Assisted Living Cost in California: 2025 Medians and the Medi-Cal ALW

Assisted Living Cost in California: 2025 Medians and the Medi-Cal ALW

Key takeaways

• CareScout 2025 California median for assisted living / Residential Care Facility: $7,000/month ($84,000/year)—above the national median of $6,200/month.[1][2]

• Bay Area and coastal cities often run higher than the state median; inland counties may run lower. Treat the median as a planning anchor, not a quote.[1]

• Medicare does not cover most custodial AL/RCFE costs.[3]

• California’s Assisted Living Waiver (ALW) is a Medi-Cal HCBS waiver (current term March 1, 2024–February 28, 2029) available in 15 counties. Slots are limited; DHCS states there is a waitlist.[4]

• ALW participants still pay the facility for room and board (with some funds left for personal needs).[4]

• Related: Assisted living and memory care costs (hub)

• Related: Long-term care options

• Related: Medicaid eligibility

• Related: Long-term care insurance and costs

• Related: Family caregiver guide

• Related: Aging in place: home modifications

• Related: How to find SHIP/SHIBA

California cost range (CareScout 2025)

CareScout labels California’s setting a Residential Care Facility. Survey July–November 2025; PDF tables opened.[1][2]

Memory care: No separate CareScout 2025 memory-care median in tables we opened—get facility quotes.

Medicare reminder

Medicare.gov: most long-term custodial care is Not Covered; you pay all costs for non-covered services unless Medicaid or private LTC insurance applies.[3]

California HICAP (SHIP): how to find SHIP/SHIBA. Education course placeholder:

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Medi-Cal Assisted Living Waiver — entry points (not an approval)

Per DHCS (opened this review), the ALW helps eligible Medi-Cal members who need a high level of daily support receive care in licensed assisted living settings instead of nursing facilities.[4]

Eligibility themes DHCS lists (confirm on the live page—do not treat as a determination):[4]

• Age 21+
• Full-scope Medi-Cal with no share of cost
• Care needs equal to Medi-Cal-funded nursing facility residents
• Able to reside safely in an assisted living facility or public subsidized housing
• Willing to live in an AL setting in one of these counties: Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara, Sonoma

DHCS also states participants pay room and board to the facility, institutional/spousal impoverishment rules apply for eligibility determinations, and new applicants should know slots are limited with a current waitlist. Care Coordination Agencies (CCAs) receive open slots; contact a CCA for process details.[4]

Official hub: DHCS Assisted Living Waiver.

For broader Medicaid concepts: Medicaid eligibility. First screen only:

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Local aging help: Eldercare Locator eldercare.acl.gov / 1-800-677-1116.

Practical checklist for California families

1. Collect two RCFE / memory care fee sheets in the target county.
2. Ask: Are you on the DHCS ALW facility list? What monthly room-and-board would we still owe?
3. If exploring ALW, contact a Care Coordination Agency listed by DHCS and ask about the waitlist.[4]
4. Compare staying home longer via aging in place.
5. Caregiver coordination: family caregiver guide.

FAQ

Why is California’s median higher than the U.S. median?
CareScout’s 2025 survey shows CA $7,000 vs national $6,200 monthly for AL/RCFE.[1][2] High housing markets pull medians up; always get local quotes.

Does ALW cover the whole monthly rent?
DHCS states ALW participants pay the facility directly for room and board.[4] Do not assume Medi-Cal pays the entire AL bill.

Sources

1. CareScout. Cost of Care Report. https://www.carescout.com/cost-of-care. Survey July–November 2025. Accessed October 30, 2026.
2. CareScout. Cost of Care Survey 2025 median tables (PDF). https://assets.carescout.com/x/8fcb50422f/282102.pdf. Accessed October 30, 2026.
3. Medicare.gov. Long-term care. https://www.medicare.gov/coverage/long-term-care. Accessed October 30, 2026.
4. California Department of Health Care Services. Assisted Living Waiver. https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/. Accessed October 30, 2026.

Disclaimer

This article is for general education only and is not medical, legal, or financial advice. We do not sell facilities, insurance, or cost PDFs. Only DHCS, Medi-Cal, and related agencies determine ALW/Medi-Cal eligibility. Talk with those agencies, a licensed attorney, or HICAP/SHIP. In an emergency, call 911.

Attribution

Portions of this page are adapted from "HowToLiveBetter" (高性价比人生指南) by eternity4719, https://github.com/eternity4719/HowToLiveBetter, licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Changes: adapted and rewritten for the U.S. context (not a direct translation), and re-sourced to U.S. research and official guidance.