What Medi-Cal home health care covers
Medi-Cal — California's Medicaid program — funds home health care through three distinct programs that confuse most families. Understanding the differences is the single most important thing you can do before applying.
| Program | Best for | Hours | Application path |
|---|---|---|---|
| In-Home Supportive Services (IHSS) | Personal care, housekeeping, meal prep | Up to 283/month | County social services |
| Community-Based Adult Services (CBAS) | Day-time medical and rehab care at a center | Up to 5 days/week | Managed care plan |
| Home Health Agency (HHA) | Short-term skilled nursing, PT, OT, ST | Intermittent visits | Doctor referral |
Most Californians needing care at home end up combining IHSS (paid family caregiver hours) with HHA visits (skilled nursing), and adding CBAS if the family needs daytime respite. All three are covered by Medi-Cal at no cost to qualified beneficiaries.
Who qualifies for Medi-Cal home health care
Medi-Cal eligibility has two parts: financial and medical. As of 2026:
Financial eligibility
- Income limit (most adults): 138% of the Federal Poverty Level (~$20,783/year individual, $28,207/year couple in 2026).
- Asset limit: California eliminated the Medi-Cal asset limit on January 1, 2024. There is no longer a resource cap for most applicants.
- Long-term care Medi-Cal: Income above the standard limit can still qualify if applicants set up a Medi-Cal Income Trust to redirect excess income.
- The Aged & Disabled (A&D) program raises the income limit to about 138% of FPL with deductions, and is the most common pathway for seniors.
Medical eligibility
- Skilled-nursing-level care is needed (for HHA visits).
- Help with at least one Activity of Daily Living, e.g., bathing, dressing, eating (for IHSS).
- A licensed physician orders the home health services.
- Services are reasonable and necessary for the diagnosis or treatment.
How many hours of home care does Medi-Cal pay for?
Hours depend entirely on which program covers the care:
IHSS hours
IHSS authorizes hours based on a county social worker's in-person assessment. The maximum is 283 hours per month (283 = roughly 9.4 hours per day if used daily). Most recipients receive 50–180 hours per month. Tasks evaluated include domestic services (housekeeping, laundry, meal prep), personal care (bathing, dressing, toileting, transferring), accompaniment to medical appointments, and protective supervision (for cognitive impairment).
Home Health Agency hours
HHA visits are intermittent and skilled, not 24-hour care. A typical post-hospital course is two to three nurse visits per week for four to six weeks, plus physical therapy a few times per week if rehab is needed. Hourly home health is not how Medi-Cal HHA is structured.
CBAS hours
CBAS centers operate weekdays, typically 8:00 a.m. to 5:00 p.m. Authorization is for up to five days per week, with transportation included. CBAS is the closest California analog to Texas's adult day care.
How to apply for Medi-Cal home health in California
- Apply for Medi-Cal at CoveredCA.com (income-based) or your county social services office (long-term care or A&D).
- Get the Medi-Cal Benefits Identification Card (BIC) in the mail, usually within 45 days.
- Choose a Medi-Cal managed care plan (Anthem Blue Cross, L.A. Care, Health Net, Kaiser, etc., depending on your county).
- For IHSS, contact your county IHSS office. A social worker will schedule a home assessment within 30–60 days.
- For Home Health Agency, get a doctor's order. The doctor faxes orders to a Medi-Cal-contracted home health agency, who schedules the first visit.
- For CBAS, ask your managed care plan to authorize CBAS services and refer you to a contracted center.
Detailed program rules are published by the California Department of Health Care Services (DHCS) at dhcs.ca.gov.
Choosing a Medi-Cal home health agency in California
California has more than 800 Medicare-certified home health agencies, the majority of which also accept Medi-Cal. Quality varies enormously. CMS publishes a star rating from one to five for every agency at data.cms.gov/provider-data; we recommend looking only at agencies rated 3.5 stars or higher.
Other quality signals to evaluate:
- Years in business under the same ownership. Home health is consolidating; an agency owned by the same family or operator for 10+ years often has more consistent staff.
- RN-to-aide ratio. A ratio of 1:6 or better suggests adequate clinical oversight.
- Recent CMS survey results. Public Health Department survey reports list deficiencies and consumer complaints.
- Bilingual staff if needed. Many California families need Spanish, Mandarin, Cantonese, Vietnamese, Tagalog, or Korean speakers; ask before signing on.
What Medi-Cal home health does NOT cover
Common misconceptions:
- 24-hour live-in care is not generally covered through standard Medi-Cal home health. IHSS provides up to 283 hours/month and the Multipurpose Senior Services Program (MSSP) bundles waiver services for seniors at risk of nursing-home placement.
- Companion-only care (someone to read or play cards with a senior) is not Medi-Cal-covered. IHSS covers Protective Supervision when cognitive impairment creates a safety risk, but pure socialization is not reimbursable.
- Care in a hotel or vacation home while traveling out-of-state is not covered. Medi-Cal services pause during out-of-state travel except in narrow emergency cases.
- Most prescription home infusion is covered separately through Medi-Cal Rx, not through home health.
Find Medi-Cal home health agencies near you
Verified Medi-Cal home health agencies in California: