How to pay for board and care in California

1. Paying privately

Most residents pay from a mix of Social Security, a pension, savings, help from family, or money from selling or renting out their home.

Before you sign, ask exactly what the monthly rate includes and which care costs extra. California law requires a home to give at least 90 days' written notice before raising its rates, with the reason for the increase. (A rate change because your loved one needs more care is handled separately.)

• Ask how much the rate went up in each of the last two years.
• Ask for every fee in writing. Any fee must be listed in the admission agreement.
• If you sell the home to pay for care, talk to HICAP or an elder law attorney first: the money can affect Medi-Cal or SSI eligibility later.

2. What Medicare does and does not pay

Medicare does not pay for long-term care. It does not pay a board and care home's monthly rate: not the room, the meals or the day-to-day help with bathing, dressing and medications.

Medicare still covers your loved one's doctor visits, hospital stays, prescriptions (Part D) and a short stay in a skilled nursing facility after a qualifying hospital stay. If your loved one goes on hospice, Medicare pays the hospice team, but it does not pay room and board, so the family still pays the home's monthly rate.

3. Medi-Cal: the Assisted Living Waiver (ALW)

Regular Medi-Cal does not pay a board and care home's monthly rate. The Assisted Living Waiver is the Medi-Cal program that pays for care services in participating homes. The resident still pays the home directly for room and board, usually from their own income such as SSI/SSP.

The ALW is offered in 15 counties: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma.

To qualify, a person must be 21 or older, have full-scope Medi-Cal with no share of cost, need the level of care of a nursing home resident, and be willing to live in a participating home in one of those counties.

The reality: the number of spots is limited and there is a waitlist, so plan on waiting and have a backup plan. Not every home takes the ALW; on RoomsInView, look for "Medi-Cal Assisted Living Waiver: Accepted". You apply through a Care Coordination Agency; the DHCS ALW page lists them by county.

Since January 1, 2026, Medi-Cal for older adults again has an asset limit: $130,000 for one person, plus $65,000 for each additional family member. The state has proposed further changes, so ask your county Medi-Cal office for the current rule.

4. SSI/SSP for licensed residential care

SSI (from Social Security) plus California's State Supplementary Payment (SSP) has a special, higher rate for people who live in a licensed board and care home. In 2026 that rate is $1,626.07 a month for one person.

The resident keeps $182 a month for personal needs. The rest is what a home may charge an SSI/SSP resident for basic services (room, meals, care and supervision).

To get SSI, a person must have low income and few resources: no more than $2,000 for one person or $3,000 for a couple. The home you live in and one car usually don't count.

Not every home accepts residents who pay with SSI/SSP. Ask before you tour. By law, a home may not charge an SSI/SSP resident any preadmission fee or deposit.

5. VA Aid and Attendance (veterans and surviving spouses)

Aid and Attendance is an extra monthly amount added to a VA pension. To get it, the veteran or surviving spouse must qualify for a VA pension (which has wartime service, income and net worth rules) and need help with daily activities such as bathing, dressing or eating, or meet one of the VA's other conditions.

Amounts change every year, so check the current pension rates on va.gov instead of trusting a number from an ad or a salesperson. You apply online or with VA Form 21-2680, which a doctor or other medical examiner fills out in part.

Applying is free. Be careful with anyone who charges a fee to help you apply or who suggests moving assets to qualify. A county veterans service office can help at no cost.

6. Long-term care insurance

If your loved one has a long-term care insurance policy, read it for "assisted living" or "residential care facility" coverage, the daily or monthly benefit, and the waiting period (elimination period) before it starts paying. Call the insurer before move-in to ask what paperwork they need from the home.

HICAP counselors give free, unbiased help with long-term care insurance questions.

7. Be careful with: life insurance sales and reverse mortgages

Some life insurance policies can pay part of the benefit early, or can be sold for cash. You usually get much less than the face value, and the money can affect Medi-Cal or SSI. Get free advice from HICAP or an elder law attorney before you sign anything.

A reverse mortgage becomes due when the borrower moves out of the home, including for medical reasons for more than 12 months in a row (unless a co-borrower or eligible spouse still lives there). So a reverse mortgage on a parent's house usually does not work to pay for a permanent move to a care home.

Sources

Retrieved October 20, 2026.

• Medicare.gov: Long-term care coverage
• Medicare.gov: Hospice care coverage
• California DHCS: Assisted Living Waiver
• California DHCS: Medi-Cal asset limit reinstatement (ACWDL 25-14)
• California DHCS: SSI/SSP Payment Standards Effective January 1, 2026
• California Assisted Living Association: SSI/SSP rates (personal needs allowance)
• Social Security Administration: Understanding SSI resources (2026 edition)
• VA: Aid and Attendance and Housebound benefits
• VA: Veterans Pension rates
• California Department of Aging: HICAP
• California Department of Aging: Long-Term Care Ombudsman
• California Department of Aging: Find services in my county
• Consumer Financial Protection Bureau: Reverse mortgages and moving out
• California Health and Safety Code §1569.651 (preadmission fees and deposits)
• California Health and Safety Code §1569.655 (notice of rate increases)