The Midwest state of Iowa offers cultural amenities, world-class hospitals and a range of programs to help seniors remain in their homes throughout their retirement years. Nearly 18% of the state’s population is aged 65 and over, and in the coming years, that population is projected to grow.
Iowa’s overall cost of living is about 15% lower than the national median, which may help older adults maintain a comfortable standard of living throughout retirement. Property taxes are relatively high, but housing costs are about 40% below the national average, and Social Security benefits are exempt from state income taxes. This may help offset home care costs, which exceed the national average at $5,529 per month. This type of care includes non-medical services, such as companion services, transportation, personal care and meal preparation. Home health care is similar but also includes some skilled nursing services.
This guide introduces home care in Iowa by providing more information on monthly care costs, including an overview of monthly costs in major cities throughout the state. It also outlines common ways seniors pay for services, a list of resources that help older adults obtain the care they need and answers to frequently asked questions.
The 2021 Genworth Cost of Care Survey shows that seniors who obtain in-home care services in Iowa pay $5,529 per month on average. By comparison, nationally, this care type costs $4,957 monthly. In Minnesota, seniors pay about $1,000 less than Iowa residents for home care, with agencies charging $4,508, and in Missouri, rates are comparable at $4,767. In Nebraska, seniors pay $5,148 for home care, and in Illinois, rates come in at $5,339. In-home care costs in South Dakota are several hundred dollars higher than in Iowa at $5,911.
The United States
$4957
Minnesota
$4508
South Dakota
$5911
Nebraska
$5148
Missouri
$4767
Illinois
$5339
Home care rates are fairly consistent throughout Iowa, with costs in nearly all surveyed cities coming within a few hundred dollars of the state median. Waterloo is the cheapest surveyed city to obtain care, with agencies charging $4,767 per month for services. In Davenport, rates are higher at $5,148, and in Dubuque, home care agencies charge $5,291 monthly. Seniors in Sioux City pay $5,339 on average, and in Cedar Rapids, rates are consistent with the state median at $5,529. Des Moines, Iowa’s capital city, is the most expensive place to obtain care, with residents paying $5,815 for services.
Cedar Rapids
$5529
Davenport
$5148
Des Moines
$5815
Dubuque
$5291
Sioux City
$5339
Waterloo
$4767
Seniors in Iowa have a variety of long-term care options to choose from, enabling them to obtain the care that fits their budgets, care needs and lifestyle preferences. For older adults who want to remain in their own homes but need help with some activities of daily living, in-home care costs $5,529. Those who require the skilled nursing services provided by home health care pay slightly more at $5,577. Adult day health care is an affordable alternative for those with restrictive budgets, costing $1,353 monthly. Assisted living provides personal care services, meals and recreational activities in a residential facility for $4,367. Nursing home care is for those who need around-the-clock medical monitoring and skilled nursing services and costs $6,874.
In-Home Care
$5529
Home Health Care
$5577
Nursing Home Care
$6874
Assisted Living
$4367
Adult Day Health Care
$1353
Iowa Medicaid is robust health insurance jointly funded by the state and federal government to cover many necessary medical expenses for qualifying individuals. This program covers home health care for those who need skilled nursing services, but non-medical home care services aren’t eligible for coverage under the regular program. Seniors seeking this coverage must apply for the Elderly Waiver.
Unlike regular Medicaid, which is an entitlement that is guaranteed to everyone who qualifies, the Elderly Waiver has limited enrollment slots. In some cases, eligible seniors are placed on a wait list until a slot opens up. As of April 2022, up to 7,930 Iowans may be enrolled in this program, and there is currently no wait list.
Elderly Waiver
The Elderly Waiver is a Home and Community-Based Services Waiver that expands Medicaid’s coverage to pay for supportive services in the individual’s own home. The services you receive under this waiver are customized to your needs, as determined by an interdisciplinary team. Services may include:
All these services must be provided in a community setting, whether it’s the individual’s home, a residential care facility or an adult day health care facility. The total cost of the services for an individual must be cheaper than what they would pay for nursing home care.
To qualify for the Elderly Waiver, applicants must be at least 65 years old, and they must require a nursing home or skilled nursing level of care. They must also be permanent Iowa residents and legal U.S. citizens or residents. Applicants must also meet financial eligibility criteria. Single applicants may have an annual income of no more than $30,276, and they may have up to $2,000 in countable assets.
Seniors must apply for the Elderly Waiver through their Iowa Department of Human Services county office. After they apply, the department will contact them to schedule an assessment.
To qualify for Medicaid, your income and assets must fall within certain limits. Single applicants can have up to $10,092 in annual income. This includes income from all sources, including wages, veterans’ and public benefits, pensions and withdrawals from savings accounts. Single applicants may also have up to $2,000 in countable assets. This limit applies to money in checking and savings accounts, stocks, investment and vacation properties and bonds. Many assets are exempt, including personal belongings, the applicant’s primary residence, irrevocable funeral contracts, burial space and their vehicle. Married applicants can have a joint income of up to $15,132 and up to $3,000 in countable assets.
2022 Medicaid Income Limits for Seniors in Iowa
2022 Basic Medicaid Income Limits for Seniors in Iowa
| Name | Income limits* | Asset limits |
|---|---|---|
| Single Person | $10,092 | $2,000 |
| Two-Person Household | $15,132 | $3,000 |
*Per year
Iowa Medicaid has other eligibility criteria applicants must meet to qualify for coverage. Along with meeting financial criteria, seniors must meet these requirements:
You can apply for Medicaid through your local Department of Human Services office. For greater convenience, you can apply for services online through the DHS Services Portal.
What Information You Will Need
Along with submitting an application, you must provide supporting documents that show you’re eligible for Medicaid. These include:
Several agencies, programs and helplines provide personalized assistance to help you navigate the Medicaid process. The following table highlights statewide resources that provide application assistance and information on beneficiaries’ rights and options if coverage is denied.
| Program | Contact | Services provided |
|---|---|---|
| Iowa Medicaid Member Services | (800) 338-8366 | Iowa Medicaid Member Services has a toll-free number you can call on weekdays between 8 a.m. and 5 p.m. for help with understanding what Medicaid covers, how to apply and where to obtain services. Its representatives can also provide more information on the Elderly Waiver, including whether there is a current wait list. |
| Managed Care Ombudsman Program | (866) 236-1430 | The Managed Care Ombudsman Program provides advocacy, information and assistance to those receiving long-term care services through Medicaid, whether through the regular program or one of the HCBS waivers. You can contact the ombudsman for help with understanding your benefits, finding providers who accept payment from Medicaid and understanding how to get in-home care services paid for. The ombudsman can also help you file a complaint if you feel that your case is being treated unfairly. |
| American Council on Aging | Contact Form | The American Council on Aging has contact information for Medicaid planners throughout the state who help seniors use strategies to meet the program’s financial limits if their income or assets exceed what’s permitted. The organization also publishes easy-to-read information on Iowa Medicaid’s waiver programs, details on spousal impoverishment rules and how to apply for coverage. |
| Department of Human Services | (515) 281-3094 | The Department of Human Services oversees Iowa Medicaid and ensures fair claims practices for members. If you feel that coverage or a claim is unfairly denied, you can file an appeal with this department to have it thoroughly investigated. To file an appeal, you can submit a request in person, over the phone or in writing. |
| Iowa Legal Aid | (800) 532-1275 | Iowa Legal Aid has licensed legal professionals who specialize in helping older adults apply for public benefits, including Medicaid and the Elderly Waiver. You can contact this agency over the phone or visit a local office to speak with a specialist and get help with the application process, gathering supporting documents and resolving issues, such as denied claims or canceled policies. |
In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.
Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.
As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)
While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.
Iowa has numerous resources that can help you find the services you need at home, access public benefits to pay for care and connect with community-based services that may save you money. The following table lists top resources available to seniors statewide.
| Resource | Contact | AreaServed | Service |
|---|---|---|---|
| 211 Iowa | 2-1-1 | Statewide | 211 Iowa is a free information and referral service that can help you connect with community-based programs in your area. You can call this toll-free helpline to find local senior centers, home-delivered and congregate meals, transportation and home modifications and repairs. The service can also help you obtain low-cost housing and provide information on local, state and federal benefits that may help you afford long-term care. This service is free and confidential. |
| Iowa Association of Area Agencies on Aging | (515) 729-8846 | Statewide | Iowa Association of Area Agencies on Aging oversees local AAAs throughout the state. Services vary slightly by region, but all AAAs provide basic services, such as financial and legal counseling, help with accessing public benefits, home-delivered and congregate meals, transportation and in-home care services. Your AAA may also provide companion services that include daily phone calls or weekly home visits. These services are available to those aged 60 and over. |
| Iowa Department of Veterans Affairs | (515) 252-4698 | Statewide | The Iowa Department of Veterans Affairs serves older veterans in Iowa through county offices. At these locations, veterans and their families obtain benefits counseling and assistance with enrolling in programs that may help pay for in-home care. Local offices can also connect qualifying individuals with community-based services, such as transportation, counseling and medical care. |
| Senior Health Insurance Information Program | (800) 351-4664 | Statewide | The Senior Health Insurance Information Program provides free over-the-phone health insurance options counseling for Medicare beneficiaries. You can contact the program’s toll-free number for help with understanding your Medicare and long-term care benefits, finding prescription drug coverage and comparing private Medicare options. SHIP counselors can also help you determine whether you’re eligible for Medicaid and Medicare Savings Programs. |
| Iowa Care Planning Council | (800) 989-8137 | Statewide | The Iowa Care Planning Council has an online database where you can access information on ways to pay for long-term care, including reverse mortgages, veterans benefits and Medicaid. It also lists local providers that offer non-medical home care services, as well as those that provide repairs, modifications, durable medical equipment loans and financial planning. |
| Iowa Community Action Association | Find Your Agency | Statewide | The Iowa Community Action Association oversees Community Action Agencies throughout the state. These agencies provide a range of services to qualifying individuals, including home-delivered and congregate meals, long-term care options counseling, utility assistance and emergency financial assistance. In some cases, individuals are required to pay for a portion of the services they receive. |
| Iowa Property Tax Credit for Senior and Disabled Citizens | (800) 367-3388 | Statewide | The Iowa Property Tax Credit for Senior and Disabled Citizens provides tax relief for those aged 65 and over and those who are completely disabled, reducing their living expenses. To obtain this credit, the property owner must file their claim by June 1 of the year before property taxes are due. In addition to age or functional criteria, applicants must also meet financial eligibility requirements. |
Iowa is one of the few states where private nonmedical home care providers are exempt from state licensing, although home care agencies usually need to have a valid business license in the county where they provide services. Staff who provide in-home care services must comply with all state and federal laws around elder abuse prevention, medication administration and reporting of suspected elder abuse. Providers that deliver services funded by Iowa Medicaid need to comply with the Iowa Department of Human Services guidelines outlined on the following table.
| Topic | Rule |
|---|---|
| Scope of Care | Nonmedical home care providers, also known as homemakers, can provide nonmedical care such as assistance with personal hygiene, housekeeping and meal preparation, companionship and help with grocery shopping, errands and scheduling medical appointments. Some home care providers are also able to transport clients to social and recreational engagements. |
| Care Plan Requirements | Homemakers are not required to provide care plans for their clients, but private-pay clients may want to obtain a service agreement prior to retaining a caregiver. Medicaid-funded programs that provide in-home care must develop and maintain care plans for beneficiaries. |
| Medication Management Requirements | Nonmedical caregivers are prohibited from administering any type of prescription or over-the-counter medications. Homemakers may provide medication reminders and assist with self-administration. |
| Staff Screening Requirements | In accordance with Iowa Code section 135C.33, in-home care staff who deliver direct services to consumers, as well as those who provide in-home services under a Home and Community-Based Services Waiver, must complete a criminal record check prior to commencing work as a homemaker. |
| Staff Training Requirements | There are no state-mandated training requirements for nonmedical in-home caregivers in Iowa, although agencies that employ homemakers often require that staff has basic first aid training. |
| Medicaid Coverage | Iowa Medicaid funds in-home care services through a number of programs, including the Home and Community-Based Services Health and Disability Waiver, and the Program of All-Inclusive Care for the Elderly. |
| Reporting Abuse | Concerns regarding the abuse, neglect or exploitation of any senior living in the community in Iowa should be reported to Iowa's 24/7 Abuse Hotline at (800) 362-2178. Emergency and/or life-threatening situations should be reported to local law enforcement officials. |
Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. When you hire an in-home care aide you’re placing a lot of trust in the hands of the person by inviting them into your home, so you’ll want to be diligent in your search. At Caring.com, we’re here to help – we’ve created a helpful checklist below that can help guide you through the process of both determining your needs and finding a home care agency that will provide the best care possible.
To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.
17 Results
2600 University Ave., Suite 210, West Des Moines, IA, 50266
4.5
(188 reviews)
"Right at Home has been extremely accommodating with my father. The care he is receiving is top notch. I would recommend this company to anyone needing help in the home. ..."
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414 61st St, Suite B, Urbandale, IA, 50322
4.8
(20 reviews)
"We've had a wonderful experience with Home Instead. They're awesome and one of the best. They went above and beyond calling and giving me updates and giving my parents rides. They made sure my dad made his doctor's appointments. They're incredible, a..."
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3706 Ingersoll Ave, West Des Moines, IA, 50312
4.6
(44 reviews)
"I cannot say enough about how pleased we were with the care and communication from Home Care Assistance Des Moines. They made an overwhelming situation much easier by being so wonderful to work with at every step. I give them my highest recommendatio..."
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1110 York St, Des Moines, IA, 50316
5.0
(1 reviews)
"Comfort Caring took really good care of my father couldn’t ask for a better company to over see his care the staff was friendly always went above and beyond staff was always on time never had to worry if someone wasn’t going to show up the owners was..."
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1200 N St, Lincoln, NE, 68508
"Sunlight Senior Care was designed around our clients’ goals: Independence: With a Caregiver’s help, you or your loved one can remain in o..."
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2348 Northwest 75th Avenue, Ankeny, IA, 50023
5.0
(9 reviews)
"I used Care by April for transportation to a surgery center that had a strict policy regarding releasing a patient but found April's business was acceptable. Kat drove me to that appointment and several other post op appointments that I was sick to d..."
READ MORECaring's Family Advisors are here to help you with questions about senior living and care options.
2301 West First Street, Ankeny, IA, 50023
4.5
(8 reviews)
"A Plus Home Care is very good. They've been in business for four years. The lady that founded it has been a registered nurse for 4 years. She has 40 people that works for her. Part of them are registered nurses and part of them are caretakers. She do..."
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1300 Metro East Drive, Pleasant Hill, IA, 50327
5.0
(1 reviews)
"We appreciate your loving care for my dad before he passed away. That is the most important thanks we want to extend. You were truly caregivers-it never seemed like it was work for you. Thank you for that tender gift. ..."
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2910 Westown Parkway, Suite 200, West Des Moines, IA, 50266
5.0
(1 reviews)
"Formerly known as Hospice of Central Iowa, HCI Care Services is a not-for-profit, independent healthcare organization, which brings comfort ..."
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699 Walnut St., Unit 400, FL4 , Des Moines, IA, 50309
5.0
(1 reviews)
"Sunlight is the best. They are careing they are friendly. They are the best. I've been with them along time, ..."
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Mohawk Square, 3rd Fl, 22 N Georgia Av, Suite 300, Mason City, IA, 50401
"The Cerro Gordo County Department of Public Health is located in Mason City, Iowa, in North Central Iowa. We are approximately two hours sou..."
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2951 86th Street, Urbandale, IA, 50322
"Senior Helpers provides non-medical companionship and personal in-home care for seniors helping them remain active and independent. The Seni..."
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3408 Woodland Avenue Suite 209, West Des Moines, IA, 50266
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