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: Senior 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, the qualifications of the caregiver 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: How to Pay for Senior Living: Your Guide to Financing Options and Costs]
Elderly Home Health Care: Two Choices
When you’re thinking about hiring in-home care, you essentially have two options:
— You can work with an agency.
— You can hire someone directly.
Agency vs. direct hire
| Feature | Private Hire | Home Health Care Agency |
|---|---|---|
| Cost | Generally lower | Generally higher (due to overhead) |
| Management Responsibility | Family is fully responsible (hiring, training, payroll, scheduling, background checks, vetting qualifications) | Agency handles all management (hiring, training, payroll, professional background checks) |
| Caregiver Choice/Flexibility | More personalized and flexible choice | Less flexibility in choosing a specific caregiver |
| Backup Care | No built-in backup (family must manage emergencies/absences) | Backup caregivers are available |
| Insurance/Liability | No professional liability insurance or professional oversight | Professional liability insurance typically included |
| Relationship Potential | Potential for a stronger personal relationship | Limited by agency staffing/schedule |
| Insurance Billing | Typically not handled by the private hire | Agencies can often bill insurance companies |
| Service Scope | Potential for a wider scope of services depending on the individual’s skills | Services may be limited to the agency’s staff capabilities |
| Overall Value | Suitable for families with a lower budget and high tolerance for administrative work and risk | Suitable for families prioritizing comprehensive management, professional oversight and reliable backup care |
[READ: Resources for Caregivers of Military Veterans]
In a nutshell, it’s cheaper to hire someone yourself, but it’s far easier to work with an agency, says Joy Loverde
, 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 notes. “Lower cost is the major benefit.”
But the savings come with its own cost: time.
“When you are hiring individuals outside of an agency, you become an employer,” Loverde explains. “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 not show up for work one day — maybe they’re sick, for example. So you’ll need to have a plan B for those occasions.
Loverde also cautions that your role isn’t over even after you find the perfect caregiver and hire them.
“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 median cost for home health aide services in the U.S. is $34 per hour, according to Genworth and Carescout’s 2024 Cost of Care Survey.
There are a number of factors that can affect cost:
— The cost of living in your location
— The level of care your loved one needs
— The training and certifications of the caregiver (state regulations may also require additional certifications)
In general, the more care — and the more training the caregiver has attained — the higher your costs. For instance, Loverde says that if you need a licensed medical professional to help treat a loved one, a certified home health aide, or CHHA, may be the best fit. That requires a level of training beyond a home care aide.
The main cost driver behind increasing in-home senior care costs is minimum wage, adds Benjamin Chernow, a certified senior advisor and the owner of Seniors Helping Seniors Bethesda, a home care agency in Maryland.
“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.
In-Home Care Cost Plans
How many hours per week you need in-home care for can also play a role in the cost.
— Senior home care for 7 hours a week: $952 per month. This is assuming the senior who could use some help can generally function fine independently. A lot of home care agencies won’t work for less than 7 hours a week, which is generally going to be enough time to prepare meals and do some light housework, and to just hang out, for an hour a day. Studies suggest that loneliness among the elderly is a serious problem.
— Senior home care for 14 hours a week: $1,904 per month. So you feel like your loved one could use a little more one-on-one time? If you double the hours, well, that doubles what you’ll spend. But two hours a day would mean more time making meals and perhaps helping with activities of daily living, such as grooming or even getting dressed in the morning.
— Senior home care for 40 hours a week: $5,440 per month. Maybe you live with an elderly parent, but you work. You could have someone with your parent while you’re out of the house.
— Senior home care 24/7: $22,848 per month. This assumes that you have someone watching your loved full time.
[What Is a Skilled Nursing Facility vs. a Nursing Home?]
Types of In-Home Caregivers and Cost Differences
How much you’ll spend depends on whether you need someone who has medical training (which will always cost more) or only need someone who can cook a few meals and bring in the mail.
How much does private home care cost per hour?
On average, it’s $34 an hour for a home health aide who provides medical services and $33 an hour for homemaker services (the nonmedical side of taking care of someone), according to Genworth and Carescout’s 2024 Cost of Care Survey.
Personal care and assistance (nonmedical help)
A nonmedical aide can assist with activities of daily living
, such as helping a client bathe, get dressed and groom themselves.
“Oftentimes, caregiving requires heavy lifting,” Loverde adds. “This is why in-home bathing and showering services are gaining in popularity. Aides may also drive clients to and from medical appointments.”
Skilled nursing care
Medical aides, such as certified nursing assistants (CHHAs), registered nurses and licensed practical nurses, can help with medical care. This includes medication management, wound care and working with doctors on individualized care plans.
Specialized care
If your loved one has Alzheimer’s or dementia, they may need specialized care. Depending on the disease’s progression, they may still be able to do a lot of things on their own, like watch TV and call friends and get dressed and bathe. On the other hand, they may need help with grooming and preparing meals and planning activities.
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 nonmedical services. The cost was $12,000 per month,” Loverde explains, though she adds that she lives in Chicago and someone in a city with a lower cost of living might spend less.
| Type of Care | Services Covered | Cost |
| Home health care (home health aide) | Duties can run the gamut but often involves medical care, such as wound care and dispersing medication. | $34 an hour (national median value) |
| Homemaker services (nonmedical help) | Duties generally involve helping a senior to do things like clean and cook but doesn’t involve medical help. | $33 an hour (national median value) |
| Adult day care | The senior is dropped off at a facility where they can be involved in structured activities; they’ll get meals and any medical needs will be met. | $100 a day (national median value) |
| Assisted living community | Generally, the senior lives independently, often in their own home, but may have cooking and cleaning and other services (i.e., yard maintenance, transportation) provided for them. | $5,900 a month (national median value) |
| Nursing home semi-private room | The senior lives in a nursing home, in a room with another guest, and receives help with grooming and meals; they’ll live in a structured environment where there should always be activities going on and ongoing medical care. | $9,277 a month (national median value) |
| Nursing home private room | It’s everything someone who would receive in a nursing home, but with more privacy. | $9,733 a month (national median value) |
Home care is still cheaper than a nursing home. The daily median cost of a nursing home (a private room) is $350 a day; with a home health aide, it’s $213 a day. At an assisted living center, the daily median cost is $194 a day. An adult day care’s daily median cost is $100 a day.
[READ: Assisted Living vs. Home Care: What’s the Difference?]
Does Medicare Pay for an In-Home Caregiver?
Generally, Medicare does not cover home health care.
“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.
He notes that Medicaid, VA benefits and long-term care insurance can also be used 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 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.
How to Pay for In-Home Care
There are a number of ways people pay for senior care. Some of your options include:
Private pay
It may not be palatable or your first choice, but many households find the money for to pay for senior care by pooling resources, among the adult children and from the seniors’ retirement fund.
Private insurance
In many cases, private insurance won’t pay for home health aides, or at least what will be paid may be limited. Still, Medicare often will pay for skilled nursing care, such as doing wound care or monitoring someone for a serious illness. You’ll want to check with your loved one’s insurance to see what will be paid and what won’t.
Long-term care insurance
If your relative has long-term care insurance, this is the reason. Long-term care insurance generally does pay for home health aides. But it’s not a perfect system, in that there is generally a benefit period that you can use it. You may be able to get home health care for three to five years, for instance. If your loved one hopes and expects to live another 10 or 20 years, you may want to hold off before utilizing long-term care insurance to pay for a home health aide.
Medicaid
Medicaid may provide coverage for home health aides, “but eligibility and coverage will vary from state to state,” Loverde says.
Making matters more uncertain are the cuts to Medicaid that were passed in July, in what was often called the One Big Beautiful Bill Act of 2025. Most of the cuts haven’t gone into effect, but states have been trimming Medicaid budgets. With all of the cutting, there has been fear that that will mean less money to go toward home health aides, and that more people could wind up needing to move to nursing homes.
Help for veterans
If your loved one is a veteran, you’ll want to reach out to the U.S. Department of Veteran Affairs. They have a homemaker and home health aide services program for elderly vets who need it.
Home equity
This is another one of those financial solutions that isn’t very palatable, but some seniors draw upon their home equity to help them pay for in-home care.
Local help
If Medicaid isn’t an avenue you’re pursuing, Loverde says that some states 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 assistance than you realize.
You may also want to try Programs of All-Inclusive Care for the Elderly (PACE). It’s a nonprofit that offers help to elderly seniors, with the goal of keeping them in their home.
Tips for Reducing In-Home Care Costs
Not all of these scenarios will work for everyone, but if your loved one doesn’t need constant supervision, you could try:
— Moving in with a relative.
— Pooling family resources and having family members visit the relative multiple times a day or at least once a day to help as needed.
— If your parent or loved one has a Medicare Advantage plan, there may be some benefits that may help save time and money, such as free transportation to and from doctors’ offices.
— You want to see if your community center has suggestions on local services or nonprofits, such as Meals on Wheels, that your loved one may be able to use.
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How Much Do In-Home Caregivers Cost? originally appeared on usnews.com
Update 11/19/25: This story was previously published at an earlier date and has been updated with new information.
