What Is Home Care and How Much Does It Cost by State?

Many aging adults prefer to age in place so they can remain independent in the comforts and safety of their homes. However, as seniors age and circumstances change, the simple acts of getting around and practicing self-care can become increasingly difficult. If moving to an assisted living facility, retirement community, or nursing home is not an option, in-home care can keep your loved one at home and maintain their independence for longer. But what exactly is in-home care and how much does in-home care cost?

In-home care is often confused with home health care, and while both take place in the home, the type of care provided is different. In-home care is nonmedical care such as assistance with personal hygiene, meal preparation, and housekeeping provided to seniors by aides and companions who are not required to have medical training. 

In contrast, home health care includes medical services and therapies like medication administration, wound care, and occupational therapy that are provided by trained and licensed or certified professionals. 

Below, we provide an extensive overview of in-home care, including the cost of in-home care services, how it compares to other care types, and how to pay for in-home care.

In the United States, the median hourly cost for in-home care services is $30 per hour, while the median monthly rate is $5,720 per month according to Genworth’s Cost of Care Survey. Note that this survey refers to in-home care services as home maker services (while home health care is referred to as home health aide services). 

The Genworth survey also uses a baseline of 44 hours worked per week, based on industry guidance. Keep in mind that these values are only estimates of care costs; actual costs will vary by the extent of care a senior needs, and thus the hours of care required, among other factors.

Most in-home care providers charge by the hour. The median hourly rate for in-home care in the United States is $30 per hour. However, the cost of in-home care for elderly loved ones can vary by the care provider, location, and level of care required. Some providers may charge a different rate than others based on their level of experience, whether or not they belong to an agency, and/or other factors. 

The costs of in-home care may vary significantly by location, as well. In Washington state, the median hourly rate for in-home care is $44 per hour, while in Louisiana the median monthly rate is $25 per hour. 

The cost of in-home care for senior loved ones will also vary by total hours needed. Seniors that require only grocery shopping assistance from their in-home care aide will pay less than those that need help with grocery shopping in addition to meal preparation, eating assistance, and after-meal cleanup. Similarly, seniors who need companionship and medication reminders as well as help with shopping, meal preparation, eating, and cleaning will need to pay yet more for the additional in-home care hours.

How you hire an in-home caregiver will also affect the cost. In this case, you have two options: hire a private home care provider, or use a home care agency. In most cases, hiring a care provider from an agency is more expensive than hiring a private one.

Private in-home care providers are generally hired through caregiver databases and job lead websites; private providers often have lower hourly costs. Although independent home aides charge by the hour, this setup has no specific payment structure, as payments, taxes, and fees are often contractually agreed upon by both parties. 

While hiring a private caregiver is less expensive, you may have to cover hidden costs of being an employer, like vetting potential hires (i.e., background checks), and emotional labor costs, like the time and effort of finding the right fit. Moreover, independent aides may not have workers’ compensation insurance, which protects both employers and caregivers if they get sick or injured on the job.

Hiring a home care aide from an agency is generally more expensive by 20%-30% than independent caregivers. While there’s a significant cost difference, the agency takes care of the scheduling and paperwork duties. The agency also vets all its employees, manages its payroll, and can provide backup caregivers when needed.

The cost of in-home care will vary not only by the services and level of care provided, but also by geographical location. Since in-home care costs depend on the caregivers’ wages, they vary widely from one state to another. Seniors who live in an area with a higher cost of living are likely to pay more than the national average for in-home care.

But don’t conflate “high cost of living” to mean “cities”— Montana has the highest hourly cost of in-home care in the country, when states like Florida, with multiple large metro areas, cost a median of $30 per hour. 

Don’t forget: the level of care also impacts cost. For example, in-home care costs less if the companion is paid only for grocery shopping and companionship, than if the companion is paid to meal prep, grocery shop, and drive your loved one to their appointments.

The 10 states with the highest hourly rates for in-home care (or home maker services) include the following:

• Montana with a median hourly rate of $50 per hour
• New Mexico with a median hourly rate of $45 per hour
• Washington with a median hourly rate of $44 per hour
• Hawaii with a median hourly rate of $38 per hour
• Iowa with a median hourly rate of $38 per hour
• Maine with a median hourly rate of $38 per hour
• Kentucky with a median hourly rate of $37 per hour
• Oregon with a median hourly rate of $37 per hour
• California with a median hourly rate of $36 per hour
• Rhode Island with a median hourly rate of $36 per hour

States with the lowest hourly rates for in-home care (or home maker services) are listed below.

• Mississippi with a median hourly rate of $15 per hour
• Arkansas with a median hourly rate of $19 per hour
• Oklahoma with a median hourly rate of $20 per hour
• Pennsylvania with a median hourly rate of $21 per hour
• Alabama with a median hourly rate of $22 per hour
• Texas with a median hourly rate of $23 per hour
• Delaware with a median hourly rate of $24 per hour
• North Dakota with a median hourly rate of $24 per hour
• Georgia with a median hourly rate of $25 per hour
• Louisiana with a median hourly rate of $25 per hour
• West Virginia with a median hourly rate of $25 per hour
• Wisconsin with a median hourly rate of $25 per hour

Care is available for older loved ones who need companionship, help with routine tasks, or who require more intensive medical assistance so they can age in place. There are also different types of care offered to seniors in residential care facilities including assisted living facilities, nursing homes, and memory care facilities to promote the health and safety of seniors and that vary by the needs of each resident.

In-home care describes nonmedical services provided to seniors in their homes by aides who are not required to have medical training. These services vary from help with personal hygiene, to housekeeping, to completing routine errands such as purchasing groceries. 

Though both take place in the home, in-home care is not the same as home health care; home health care includes medical services and therapies administered by medically trained and state-certified professionals. 

In addition to the different types of care provided and the varying qualifications of those who provide them, the costs of in-home care and home health care are considerably different. The national median cost for home maker services like cooking and cleaning offered by in-home care providers is $30 per hour and $5,720 per month (at a rate of 44 hours a week). The national median cost of home health aide services is more expensive, at $33 per hour and $6,292 per month (at a rate of 44 hours a week). 

At Genworth’s reported $5,350, the monthly cost of assisted living is similar to home care’s $5,720 a month per 44 hours of care per week. In-home care and assisted living facilities offer very similar services and levels of care. Assisted living facilities are intended for seniors who don’t require extensive medical care, hence the almost identical costs. However, residents of assisted living communities have aides available to help them 24/7, while those living at home typically do not.

Nursing homes, also called skilled nursing facilities, are long-term care facilities designed for seniors who don’t require hospitalization, but can’t be cared for safely at home. Since nursing homes provide more extensive medical and personal care, they’re significantly more expensive than in-home care. A stay in a semi-private room in a nursing home will cost you $8,669 monthly and a private room is even pricier at $9,733 per month, according to Genworth.

Below are some options that seniors and their families may be able to use to help cover the costs of in-home care. In addition to these, some government assistance programs may help seniors save money in other areas so they have additional funds to spend on in-home care.

• Medicare: Medicare will only pay for in-home medical services mandated by a doctor and, therefore, the nonmedical services provided by in-home caregivers are not covered under Medicare. 
• Medicaid: Medicaid covers the cost of assistance delivered by home care aides so seniors can remain at their homes instead of relocating to a facility. However, covered services and amounts can vary by state.
• Veterans Benefits: Seniors who have served in the U.S. Armed Forces are eligible for a benefit known as the Veteran Directed Care Program. This program covers various homemaking services that in-home caregivers generally provide.
• Long-Term Care Insurance: Long-term care insurance coverage can vary by policy, but may include the homemaker and custodial services offered by in-home care providers. Make sure to research and compare long-term care insurance plans to ensure your loved one gets a policy that best meets his or her needs.    
• Private Payment: It’s common for families to pay for senior in-home care out of pocket. Some popular sources of private payment funds include personal savings, pensions or other retirement funds, funds from a home sale, income from stocks and bonds, funds from selling a life insurance policy, and reverse mortgages.
• Life Insurance Cashout/  Accelerated Death Benefit (ADB): For the cost of an extra premium, some life insurance policies have a feature that enables you to receive a tax-free advance on your life insurance death benefit while you’re still alive. Depending on your loved one’s policy, it may be possible to use this type of cash advance to pay for long-term care services, including in-home care. 

Finding in-home help for your senior loved one can be overwhelming. You’ll need to do some research to ensure that you hire a trustworthy and reliable in-home care aide. You can start by browsing Caring.com’s extensive directory of nonmedical in-home care agencies and home health agencies. You can search these directories for agencies in your area and read customer reviews.

Alternatively, you can also get in touch with Caring.com’s trained Family Advisors to receive personal, one-on-one assistance in finding an in-home caregiver that’s right for your loved one, all at no cost for you. Please call (800) 973-1540 to reach our Family Advisors.

In-home care services are nonmedical services provided by aides and companions to seniors who choose to remain in their homes. Services include assistance with personal hygiene, cooking, cleaning, and transportation and are similar to the services provided by an assisted living facility. In contrast, home health care aides are certified or licensed professionals who can offer more extensive care including medical services and therapies to seniors in their homes. The cost of in-home care is less than home health care and may be covered by Medicaid, veteran’s benefits, and certain insurance policies.