The California Medicaid answer, verified
Yes for services, not for rent, and not statewide - Medi-Cal's Assisted Living Waiver (ALW, 1915(c) #0431.R04.00) provides care coordination, residential habilitation, assisted living services (homemaker, home health aide, personal care), augmented plan-of-care development and nursing-facility transition coordination to people 65+ and adults 21-64 with physical or other disabilities who meet a nursing-facility level of care; as an HCBS waiver it cannot pay room and board (42 CFR 441.310(a)(2)), which the resident pays from their own income. Here is what that means in practice for Los Altos Hills families - eligibility, what waivers cover, and what stays out of pocket.
Assisted living near Los Altos Hills compares against a national median of $6,200 a month - and California's own median of $7,000, ranked #14 of 50 states.
A semi-private nursing home room runs $9,581 a month at the 2025 national median - the number Los Altos Hills families weighing skilled care start from.
In-home care averages $35 an hour nationally - about $80,080 a year at 44 hours a week for Los Altos Hills households.
Medicaid is the payer of last resort for long-term care, and whether it helps with assisted living depends entirely on your state. Yes for services, not for rent, and not statewide - Medi-Cal's Assisted Living Waiver (ALW, 1915(c) #0431.R04.00) provides care coordination, residential habilitation, assisted living services (homemaker, home health aide, personal care), augmented plan-of-care development and nursing-facility transition coordination to people 65+ and adults 21-64 with physical or other disabilities who meet a nursing-facility level of care; as an HCBS waiver it cannot pay room and board (42 CFR 441.310(a)(2)), which the resident pays from their own income. Nursing home care is covered in every state for those who qualify financially - assisted living is the state-by-state question.
The honest California answer, verified against official sources: Yes for services, not for rent, and not statewide - Medi-Cal's Assisted Living Waiver (ALW, 1915(c) #0431.R04.00) provides care coordination, residential habilitation, assisted living services (homemaker, home health aide, personal care), augmented plan-of-care development and nursing-facility transition coordination to people 65+ and adults 21-64 with physical or other disabilities who meet a nursing-facility level of care; as an HCBS waiver it cannot pay room and board (42 CFR 441.310(a)(2)), which the resident pays from their own income. Eligibility is strict - income and asset limits apply, and there is typically a five-year look-back on gifts and transfers - so families planning a Medicaid path should talk to an elder law attorney early.
The 2026 numbers
| Care type | 2025 national median | What it covers |
|---|---|---|
| In-home care | $35/hour | Non-medical help at home - meals, bathing, companionship |
| Adult day care | $95/day | Daytime supervision and activities, evenings at home |
| Assisted living | $6,200/month | Housing plus daily-living help; care-level fees extra |
| Memory care | typically 20-40% above assisted living | Secured dementia care with higher staffing |
| Nursing home (semi-private) | $9,581/month | 24/7 skilled medical care |
| Nursing home (private room) | $355/day | Same care, private room |
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California: Medicaid, prices and the inspection file
| Question | California answer |
|---|---|
| Medicaid & assisted living | Yes for services, not for rent, and not statewide - Medi-Cal's Assisted Living Waiver (ALW, 1915(c) #0431.R04.00) provides care coordination, residential habilitation, assisted living services (homemaker, home health aide, personal care), augmented plan-of-care development and nursing-facility transition coordination to people 65+ and adults 21-64 with physical or other disabilities who meet a nursing-facility level of care; as an HCBS waiver it cannot pay room and board (42 CFR 441.310(a)(2)), which the resident pays from their own income. |
| State median, assisted living | $7,000/month (#14 of 50 states) |
| Licensing & inspection records | California Department of Social Services (CDSS), Community Care Licensing Division - Senior Care Licensing Program |
California law does not use the term 'assisted living' - these homes are licensed as 'Residential Care Facilities for the Elderly' (RCFE). Search 'RCFE', not 'assisted living', when you check a licence or inspection record.
This guide is research, not advice: an independent summary of published costs and state rules. It is not a care provider, placement agency, law firm or financial advisor - care and Medicaid decisions deserve professional advice for your family's situation.
What this means for Los Altos Hills families
Home care keeps your parent in familiar surroundings and costs less at low hours; communities win on 24/7 coverage, social contact and predictable pricing. The wrong choice is usually the one made in a crisis - which is why running these numbers early matters more than getting them perfect.
This guide is research, not advice: an independent summary of published costs and state rules. It is not a care provider, placement agency, law firm or financial advisor - care and Medicaid decisions deserve professional advice for your family's situation.
Common questions
Does Medicaid pay for assisted living?
It depends entirely on your state: 36 states cover some assisted living services through waivers, 9 cover them in limited settings, and 6 have no assisted living pathway at all. Even where covered, waivers typically pay for care services while the family handles room and board. This guide's Medicaid page gives your state's verified answer.
How much does in-home care cost?
About $35 an hour at the 2025 national median - roughly $80,000 a year at 44 hours a week. Since the 2025 survey, non-medical caregivers are tracked as a single category, so quotes for 'homemaker' versus 'home health aide' services should no longer differ much for non-medical help.
What is the difference between assisted living and a nursing home?
Assisted living provides housing plus help with daily activities - meals, medication, bathing - at a median $6,200 a month. Nursing homes provide 24/7 skilled medical care at a median $9,581 a month for a semi-private room. The dividing line is medical need: wound care, feeding tubes and ventilators are nursing-home territory.
Should my parent stay home with help or move to assisted living?
Run the hours math first: in-home care at about $35 an hour serves people who need help, not round-the-clock supervision. Below about 30-40 hours a week, home usually costs less; past that - or when safety needs someone always present - assisted living's $6,200 median often buys more coverage. The right answer follows the care needs, not the buildings.
What is memory care and why does it cost more?
Memory care is assisted living specialized for dementia - secured areas, higher staffing, trained caregivers - and typically prices 20-40% above standard assisted living in the same market. If dementia is in the picture, ask specifically about memory-care rates and staff training, not the general rate.
Find senior care options near Los Altos Hills
These platforms show communities and home-care agencies near you with pricing guidance. Advisors are free to families - providers pay them, as they do this site.
Disclosure: this is an independent guide. If you connect with a provider through a link here, the platform may pay this site a referral fee. That fee never changes your price - and it never changes what the inspection records say.
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