How Will We Pay for Mom's Care? A Sacramento & Placer Family Roadmap

Quick answer: Most Sacramento and Placer families pay for a care home with a mix of income, savings, long-term care insurance and, for some veterans, VA Aid & Attendance. Medicare doesn’t pay for assisted living. Medi-Cal’s Assisted Living Waiver can help in Sacramento County, not Placer, and has a waitlist. Care homes here typically cost $4,000 to $15,000 a month.

The care conversation usually turns to money fast. “Can Mom afford this? For how long? What if she runs out?” Those are the right questions. This roadmap walks through every common way families in the Sacramento area pay for care, in the order most families look at them.

The short version

• Start with the real monthly number: licensed care homes here typically cost $4,000 to $15,000 a month.
• Add up every source of income and savings, then work out how many months it covers.
• Check four helpers: long-term care insurance, VA Aid & Attendance, the Medi-Cal Assisted Living Waiver, and Medicare for short-term rehab only.
• Where your parent lives matters. Sacramento County has the waiver. Placer County doesn’t.

Step 1: What will care actually cost?

Licensed care homes in the Sacramento area typically cost $4,000 to $15,000 a month. A few homes charge less, but a price under $4,000 a month is rare. Small board and care homes with shared rooms tend to sit toward the lower end. Memory care and high-care needs sit toward the top.

For a statewide view, CareScout’s 2025 Cost of Care Survey puts the California median for assisted living (called residential care in California) at $7,000 a month (CareScout 2025 state data tables).

These are planning ranges, not quotes. Each home sets its own price based on the room and your parent’s care needs.

Step 2: Build a simple monthly budget

Before looking at programs, sit down with a notepad or spreadsheet:

• Monthly income: Social Security, pensions, annuity payments, any other regular money
• Savings and investments that can be used for care
• Current monthly costs that would stop after a move (rent, utilities, groceries, in-home help)
• Insurance policies: long-term care, life insurance, Medicare supplement
• Military service: was your parent, or their late spouse, a wartime veteran?

Then do the math: monthly care cost minus monthly income equals the monthly gap. Divide savings by that gap to see roughly how many months the money lasts. That one number guides almost every decision that follows.

Step 3: Which helpers might apply?

• Private pay (income + savings). What it does: Pays the monthly bill directly. Reality check: How most families pay, at least at first.
• Long-term care insurance. What it does: Pays a daily or monthly benefit for care, per the policy. Reality check: Policies differ. Many have a waiting period before payments start, so call the insurer early.
• VA Aid & Attendance. What it does: Extra monthly money added to a VA pension for qualifying wartime veterans and surviving spouses who need help with daily activities. Reality check: Income and net worth limits apply; decisions take time (VA.gov)
• Medi-Cal Assisted Living Waiver. What it does: Pays for care services in participating homes; your parent pays room and board. Reality check: Only in 15 counties, including Sacramento but not Placer, and there is a waitlist (DHCS)
• Standard Medi-Cal. What it does: Pays for long-term skilled nursing for people who qualify. Reality check: Doesn't pay for assisted living or board and care.
• Medicare. What it does: Hospital care, short-term skilled nursing and rehab, hospice. Reality check: Doesn't pay for assisted living or board and care (Medicare.gov)

Step 4: Know the 2026 numbers that matter

Medi-Cal asset limit. Medi-Cal started counting assets again on January 1, 2026, for people 65 and older. Through June 30, 2027, the limit is $130,000 for one person plus $65,000 for each additional household member. Starting July 1, 2027, it drops to $21,000 for one person and $31,000 for two (DHCS Asset Limit FAQ). Your parent’s main home and main car don’t count.

VA pension net worth limit. From December 1, 2025, to November 30, 2026, the net worth limit for VA pension is $163,699. The maximum yearly pension for a veteran with no dependents who qualifies for Aid and Attendance is $29,093 (VA pension rates). The actual payment depends on income and medical expenses.

Medicare rehab. If your parent goes to a skilled nursing facility after a qualifying hospital stay, Medicare covers days 1 to 20 at $0 per day, then $217 per day for days 21 to 100 in 2026, and nothing after day 100 (Medicare.gov).

Step 5: Match the plan to your situation

A simple way to decide where to start:

• If savings and income cover care for several years, then private pay, and ask homes about rate increases so there are no surprises.
• If your parent has a long-term care policy, then call the insurer this week to start the claim and learn the waiting period.
• If your parent or their late spouse served during wartime, then contact your County Veterans Service Office about Aid & Attendance.
• If savings are very limited and your parent lives in Sacramento County, then ask about the Assisted Living Waiver now and plan for the wait.
• If savings are very limited and your parent lives in Placer County, then the waiver isn’t offered there. Talk with a qualified advisor about options, including participating homes in Sacramento County.
• If money will run out in a year or two, then plan now for what happens next, rather than at the last minute.

The surprise most families hit: Medicare does not pay for assisted living or board and care, no matter how much care your parent needs.

Ways families stretch the budget

• A shared room instead of a private one
• A small board and care home with one all-in rate, instead of base rent plus care levels
• Asking whether the move-in or community fee can be reduced
• Asking what the last few yearly increases were, so the budget holds up

Free local help

• Agency on Aging Area 4 serves Sacramento and Placer counties with free information on senior programs.
• Sacramento County Veterans Service Office: (916) 874-6811 (Sacramento County).
• Placer County Veterans Service Office: (916) 780-3290 (Placer County).
• Your county Medi-Cal office for Medi-Cal and asset questions.

How Nonna Placements works: Nonna Placements is free to families. Licensed homes pay us a placement fee when someone moves in. You can choose any home. This article is general information, not medical, legal, or financial advice.

Talk it through with us

Money questions are easier with someone in your corner. Call us, tell us your parent’s needs and budget, and we’ll explain realistic options in Sacramento and Placer County and set up tours of licensed homes. It’s free to your family.

Call or text (916) 261-2644 or email roberto@nonnaplacements.com.

Related reading: How Much Does Assisted Living Cost in Sacramento in 2026? · Does Medi-Cal Pay for Assisted Living? · VA Aid & Attendance for Sacramento & Placer Families

Sources

• CareScout, 2025 Cost of Care Survey, state data tables: https://assets.carescout.com/x/5c90319b6a/298701.pdf
• California DHCS, Assisted Living Waiver: https://www.dhcs.ca.gov/services/long-term-care-alternatives-home-and-community-based-service-options/assisted-living-waiver/
• California DHCS, Asset Limit FAQ: https://www.dhcs.ca.gov/medi-cal/help/asset-limit-frequently-asked-questions/
• VA, Current pension rates for Veterans: https://www.va.gov/pension/veterans-pension-rates/
• VA, Aid and Attendance and Housebound: https://www.va.gov/pension/aid-attendance-housebound/
• Medicare.gov, Skilled nursing facility care: https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care
• Medicare.gov, Long-term care: https://www.medicare.gov/coverage/long-term-care
• Sacramento County Veterans Service Office: https://ha.saccounty.net/benefits/VeteransServices/Pages/ContactUs.aspx
• Placer County Veterans Services: https://www.placer.ca.gov/veterans
• Agency on Aging Area 4: https://agencyonaging4.org/

About the author

Roberto Hategan is the CEO & Founder of Nonna Placements, a senior placement service serving families across California. Contact: roberto@nonnaplacements.com

Photo credits: Mikhail Nilov, Jsme MILA, and SHVETS production, via Pexels, Pexels License.