Home Care in Iowa: Agencies, Medicare Home Health Ratings, and What It Costs

Families in Iowa choosing help at home have 263 agencies to compare on MyLivingChoice: 103 home care agencies for ongoing, non-medical help with daily life, and 160 home health agencies for nursing and therapy at home, 125 of them Medicare certified. This guide covers where they are, how the home health agencies rate, what care costs at common schedules, and how to pay for it.

Home care vs home health in Iowa

The two are easy to confuse and pay for differently. Home care (personal care, companion care, in-home care) is ongoing help with bathing, dressing, meals, medication reminders, errands and company, billed by the hour and paid privately, through long-term care insurance, a Medicaid waiver, or VA benefits. No referral is needed. Home health is short-term, doctor-ordered clinical care, usually after a hospital stay, and Medicare covers it in full when the patient qualifies. The full comparison is here.

Medicare home health ratings in Iowa

125 Iowa agencies are Medicare certified for home health, which means Medicare pays for their nursing and therapy visits and reports on how their patients do.

Medicare publishes a Quality of Patient Care star rating for 91 of them. The Iowa average is 3.1 out of 5 (national average 3.2), and 21% of rated agencies score 4 stars or better. On average, Iowa agencies start care within two days of referral for 95% of patients (national 94%). About 4.1% of patients are readmitted to the hospital within 30 days of discharge, against 4.1% nationally.

Browse Medicare-certified home health agencies in Iowa, each with its star rating, services, and hospital outcomes.

Where the agencies are

The cities with the most home care and home health agencies in Iowa:

• Cedar Rapids: 15 agencies (9 Medicare certified)
• West Des Moines: 12 agencies (7 Medicare certified)
• Carroll: 11 agencies (7 Medicare certified)
• Bettendorf: 10 agencies (2 Medicare certified)
• Fort Dodge: 9 agencies (3 Medicare certified)
• Waterloo: 9 agencies (5 Medicare certified)
• Cedar Falls: 8 agencies (2 Medicare certified)
• Mason City: 8 agencies (4 Medicare certified)

Outside these cities, most agencies serve a radius of 25 to 40 miles from their office, so a listing in a neighboring town usually covers yours. Enter your ZIP code to see who serves your address.

What home care costs

The national median for a home health aide or homemaker is about $35 an hour (CareScout Cost of Care Survey, 2025 data); Iowa rates run above or below that with the local cost of living, and agencies in larger metros charge more than rural ones. At the national rate, common schedules come to roughly:

Schedule	Hours per week	Monthly cost at $35/hr
A few mornings a week	12	$1,820
Daily visits, 4 hours	28	$4,250
Daily visits, 8 hours	56	$8,490
Around the clock (hourly)	168	$25,480

For comparison, the national median for assisted living is about $6,200 a month. Home care usually costs less up to about 40 hours a week and more beyond it; the cost guide walks through the crossover, and home care vs assisted living covers how to decide.

Paying for home care in Iowa

• Medicare pays for home health (doctor-ordered, short-term skilled care) but not for ongoing non-medical home care.
• Medicaid in Iowa funds home and community-based services for people who qualify by income, assets and need, often including hours a family member can be paid to provide. Apply through the state Medicaid office or the local Area Agency on Aging; waiting lists exist in some programs, so apply early.
• VA benefits, including Aid and Attendance and the Homemaker and Home Health Aide program, cover part-time care for eligible veterans and surviving spouses.
• Long-term care insurance typically covers agency home care after an elimination period.

Every payment option, explained.

Choosing an agency

Ask about state licensing, background checks, backup caregivers, the minimum visit length, and exactly what the hourly rate includes; here is the full checklist. Then compare home care agencies across Iowa by city, or answer a few questions and we will send your request only to the agencies you choose.