If your parents or an older relative needs in-home care, and you’re worried about the cost, that’s understandable. There’s no sugarcoating it: elderly home health and personal care can be expensive.
Several factors affect the cost of in-home care, including location and state regulations, the level of care your loved one needs and how often you will need to have someone visit the home. We’ll break down the expenses and what you’ll need to consider if you decide to spend money on in-home caregiving
[Read: Hiring an In-Home Caregiver: What to Consider]
Elderly Home Health Care: 2 Choices
When you’re thinking about home care for seniors, you essentially have two options for hiring in-home care. You can work with an agency — or hire someone yourself directly.
Agency vs direct hire
In a nutshell, it’s cheaper to hire someone yourself, but it’s far easier to work with an agency, says Joy Loverde, a Chicago-based author of “The Complete Eldercare Planner, 4th Edition” and “Who Will Take Care of Me When I’m Old?”
“There are advantages and disadvantages to hiring freelance helpers,” Loverde says. “Lower cost is the major benefit.”
But the savings comes with its own cost: time.
“When you are hiring individuals outside of an agency, you become an employer,” Loverde says. “You will need to pay employer taxes, insurance and workers’ compensation; track tax withholdings; and make payroll tax reports.”
She adds that “work-related injuries might not be covered by your loved-one’s homeowner’s insurance.”
In addition, you should do a background check on whomever you hire. Loverde cautions that if you’ve hired one person to care for your parent or relative, they could one day not show up for work — maybe they’re sick, for example. So you’ll need to have a plan B for those occasions, she adds.
As you can imagine, there are pros and cons to hiring an agency instead of hiring someone directly. In a nutshell:
Pros of using an agency to hire a caregiver:
— They do a lot of work for you. That is, they’ll do background checks of the people who care for your loved one. They’ll take care of paperwork, like taxes and workers comp.
— Dependability. If somebody who usually cares for your parent or relative can’t make it, the agency is likely to have someone else who can fill in.
— An easier fix if personalities clash. If you hire someone, and they aren’t a good fit for your parent, you have to start the hiring process over. If the agency’s caregiver isn’t a good fit, while you could switch agencies, you could also have them find a new caregiver.
Cons of using an agency to hire a caregiver:
— Expensive. And it’s just getting more expensive. According to the Consumer Price Index, from February 2024 to February 2025, the care of the elderly at home went up 5.3%.
— Impersonal. Not necessarily, but if the agency has a lot of caregivers, scheduling issues and turnover, you may or may not always get the same person caring for your loved one.
Loverde also cautions that once you find the perfect caregiver and hire them, even from a reputable agency, your role isn’t over.
“Hiring a worker from an in-home care agency does not guarantee quality of services provided by an employee,” Loverde says. “It’s important to continuously monitor the quality of services rendered by anyone you bring into your parent’s home.”
[Read: What to Do When You Become the Family Caregiver]
Cost of In-Home Caregivers
The rule of thumb is that it’ll always be less expensive to hire someone directly. According to a 2024 Cost of Care Survey from Genworth Financial, the median cost for home health aide services in the U.S. is $34 per hour. The website and nonprofit SeniorLiving.org has similar numbers, suggesting you’ll pay between $31 and $35 for in-home senior care.
While it will vary, you can probably expect to pay between $20 to $35 an hour, says Benjamin Chernow, a certified senior advisor and the owner of Seniors Helping Seniors Bethesda, a home care agency in Maryland. He says that minimum wage is the main cost driver that makes the cost of in-home senior care go up.
“In areas that adhere to the federal minimum wage, I would expect prices to be around $20 to $25 an hour, whereas I would expect to see something closer to $35 an hour in areas with a $15 an hour minimum wage,” Chernow says.
But it all depends on everything from the level of care your loved one needs to the cost-of-living in your city. The exact cost that you’ll ultimately pay will also depend on the training and certifications of the caregiver as well as state regulations that require additional certifications. In general, the more care — and the more training the caregiver needs — the more the costs are going to go up.
For instance, Loverde says that if you need a licensed medical professional to help treat a loved one, you may need a certified home health aide (CHHA). That requires a level of training beyond a home health aide, which isn’t considered a medical professional.
[Read: 11 Signs Your Aging Parent Needs Senior Care]
Nonmedical vs Medical Caregivers
“There are different people who provide specific services,” she says. How much you spend depends on your needs and whether you need someone who has medical training (which will always cost more) or someone who can cook a few meals and bring in the mail.
Loverde says that a nonmedical aide could help a client bathe, get dressed, groom themselves and change the bedding.
“Oftentimes, caregiving requires heavy lifting,” Loverde says. “This is why in-home bathing and showering services are gaining in popularity. Aides may also drive clients to and from medical appointments.”
Loverde says she recently helped a client find care for an elderly family member. “His 24/7 care was provided by two sisters who were licensed to provide both medical and non-medical services. The cost was $12,000 per month,” Loverde says. She lives in Chicago and says that someone in a city with a lower cost of living might spend less. “Transportation expenses to and from the job site may be an extra cost,” she adds.
[READ: Assisted Living vs. Home Care: What’s the Difference?]
Short-Term Coverage Is Scarce and Costly
You may struggle to find a caregiver for elderly home care services if you only need one occasionally, says Alyson Austin. She is the co-owner of a public relations firm and lives in Wells, Maine, with her 90-year-old mother while running her business from home. But sometimes Austin has looked into in-home senior care for her mother, and she says it can be almost impossible to find occasional help.
“I have inquired with many professional services, and they do not take clients for occasional visits. I am told I must hire a service for a minimum of 12-hours per week,” Austin says. “I am here most of the time, but if I need to travel for work, I have to ask my brother to come for several days.”
Her brother lives 300 miles away. “It’s difficult to find help for short spurts,” Austin says. “It’s all or nothing with hiring a service.”
Chernow agrees that it can be hard to find occasional help. On the plus side, he says that sometimes, the more hours you have someone working, the less you’ll pay per hour.
“You should generally expect the hourly rate to decrease as the hours increase, and thus the hourly rate for 24/7 care should be substantially less than for a single short visit,” Chernow says. “This reflects what is essentially a minimum threshold of unit economics. A caregiver is not going to buy gas and commute to a one-hour job where they make $15. Conversely, it is worthwhile for them to commute to a 14-hour job, even if the hourly rate is lower.”
Does Medicare Pay for an In-Home Caregiver?
Unfortunately, in most cases, no.
“Most people should expect to pay out-of-pocket for a caregiver. Health insurance rarely covers the cost of an in-home caregiver, and Medicare only covers an in-home caregiver for a limited time and under very specific situations,” Chernow says.
She notes that Medicaid, VA benefits and long-term care insurance are also options to pay for in-home care.
Medicare Part A will cover some home health services, including wound care, physical and occupational therapies, speech-language pathologist services, home health aide care and medical monitoring under very specific guidelines. For example, you must be unable to leave your home because of illness or injury or had a medical professional recommend that you remain homebound.
Loverde says that if somebody on Medicare needs a home care aide after, for instance, a hospital visit, it would pay for that, “but it’s limited in time and duration.” So Medicare can pay for in-home senior care, but only in short bursts. It isn’t a fix for a long-term situation.
Other ways to pay for caregiving help
“Medicaid may be an option to pay for home health aides. Medicaid covers the cost for home health aides, but eligibility and coverage will vary from state to state,” Loverde says.
Loverde adds that states may have local programs devoted to covering senior care costs.
For example, Idaho has the Idaho Commission on Aging. Ohio has the Ohio Department of Aging. The Minnesota Department of Human Resources has aging programs. Louisiana has its Office of Aging and Adult Services. You may have to do some searching on the internet to locate your state’s aging agency, and you’re not likely to find a service that pays for all of your loved one’s home health aide needs, of course, but your state may offer more senior care help than you realize.
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How Much Do In-Home Caregivers Cost? originally appeared on usnews.com
