What Long Term Care Costs in California
California is one of the more expensive states in the country for long term care, and the gap between what people expect to pay and what care actually costs catches many families off guard. A private nursing home room now runs a median of $182,135 a year in the state, and even a semi private room comes in at $140,343 a year. Assisted living and home health aides cost less, but both still add up to well over $85,000 a year at the median. These are statewide medians, so costs in Los Angeles, San Diego, San Francisco, or Sacramento can run higher still. Home health aide care, at $7,436 a month, is often where families start, since it lets a parent or spouse stay at home longer, but many people eventually need assisted living or nursing home care as needs increase. California costs run above national medians, and costs continue to rise year over year, so plan using higher future figures rather than today's numbers. A policy purchased now locks in insurability while you are healthy, which matters more than the exact premium quoted today.
| Care type | Monthly median | Annual median |
|---|---|---|
| Home health aide | $7,436 | $89,232 |
| Assisted living community | $7,350 | $88,200 |
| Nursing home, semi private room | $11,695 | $140,343 |
| Nursing home, private room | $15,178 | $182,135 |
Source: Genworth and CareScout Cost of Care Survey, 2024 medians for California. CareScout published 2025 medians in March 2026, and our California cost page carries those newer figures.
California costs run above national medians, and costs continue to rise year over year, so plan using higher future figures.
Who Should Consider Long Term Care Coverage in California
Long term care insurance tends to make the most sense for people in their 50s to mid 60s who are in reasonably good health and have assets they want to protect. That includes homeowners in high cost metros like Los Angeles, San Diego, San Francisco, and Sacramento, where home equity alone can put a family well outside the range where relying on public assistance makes sense. It also fits families who have already seen a parent or older relative need care and understand firsthand how quickly costs and stress can build. Medicare covers only short skilled nursing or rehabilitation stays after a qualifying hospital stay, not the ongoing custodial care, help with bathing, dressing, meals, and supervision, that most people eventually need. Medi-Cal can cover long term care, but only after a person spends down assets to strict limits, which can mean selling a home or depleting savings first. For people who want to protect what they have built and keep more choice over where and how they receive care, private coverage purchased while healthy is worth a serious look. A no cost comparison with Lara Goulson, an independent long term care insurance agent who compares several carriers, can show what coverage would cost at your age and health today.
Long Term Care Insurance for Memory Care in California
Memory care is the question families in California ask most often, and the state's Insurance Code answers a good part of it. A tax qualified long term care policy sold here pays on one of two triggers. The first is needing substantial help with two of six activities of daily living. The second is cognitive impairment on its own, which Insurance Code section 10232.8 defines as needing "substantial supervision due to severe cognitive impairment." A parent with Alzheimer's disease or another dementia who can still bathe and dress but needs continual supervision to stay safe can qualify on that second trigger without failing any physical test. The certification comes from a licensed health care practitioner who is independent of the insurer, it is renewed every 12 months, and the federal 90 day duration test that applies to the activities of daily living trigger does not apply to the cognitive one. Where the care happens matters just as much. Residential memory care in California is delivered either in a residential care facility for the elderly, the licence category in which state law lets a facility use locked exit doors and secured perimeters for residents with Alzheimer's disease and related disorders, or in a skilled nursing facility. Any California policy that covers nursing facility care covers both settings: Insurance Code section 10232.92 requires it to cover care in a residential care facility as well, at a benefit "no less than 70 percent of the benefit amount payable for institutional confinement." Seventy percent is a floor, so when you compare quotes ask for the residential care benefit as a percentage of the nursing facility benefit, and confirm that the community you have in mind holds one of those two licences. The difference between 70 and 100 percent is the difference between a policy that covers a memory care bill and one that leaves a gap. Two more protections matter for a family planning around dementia. The outline of coverage that California requires an agent to hand you before any application must state that the policy covers people "clinically diagnosed as having Alzheimer's Disease, organic disorders, or related degenerative and dementing illnesses" and must spell out every precondition to benefits for that person, so read that item before the premium. And because early cognitive decline is exactly when premium notices get missed, every individual policy gives you the right to name someone else to receive a lapse notice, and under Insurance Code section 10235.40 an insurer must reinstate a lapsed policy on proof of cognitive impairment when the request is made within five months of termination, with any past due premium collected. Lara Goulson walks families through those pages of a policy side by side before they buy, at no cost, and can set what assisted living and nursing home care cost in California against the benefit levels quoted.
Does California Have a State LTC Program or Tax?
California created a Long Term Care Insurance Task Force under AB 567 to study a statewide program that would be funded by a payroll tax, similar in spirit to Washington's program. The task force delivered its recommendations and an actuarial report in December 2023, but as of 2026 no program or payroll tax has actually been enacted in California. Buying private coverage now is a planning choice, not a way to opt out of a tax that does not yet exist, so be cautious of any marketing that suggests otherwise. Separately, the California Partnership for Long Term Care does exist, and Partnership qualified policies carry Medi-Cal asset protection for policyholders. However, no Partnership approved insurers are currently selling new Partnership policies in California. That means today's buyers are choosing among non Partnership options rather than Partnership policies, which changes how a policy should be structured and compared. Lara Goulson can walk through what is actually available right now, rather than what existed in the past or may exist in the future.
CalPERS Long Term Care Is Closed to New Applicants
Many California public employees assumed long term care would be handled through CalPERS. It is not, at least for now. The CalPERS Long-Term Care page, read on September 22, 2026, says: "We have temporarily suspended open enrollment for the Long-Term Care Program due to current uncertainty in the long-term care market. Therefore, until further notice, we are no longer accepting new applications for coverage." No reopening date is given. If you work for the state, a county, a city, a school district or a public university and had been counting on that program, the practical position is simple: there is no application to file. The suspension applies to new applications only. CalPERS continues to administer the policies it already issued through its third party administrator, illumifin, sends current policyholders with coverage questions to that administrator, and in May 2024 added a voluntary aging in place program for policyholders aged 75 and older. If you already hold a CalPERS policy, keep paying it; the suspension does not touch it. CalPERS was also one of the participants in the California Partnership for Long Term Care, according to the Department of Insurance's long term care consumer guide, and with no insurer currently selling new Partnership policies either, a public employee who was counting on either program is shopping the same private market as everyone else. That market has two designs: traditional standalone policies and hybrid life and long term care policies, subject to the same Insurance Code rules on benefit triggers, residential care coverage and lapse protection described on this page. The CalPERS program is an optional, employee paid benefit, so a private policy is the same arrangement with a different issuer, and it can be timed to your own health rather than to an open enrollment window that may not return. Lara Goulson compares what is available to a California public employee today, at no cost, and can look at an existing CalPERS policy alongside a private quote for a spouse or parent who was never enrolled.
Hybrid Life and LTC Policies
Hybrid policies combine life insurance or an annuity with a long term care benefit in a single contract. If care is never needed, heirs receive a death benefit, which directly answers the use it or lose it objection that keeps many people from buying traditional long term care insurance. Premiums on hybrid policies are typically guaranteed not to increase, which offers more certainty than some traditional LTC policies have delivered over time. The long term care insurance California buyers can actually purchase today comes in two designs, since Partnership qualified policies are unavailable for new sales: traditional standalone LTC insurance and the hybrid life and LTC policies described here. For many households the hybrid design is the more practical of the two. Each approach has tradeoffs in cost, benefit structure, and flexibility, and the right fit depends on your age, health, and financial goals. Lara Goulson compares traditional and hybrid options across carriers at no cost, so you can see real numbers side by side before deciding.
Talk Through Your Options at No Cost
Lara Goulson offers phone and video consultations across California, at no cost, in English, Spanish, and Hebrew. Call (818) 472-5484 to compare traditional and hybrid long term care coverage and see what fits your health, budget, and goals.
Call (818) 472-5484 for a no cost long term care insurance comparison in California.
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