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Assisted Living in Iowa

owa is a popular destination for retirees looking to take advantage of a low cost of living and the state’s lack of income tax on Social Security payments. Of Iowa’s 3.19 million inhabitants, 17.1% are adults aged 65 and older.

Genworth’s Cost of Care Survey 2021 lists the cost of assisted living in Iowa at $4,367 per month, lower than the U.S. median and one of the most affordable rates in the region. To help pay for long-term care, Iowa Medicaid provides the Home and Community-Based Services Elderly Waiver to eligible seniors. Retirees can also look to a number of other financial assistance programs to help cover assisted living costs.

This guide discusses the cost of assisted living in Iowa and how it compares to neighboring states and other care types. It also looks at financial assistance options and lists local resources that help seniors make the right choices for their future.

How Much Does Assisted Living Cost in Iowa?

Iowa seniors spend an average of $4,367 per month on assisted living according to the 2021 Genworth Cost of Care Survey. Being below the national average of $4,500, this cost makes the state an affordable option for assisted living. Iowa’s rates compare favorably to its neighboring states, only surpassed by Nebraska ($4,076) and Missouri ($3,000), the cheapest state in the region. Prices in Minnesota and Illinois are higher than in Iowa but on a par with the U.S. median, with assisted living costing $4,508 and $4,488, respectively. Seniors residing in Wisconsin spend the most, with an average monthly fee of $4,600.

$4367

Iowa

$4500

The United States

$3000

Missouri

$4508

Minnesota

$4600

Wisconsin

$4488

Illinois

$4076

Nebraska

The Cost of Assisted Living in Iowa’s Top Cities

Across Iowa, assisted living costs vary by location. The most affordable communities can be found in Sioux City to the west, where retirees spend an average of $4,148 per month. Rates in Iowa City and Davenport are more on a par with the state median at $4,410 and $4,350, respectively. Assisted living facilities in the east part of the state charge slightly more, with those in Dubuque charging $4,525 and Cedar Rapids $4,748. However, seniors choosing to retire in the state capital of Des Moines pay a premium, as the city has the highest rates in Iowa at $4,803 per month.

$4148

Sioux City

$4803

Des Moines

$4525

Dubuque

$4350

Davenport

$4748

Cedar Rapids

$4410

Iowa City

The Cost of Assisted Living vs. Other Types of Care

Different levels of care are available to Iowa seniors depending on their individual needs. At $1,353 per month, adult day care is the cheapest option, as services are only offered during the daytime. Assisted living is the next most affordable choice, with costs averaging $4,367. Seniors who remain in their own homes but require some assistance with everyday tasks can find help from homemaker services that charge $5,529. Home health aides also assist retirees in their homes but provide basic medical services, so they charge an additional $48. Offering the highest level of services, skilled nursing is the most expensive care type in Iowa at $6,874.

$4367

Assisted Living

$1353

Adult Day Health Care

$5529

Homemaker Services

$5577

Home Health Aide

$6874

Nursing Home Facility (semiprivate room)

Can You Use Medicaid to Pay for Assisted Living in Iowa?

Although Iowa Medicaid pays for skilled nursing home care, it doesn’t cover the cost of other long-term care services. However, retirees choosing to move into an assisted living community can apply for financial assistance through Medicaid waiver programs to help cover the costs of community services, such as transportation, meals, assistance with personal care and medication management.

Medicaid’s Coverage of Assisted Living in Iowa

Assisted living is covered through the Iowa Medicaid Home and Community-Based Services Elderly Waiver. The program is open to seniors aged 65 and older who require nursing-home level care but could safely live in a less intrusive environment. Included services are tailored to meet the health and financial needs of each resident and designed to provide the assistance they need to live as independently as possible.

Waiver Programs for Assisted Living in Iowa

Home and Community-Based Services Elderly Waiver

The Home and Community-Based Services Elderly waiver is available in all 99 Iowa counties. Applicants need to be aged 65 or older and eligible to receive Medicaid, so they must meet the same income and asset limits. An annual assessment is used to determine the services required and the amount of coverage each senior receives.

The Elderly waiver only has a limited number of slots available so successful applicants may be placed on a waiting list. For more information and to apply for Iowa Medicaid Elderly waiver, seniors can call (800) 338-8366 or contact their local Department of Human Services (DHS) office.

Eligibility for Medicaid in Iowa

To be eligible for Iowa Medicaid, seniors need to meet certain financial criteria. Each applicant’s income must not exceed $2,523 per month or $30,276 per year from all sources, including Social Security payments, pension, annuities and stock dividends. If married couples apply together, their annual household income limit is $60,552. Limits are also placed on assets, such as savings, investments, stocks and bonds. Single applicants can hold no more than $2,000 in assets, while married couples are limited to $3,000. If only one spouse is applying for Medicaid, their partner can hold assets up to $137,400.

2022 Medicaid Income Limits for Seniors in Iowa


Income Limits* Asset Limits
Single Applicant$30,276$2,000
Two-Person Household(Only One Person Applying)$30,276$2,000 for applicant$137,400 for non-applicant
Two-Person Household
(Both People Applying)
$60,552$3,000

*per year

In addition to financial constraints, Iowa Medicaid applicants also have to meet certain personal criteria:

  • Be aged 65 years or older
  • Be a U.S. citizen, permanent resident or legal alien
  • Reside in Iowa
  • Assessed as requiring skilled nursing care

Applying for Medicaid in Iowa

Iowa seniors wanting to apply for Medicaid can do so online at the DHS Services Portal or by downloading an application and mailing the completed form to:

Imaging Center 4
PO Box 2027
Cedar Rapids, Iowa 52406

Applications can also be made in person at a DHS office.

Before You Apply

When applying for Iowa Medicaid, applicants are required to provide in-depth personal and financial information. Having the following details on hand can help speed up the process.

  • Full name and date of birth
  • Social Security number
  • Proof of citizenship
  • Income details
  • Bank statements
  • Proof of vehicle ownership
  • Details of retirement benefits as well as life and health insurance policies
  • Mortgage or property deed

Where to Go to Get Help

Navigating the Iowa Medicaid system can be overwhelming, but seniors and their families can find help and guidance from a number of free resources.

Resource Contact Service 
American Council on AgingOnline onlyThe American Council on Aging website provides detailed information on Iowa Medicaid and waiver programs. It lists eligibility requirements and defines what is counted as income and assets. The website also features a Medicaid Planner to help seniors understand their eligibility status.
Iowa Department of Human Services (DHS)(855) 889-7985The Iowa DHS provides assistance to anyone needing help with their Medicaid application. Seniors can call the help center or visit their local county DHS office with any questions. In addition to applying for Medicaid via the DHS Services Portal, visitors to the portal can also use an eligibility checker to see which programs they are entitled to.
Iowa Legal Aid(800) 992-8161Iowa Legal Aid provides free civil legal advice to low-income Iowan seniors. Its website provides clear information on Medicaid eligibility and what to do should an application be denied. The organization helps with re-applying for Medicaid and appealing against decisions, and it can represent seniors at hearings.

Can You Use Medicare to Pay for Assisted Living in Iowa?

Unfortunately, Medicare does not cover the cost of assisted living in Iowa. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

For more information about Medicare visit medicare.gov.

Are There Other Financial Assistance Options for Assisted Living in Iowa?


How to ApplyHow It Works
Aid and AttendanceApply online at va.gov.If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse MortgagesResearch and learn about the different types at ftc.govIf you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) InsuranceLearn about how to receive LTC insurance benefits at acl.gov.While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free and Low-Cost Resources for Seniors in Iowa

Iowa seniors can find support from a number of resources in the state. These organizations provide information, counseling and advice on a range of senior issues to help older adults improve their quality of life and live as independently as possible.

Resource Contact Service 
Iowa Department on Aging(866) 468-7887The Iowa Department on Aging supports the state’s seniors and their families through a range of programs and a network of agencies. It provides advice and counseling on health insurance options, the benefits system and long-term care to ensure seniors make the best decision for their future. The department also offers nutrition services, caregiver support, employment assistance and elder abuse case management.
Area Agencies on Aging in Iowa(515) 255-1310Coordinated by the Aging Resources of Central Iowa, the state’s Area Agency on Aging (AAA) is a network of six offices serving all counties in Iowa. Seniors can access support, information and advice on a range of issues, including long-term care options, transportation and home-delivered meals. The AAA also offers counseling and connects older adults with helpful resources and services in the local community. Seniors can find details of their nearest AAA office on the Aging Resources locator map.
Iowa Department of Veterans Affairs(515) 252-4698
or
(800) 838-4692
Iowa Department of Veterans Affairs supports seniors who have served in the U.S. armed forces. It helps vets and their families access the federal, state and county benefits they’re entitled to. IDVA also provides VA health care information and sponsors veteran-related events held throughout the state.
Social Security Offices in Iowa Iowa’s Social Security offices assist seniors by helping them understand their insurance options and eligibility for benefits, including Medicaid and Supplemental Security Income (SSI), which can be used to cover some of the costs associated with assisted living and other long-term care. Detailed information can be found on the Social Security website, or seniors can contact their local office for further assistance.
Office of the State Long-Term Care Ombudsman(515) 725-3308
or
(866) 236-1430
Operating within the Iowa Department of Aging as an independent entity, the Office of the State Long-Term Care Ombudsman (OSLTCO) advocates for the rights of Iowa seniors residing in long-term care facilities, including assisted living communities. It protects residents’ safety by investigating and helping resolve elder abuse and quality-of-care complaints. The OSLTCO also educates the public and long-term care providers on good care practices.

COVID-19 Rules for Assisted Living in Iowa

The following information is based on research done on several government websites, including idph.iowa.gov and cms.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/8/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?Yes
Will my loved one be required to self-quarantine after I visit him or her?No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives? Yes
Are visitors being screened for elevated temperatures?Yes
Are visitors being asked questions about health, travel, and potential virus contact?Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?Yes
Are residents of senior living facilities who leave and return required to self-quarantine?No (Conditions Apply)
Are senior living facilities required to cancel all group outings?No
Are residents still eating together in the dining hall?Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?Yes
Are staff members and contractors being tested for Coronavirus?Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?No
Are staff members required to take residents’ temperatures?Yes
Are residents being tested for coronavirus?Yes (Conditions Apply)

Assisted Living Laws and Regulations in Iowa

The Health Facilities Division of the Iowa Department of Inspections & Appeals oversees assisted living facilities in the state. All facilities must meet the regulations and licensing rules set out by the division. Details on licensing can be found in Iowa Code 231C & Administrative Rules.

Laws and Regulations for Assisted Living in Iowa
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