IHSS in California
- Last updated
- October 11, 2026
- Read time
- 7 min
Key points
- In-Home Supportive Services (IHSS) pays for help at home with bathing, dressing, meals and housework if you have Medi-Cal.
- Your adult child, another relative or a friend can be your paid IHSS caregiver.
- IHSS pays for up to 283 hours a month, about 9.5 hours a day, for people who need the most help.
- In 2026, the Medi-Cal savings limit is $130,000 for one person, and it drops to $21,000 on July 1, 2027.
If you're new to this, start with in-home care through Medicaid or help for family caregivers.
IHSS is California's program that pays for help at home, so you can stay out of a nursing home. Each county runs it, and a social worker visits your home to decide your hours. If you're already helping a parent bathe and dress without pay, IHSS may pay you for that time.
You may qualify if
- You have Medi-Cal, or can get it. In 2026 that means savings under $130,000 for one person, and your home and main car don't count.
- You are 65 or older, blind, or have a disability.
- You live at home and need help to stay there safely.
Not sure you qualify? Apply anyway, because the county decides after a home visit. A Pair Team advocate can walk through it with you in one call.
What IHSS pays for
| Type of help | What it covers |
|---|---|
| Personal care | Bathing, dressing, grooming, feeding, using the bathroom, help with medicines |
| Housework and meals | Cleaning, laundry, shopping, cooking and cleanup |
| Rides | Getting to medical appointments |
| Paramedical care | Shots, range of motion exercises and other care a doctor orders |
| Protective supervision | Watching over someone with dementia or a mental illness who could get hurt alone |
IHSS does not pay for 24-hour care, but other programs below can help.
Who can be my paid caregiver?
Your paid caregiver can be almost anyone you choose, like your daughter, son, friend or neighbor. You're the employer, so you hire, train and supervise them, and the state sends the paychecks.
A spouse can be paid for personal care and paramedical care, like bathing or help with shots. The county expects a spouse to do housework and meals without pay, unless the spouse works or a doctor says they can't. Then someone else can be paid for them.
If you have no one to hire, your county's IHSS Public Authority has a list of caregivers.
To get paid, your caregiver fills out form SOC 426 and passes a fingerprint background check. Then they go to an orientation and sign form SOC 846.
How much does IHSS pay caregivers in 2026?
Each county sets IHSS caregiver pay. On the state's October 2026 list, it runs from $16.90 an hour in Siskiyou County to $25.00 in San Francisco. The low end is the state minimum wage.
How to apply for IHSS
- Get Medi-Cal if you don't have it. Apply at BenefitsCal.com or your county office, and see Medicare and Medi-Cal together.
- Apply to your county IHSS office. You can call and say, "I want to apply for IHSS," or send form SOC 295.
- Get the health form filled out. Your doctor or another licensed health worker fills out form SOC 873. You usually have 45 days to return it, and services cannot start without it.
- Have the home visit. A social worker asks what you can and cannot do safely, and family can be there.
- Read your notice, because it lists your hours for each task. Then name your caregiver on form SOC 426A.
How are IHSS hours decided?
The social worker decides your IHSS hours by scoring how much help you need with each task. Some people need 20 or more hours a week of personal care, meal help and paramedical care. They can get up to 283 hours a month, and most others can get up to 195.
Before the visit, write down what a bad day looks like. The county checks again each year, and you can ask for a new visit if your needs change.
What if IHSS isn't enough?
If IHSS isn't enough, other Medi-Cal programs can add help, like adult day health care in California.
| Program | What it adds |
|---|---|
| Adult day health care | A day center with nursing, therapy, a meal and rides, called Community-Based Adult Services. Your Medi-Cal plan decides who qualifies, the Department of Health Care Services (DHCS) says. |
| Community Supports from your Medi-Cal plan | Personal care and housework hours when IHSS hours fall short, respite so a family caregiver can rest, and home changes like grab bars and ramps. Home changes are capped at $7,500 for a lifetime, DHCS's 2025 guide says. Not every plan offers every service, so ask yours. |
| Multipurpose Senior Services Program | A care manager and some extra services, like respite and minor home repair, for people 60 and older who would otherwise need a nursing home and live in a county with a program site. Most people in it also get IHSS, the California Department of Aging says. |
| Home and Community-Based Alternatives Waiver | A nurse and social worker who manage your care, and extra personal care hours on top of IHSS. It has had a waitlist since July 12, 2023, and 7,058 people were waiting in May 2026, DHCS says. People who have lived in a nursing home or hospital for 60 days or more go first. |
| Assisted Living Waiver | Care in assisted living in 15 counties, but not rent or meals, and the waitlist is long. IHSS doesn't pay in a licensed care home, so the waiver covers personal care there instead. See Assisted Living Waiver in California. |
| Program of All-Inclusive Care for the Elderly (PACE) | A care team and PACE center that handle all your care. It's for people 55 and older who need nursing home level care, can live safely at home and live in a PACE service area, DHCS says. |
For a shower chair or grab bars, see what Medicare pays for in the bathroom.
What if IHSS hours are denied or cut?
You can ask for a state hearing within 90 days of the notice if IHSS hours are denied or cut. To keep your hours while you wait, ask before the cut starts. This is called aid paid pending. Ask in any of these ways:
- Online, on the California Department of Social Services state hearings page.
- By phone at 1-800-743-8525.
- In writing, on the back of the Notice of Action.
What a Pair Team advocate does
By the time a family calls us about IHSS, someone is usually doing the caregiving already, without pay. Often the doctor's form is stuck somewhere and the Medi-Cal renewal is due too. This is what we do:
- Check if you can likely get Medi-Cal and IHSS, in one call.
- Help you apply, and get the SOC 873 back from the doctor in time.
- Help you get ready for the home visit, and ask for a hearing if hours come back too low.
- Help with what usually comes with it: a shower chair or hospital bed, rides, CalFresh and utility bills.
An advocate is covered by Medicare if you qualify. It takes two minutes to find out.
Check if you qualify for a Pair Team advocate
Frequently asked questions
Can I get paid to take care of my mom in California?
Yes, you can get paid to care for your mom if she has Medi-Cal and the county approves her for IHSS. She names you as her caregiver, and the state pays you for the approved hours.
Can I get IHSS if I have Medicare?
Yes, you can get IHSS with Medicare if you also have Medi-Cal. Medicare does not pay for IHSS, so apply for Medi-Cal if you don't have it.
Does IHSS cost anything?
Most people with Medi-Cal pay nothing for IHSS, but some with higher income pay a share of cost each month first. Your county can tell you if you have one.
Can I get IHSS if I live with my daughter?
Yes, you can get IHSS if you live with your daughter. You can live in your own home or a home you choose, like a relative's. Hospitals, nursing homes and licensed care homes don't count.
Can I get IHSS if I'm undocumented?
Getting IHSS if you're undocumented depends on Medi-Cal. Since January 1, 2026, adults 19 and older without satisfactory immigration status can't newly sign up for full-scope Medi-Cal, DHCS says. People who have it can keep it if they renew on time and still qualify. For free legal help, call the Health Consumer Alliance at 1-888-804-3536.
Who do I call about a timesheet problem?
For a timesheet problem, call the IHSS Service Desk at 1-866-376-7066.
Sources
- In-Home Supportive Services (IHSS) Program, California Department of Social Services
- County IHSS Offices, California Department of Social Services
- State Hearing Requests, California Department of Social Services
- County IHSS Wage Rates and the October 2026 county wage list, California Department of Social Services
- SOC 847 provider enrollment instructions, California Department of Social Services
- All County Letter 21-91, able and available spouse rules, California Department of Social Services
- Medi-Cal Changes, DHCS
- Medi-Cal Immigrant Eligibility FAQs, DHCS
- Immigration Status and Changes to Medi-Cal Eligibility, DHCS
- Asset Limit Frequently Asked Questions, DHCS
- Community-Based Adult Services, DHCS
- Enhanced Care Management and Community Supports, DHCS
- Community Supports Policy Guide, Volume 1, updated April 2025, DHCS
- Multipurpose Senior Services Program, DHCS
- Multipurpose Senior Services Program, California Department of Aging
- Home and Community-Based Alternatives Waiver, DHCS
- Home and Community-Based Alternatives Waiver monthly dashboard, May 2026, DHCS
- Waiver Personal Care Services Frequently Asked Questions, DHCS
- Assisted Living Waiver, DHCS
- Program of All-Inclusive Care for the Elderly, DHCS
- Minimum Wage, California Department of Industrial Relations
- IHSS Provider Wages, San Francisco Human Services Agency
- Health Consumer Alliance, free Medi-Cal help
- County Public Authorities, California Association of Public Authorities for IHSS
- Health Care Certification Requirement, Los Angeles County DPSS
- In-Home Supportive Services: The Benefit, DB101 California
- IHSS able and available spouse rule, Legal Services of Northern California
- IHSS Fair Hearings Guide, Disability Rights California
About the author
Holly Cuevas
Lead RN Care Manager
Holly Cuevas is a registered nurse and a lead nurse care manager at Pair Team. Since 2022, she has helped patients after a hospital stay.
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