eating. That includes care in an assisted living home. Medicare Supplement (Medigap) plans do not pay for it either.

The exception people mix this up with: Medicare Part A can cover a short stay for skilled nursing or rehab in a Medicare-certified nursing home after a hospital stay, for up to 100 days. That is short-term medical care, not assisted living.

Medi-Cal and the Assisted Living Waiver

Medi-Cal is California’s Medicaid program. Its Assisted Living Waiver pays for the care services in a participating assisted living home. It does not pay for room and board: the resident still pays that part.

To qualify, a person must:

• be 21 or older;
• have full-scope Medi-Cal with no share of cost (a share of cost is a monthly amount some people must pay before Medi-Cal pays);
• need the level of care that Medi-Cal-funded nursing home residents need;
• be willing to live in an assisted living setting in one of the counties the waiver serves, and be able to live there safely.

The waiver runs in 15 counties. Sacramento County is one of them. Placer County is not. What counts is where the home is, not where your parent lives now: someone from Placer County can use the waiver in a participating home in a county it serves. In Sacramento County, 75 of the 685 licensed care homes for seniors (the state calls them Residential Care Facilities for the Elderly, or RCFEs) are on the state’s list of homes that take the waiver. So most homes do not, and choosing a home that does matters from the start.

Spots are limited and there is a waitlist. The state gives open spots first to people who have lived in a nursing home or similar facility for at least 60 days when their waitlist request is sent, and to people whose urgent need is documented in a referral from Adult Protective Services or the Long-Term Care Ombudsman. Other applicants get a spot only if spots remain, in the order they joined the list. In our experience, qualifying and getting a spot can take several months, though the state publishes no timeline and it varies.

Some Medi-Cal health plans also offer a service called Assisted Living Facility Transitions. For people who need nursing-home-level care, it can pay for ongoing care services in an assisted living home, including while someone waits for a waiver spot. Like the waiver, it does not pay room and board, and health plans choose whether to offer it. Ask your parent’s Medi-Cal plan whether it does before you plan how to cover the wait.

If your parent gets SSI

Start with the practical reality: in our experience, most assisted living homes do not accept residents who pay with SSI. California Advocates for Nursing Home Reform notes that the law does not require homes to admit SSI recipients. So ask each home directly before you plan around SSI.

SSI (Supplemental Security Income, with California’s State Supplementary Payment) is a monthly payment for people 65 or older, blind, or disabled, with low income and few savings: generally less than $2,000 in countable resources for one person. California pays a higher SSI amount to people living in a licensed care home. The table shows the most SSI pays. Other income, such as Social Security retirement, lowers the actual SSI payment, so use your parent’s actual award letter when you work out the monthly gap.

If a home does accept an SSI resident, California’s rules say the home must provide its basic services at that basic rate, with no extra charge. One exception: if the resident has income besides SSI, such as a pension or Social Security retirement, the home may charge $20 more a month when the resident agrees to it in the admission agreement. Basic services include the room, three meals a day, help with daily tasks, and watching over the resident’s health. A home may charge a little more for a private room when a shared room is available, capped at 10% of the room and board part of the SSI payment. Family members may also give the home voluntary contributions.

Help for veterans and surviving spouses

Veterans and surviving spouses who get a VA pension may qualify for Aid and Attendance, a monthly amount added to the pension. It is for people who need another person’s help with daily activities like bathing, eating and dressing, among other conditions. The VA pension itself has service, age or disability, income and net-worth rules. The amounts change every year, so check them with the VA directly rather than relying on a number from any website.

Paying with private money

For most families the first months are paid from the parent’s own income and savings. Other common sources are the sale of a home and long-term care insurance, if your parent bought a policy. Policies differ in what they cover and when payments begin, so read the policy or call the insurer. We do not give financial, tax or legal advice.

Working out your family’s monthly gap

Take the monthly price of the home, subtract your parent’s monthly income, and the difference is what savings or family must cover. For example, if a home charges the regional median of $7,750 and your parent’s income is $2,500, the gap is $5,250 a month. That income is an example, not a typical figure. Use your parent’s real numbers and the real price of the home.

If you are counting on the Assisted Living Waiver, plan for the full price until the waiver or a Medi-Cal plan’s assisted living service starts paying for care, and for the room-and-board part after that. Ask the home what that part costs.

Method and source

• All program rules and amounts were read from the official sources listed below on 2026-09-23.
• SSI amounts are for 2026 and change every January.
• We counted the homes that take the waiver by matching the state’s participating-facility list to the state licence file (status LICENSED) by street address. The two lists are dated differently, so treat the count as approximate.
• Our price range, and our statements that most homes do not accept SSI and that the waiver can take several months, come from our own calls to homes. They are our experience, not a survey.
• Nothing here is financial, legal or medical advice, and no one is promised eligibility for any program.

For the difference between assisted living and board and care, see assisted living vs board and care. For a count of licensed homes by city, see our census of licensed senior care homes in Sacramento and Placer.