Understanding home care costs San Diego families face can feel overwhelming, especially when you’re already managing the emotional challenges of caring for an aging parent or spouse. The good news? San Diego County residents have access to more financial resources than most families realize.
This guide covers every major funding source available in 2026—from government programs like Medi-Cal, IHSS, and VA benefits to private options like reverse mortgages and life insurance conversions. We’ll explain who qualifies, how much each program pays, and exactly how to apply in San Diego County.
Whether your loved one has limited income or substantial assets, there’s likely a combination of programs that can help make home care affordable.
Home Care Costs San Diego Families Face
Before exploring payment options, it helps to understand what you’re budgeting for. San Diego home care costs are among the highest in California, reflecting our region’s cost of living.
San Diego County Home Care Rates (2025):
- Agency rates: $35–$45 per hour
- Median rate: $39.14 per hour (CareScout 2024 data)
- National comparison: San Diego is approximately 15% above the national median of $33–$34/hour
Here’s what that looks like in real monthly costs:
| Care Level | Hours/Week | Monthly Cost |
|---|---|---|
| Part-time care | 20 hours | $3,000–$3,500 |
| Full-time daytime care | 40 hours | $6,000–$7,500 |
| Extended care | 60 hours | $9,000–$10,500 |
| 24-hour care | Full-time | $15,000–$20,000 |
Most families use multiple funding sources to manage the home care costs San Diego agencies charge.
Medi-Cal In-Home Supportive Services (IHSS)
IHSS is California’s largest home care program, and San Diego County has a well-established system for helping residents access these benefits. The program pays for a caregiver—including family members—to assist with daily activities such as bathing, dressing, meal preparation, and housekeeping.
Who Qualifies
✓ Age or disability — Must be 65 or older, blind, or have a qualifying disability
✓ Income limits (as of April 2025) — Single applicant: $1,801/month; Married couple: $2,433/month
✓ Asset limits — $130,000 for individuals; $195,000 for couples
✓ Functional need — Must require assistance with activities of daily living
What IHSS Covers
Recipients can receive up to 283 hours of care per month, though the average is about 124. A San Diego County social worker conducts an in-home assessment to determine the specific hours needed.
Services covered include:
- Personal care (bathing, dressing, grooming, toileting)
- Meal preparation and cleanup
- Housekeeping and laundry
- Shopping and errands
- Accompaniment to medical appointments
- Protective supervision for those with cognitive impairments
The Family Caregiver Advantage
One of IHSS’s most valuable features is that family members—including adult children, siblings, and, in many cases, spouses—can be paid as caregivers. In San Diego County, IHSS providers currently earn approximately $17–$18 per hour.
An important tax benefit: If the caregiver lives in the same household as the care recipient, IHSS wages may be exempt from federal income tax under IRS Notice 2014-7.
How to Apply in San Diego County
- Call the AIS Call Center: (800) 339-4661 to apply by phone
- Email your application: AIS.295only.HHSA@sdcounty.ca.gov
- Fax: (619) 344-8077
- Obtain a Health Care Certification form (SOC 873) from a physician
- Complete the in-home assessment with a county social worker
- Once approved, select your caregiver, who completes provider enrollment through the San Diego IHSS Public Authority
San Diego IHSS Public Authority: (866) 351-7722 — Helps with caregiver enrollment, registry matching, and payroll questions.
▶ Important: Even if your income exceeds the limits, you may qualify with a “share of cost”—essentially a monthly deductible you pay before Medi-Cal coverage begins.
VA Aid and Attendance Benefits
San Diego has one of the largest veteran populations in the country, yet fewer than 25% of eligible veterans apply for Aid and Attendance benefits. This tax-free monthly pension can significantly help cover home care costs.
2026 Benefit Amounts (Effective December 2025)
| Recipient Category | Monthly Maximum | Annual Maximum |
|---|---|---|
| Single veteran | $2,424 | $29,093 |
| Veteran with spouse | $2,874 | $34,488 |
| Surviving spouse | $1,558 | $18,697 |
| Two veterans are married (both qualify) | $3,845 | $46,143 |
Eligibility Requirements
Service requirements:
- At least 90 days of active duty, with at least one day during a wartime period
- Honorable or general discharge
- No requirement to have served in combat
Qualifying wartime periods: WWII (Dec 1941–Dec 1946), Korea (June 1950–Jan 1955), Vietnam (Aug 1964–May 1975), Gulf War (Aug 1990–present)
Medical requirements (must meet at least one):
- Need assistance with activities of daily living (bathing, dressing, eating)
- Bedridden or spend most of the day in bed due to illness
- Patient in a nursing home due to mental or physical incapacity
- Severely limited eyesight (5/200 or less in both eyes)
Financial requirements (2026):
- Net worth limit: $163,699 (includes assets plus annual income)
- Unreimbursed medical expenses can reduce countable income
How Payments Are Calculated
The VA uses a formula: Maximum Annual Pension Rate (MAPR) minus your countable income equals your annual benefit. Unreimbursed medical expenses—including home care costs—can be deducted from your income calculation, often increasing your benefit significantly.
Example: A veteran with a spouse has $15,000 in annual income and $8,000 in unreimbursed home care costs. Countable income: $15,000 – $8,000 = $7,000. With a MAPR of $34,488, the veteran would receive approximately $27,488 annually ($2,290/month).
How to Apply in San Diego
San Diego VA Regional Office:
- Address: 8620 Spectrum Center Blvd, Suite 629, San Diego, CA 92123
- Phone: (800) 827-1000
- Email: PCTC.vbasdc@va.gov
- Hours: Monday–Friday, 8:30 am–4 pm (walk-ins or appointments)
You can also apply online at VA.gov or through a VA-accredited claims agent. The San Diego VA Regional Office hosts regular benefits clinics throughout the county—visit benefits.va.gov/sandiego for the current schedule.
California Paid Family Leave
If you’re employed and need to take time off work to care for a seriously ill family member, California’s Paid Family Leave (PFL) program can replace a significant portion of your wages for up to 8 weeks.
2025 Benefit Increases
Starting January 1, 2025, California significantly increased PFL benefits:
- Lower-wage workers (earning less than $63,000/year): Up to 90% of regular wages
- Higher-wage workers: Up to 70% of regular wages
- Maximum weekly benefit: $1,765
Who Can Use PFL for Caregiving
You can take PFL to care for a seriously ill parent, parent-in-law, grandparent, grandchild, sibling, spouse, registered domestic partner, or child. The care recipient doesn’t need to live with you—you can even provide care for someone in another state or country.
“Care” includes: helping with eating, self-care, and medical needs; transportation to appointments; providing emotional support; planning future care; and providing relief for other caregivers.
How to Apply
File a claim through the California Employment Development Department (EDD) at edd.ca.gov. You’ll need the care recipient’s physician to certify the medical need. Claims can be filed up to 41 days retroactively.
▶ Important: PFL provides wage replacement only—it doesn’t guarantee job protection. However, if you work for a company with 5+ employees, the California Family Rights Act (CFRA) may protect your job for up to 12 weeks.
Long-Term Care Insurance
If your loved one purchased a long-term care insurance policy years ago, now is the time to use it. These policies typically cover in-home care, assisted living, and nursing home care.
Activating Your Policy
Most policies require you to need help with at least two activities of daily living (bathing, dressing, eating, toileting, transferring, continence) or have a cognitive impairment. Contact the insurance company to start a claim and understand your specific benefits.
Key questions to ask:
- What is the daily or monthly benefit amount?
- Is there an elimination period (waiting period before benefits begin)?
- What types of care are covered (home care, assisted living, nursing home)?
- Must caregivers be from a licensed agency, or are private caregivers covered?
- What is the maximum benefit period or lifetime maximum?
If You Don’t Have LTC Insurance
If your loved one doesn’t have a policy and needs care now, traditional long-term care insurance is generally not an option—most insurers won’t issue new policies to people who already need care. However, some newer “hybrid” policies combine life insurance with long-term care benefits and may have more flexible underwriting.
Reverse Mortgages (HECM)
A reverse mortgage allows homeowners 62 and older to convert home equity into cash without selling the home or making monthly mortgage payments. Given San Diego’s high property values, this can be a significant source of funding for care.
2025 Limits
The FHA lending limit for Home Equity Conversion Mortgages (HECMs) increased to $1,209,750 in 2025—meaning the first $1.2 million of your home’s value can be used in calculating your loan amount. This is particularly relevant for San Diego homeowners, where median home values often exceed $800,000.
How Much Can You Access?
The amount depends on the borrower’s age, home value, and current interest rates. Generally, older borrowers receive a higher percentage. A 75-year-old might access 45–55% of their home’s value, while an 85-year-old might access 55–65%.
Payment options include:
- Lump sum: One large payment at closing
- Monthly payments: Regular income for a set term or for life
- Line of credit: Draw funds as needed (unused funds grow over time)
- Combination: Mix of the above
Important Considerations
- You must continue paying property taxes, insurance, and maintenance
- If you move to a nursing home for more than 12 consecutive months, the loan becomes due
- Closing costs can be high (origination fees, mortgage insurance, appraisal)
- The loan balance grows over time as interest accrues
- Heirs won’t owe more than the home is worth (non-recourse loan)
HUD requires counseling with a HUD-approved counselor before you can proceed. Find one at HUD.gov or call (800) 569-4287.
Life Insurance Conversions
Many seniors have life insurance policies they no longer need—perhaps the children are grown and financially independent. Rather than letting these policies lapse or surrendering them for a small cash value, you may be able to convert them into funds for care.
Options for Using Life Insurance
Accelerated Death Benefit (ADB): Many policies include a provision allowing you to access 25–50% of the death benefit while still alive if you’re terminally ill or need long-term care. Check your policy or contact your insurer.
Life Settlement: Sell your policy to a third party for a lump sum (typically 20–50% of the death benefit). You can use the proceeds however you choose, including for care. Generally available to those 65+ or with shortened life expectancy. Proceeds may be taxable.
Long-Term Care Benefit Conversion: A newer option that converts your policy into a care funding account. Monthly payments go directly to your care provider. This option typically yields more than a life settlement, doesn’t affect Medicaid eligibility, and preserves a small funeral benefit for heirs.
What to Consider
- These options eliminate or reduce the death benefit your heirs would receive
- Life settlements and cash surrenders can affect Medicaid eligibility
- Tax implications vary by option—consult a tax professional
- Minimum policy values typically apply ($50,000–$100,000)
Tax Benefits for Family Caregivers
If you’re providing or paying for a loved one’s care, several federal tax benefits may help reduce your costs.
Credit for Other Dependents
If you can claim your parent or elderly relative as a dependent, you may qualify for a $500 tax credit. Your loved one must have a gross income below $5,050 (2024), and you must provide more than half of their support.
Child and Dependent Care Credit
Despite the name, this credit applies to adult dependents who are incapable of self-care. If you pay a caregiver so you can work, you may claim a credit on up to $3,000 in expenses for one dependent or $6,000 for two or more. The credit ranges from 20% to 35% of your expenses, depending on your income.
Medical Expense Deduction
Unreimbursed medical expenses exceeding 7.5% of your adjusted gross income (AGI) are deductible if you itemize. Qualifying expenses include payments to home care aides, nursing services, medical equipment, and home modifications made for medical purposes.
Dependent Care FSA
If your employer offers a Dependent Care Flexible Spending Account, you can set aside up to $5,000 in pre-tax dollars to pay for care that enables you to work. This reduces your taxable income.
Head of Household Status
If you’re single and support a dependent parent (who doesn’t have to live with you), you may qualify to file as Head of Household, increasing your standard deduction to $21,900 for 2024.
▶ Important: Tax laws are complex. The personal exemption for dependents has been suspended since 2018. Consult a tax professional to understand which benefits apply to your situation.
San Diego County Resources
San Diego County Aging & Independence Services (AIS):
- AIS Call Center: (800) 339-4661 — Information, referrals, and IHSS applications
- Website: sandiegocounty.gov/hhsa/programs/ais
- Elder abuse reports: Available 24/7 through the AIS Call Center
San Diego IHSS Public Authority: (866) 351-7722 | sdihsspa.com
San Diego VA Regional Office: (800) 827-1000 | benefits.va.gov/sandiego
National Council on Aging BenefitsCheckUp: benefitscheckup.org — Free tool identifying federal, state, and local benefits seniors may qualify for.
California Paid Family Leave: edd.ca.gov/disability/paid-family-leave
How All Heart Home Care Can Help
At All Heart Home Care, we’ve been helping San Diego County families navigate care options since 2014. Our team can help you understand your coverage, work with your insurance company, and create a care plan that fits your budget.
We work with families using IHSS, VA benefits, long-term care insurance, and private pay—and we’re experienced in coordinating multiple funding sources. Our transparent pricing means no surprises: rates start at $37/hour, with no hidden fees, no minimum hours, and no weekend surcharges.
With offices in La Mesa, La Jolla, and Rancho Bernardo, we serve families throughout San Diego County.
Call us at (619) 736-4677 for a free consultation, or contact us online to discuss your family’s situation.
References:
- San Diego County Health and Human Services Agency. (2025). In-Home Supportive Services (IHSS). sandiegocounty.gov
- U.S. Department of Veterans Affairs. (2025). Current Pension Rates for Veterans. va.gov/pension/veterans-pension-rates
- California Employment Development Department. (2025). Paid Family Leave. edd.ca.gov/disability/paid-family-leave
- U.S. Department of Housing and Urban Development. (2025). HUD FHA Reverse Mortgage for Seniors (HECM). hud.gov
- Internal Revenue Service. (2025). For Caregivers. irs.gov/faqs/irs-procedures/for-caregivers
- CareScout. (2024). Cost of Care Survey — San Diego, California.
Disclaimer: This information is provided for educational purposes only and should not be considered financial, tax, or legal advice. Eligibility requirements and benefit amounts change regularly. Consult with qualified professionals—including elder law attorneys, tax advisors, and financial planners—before making decisions about care funding. All Heart Home Care does not provide financial planning services.
