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 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]
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
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.
Pros and cons of using an agency to hire a caregiver
As you can imagine, there are pluses and minuses to hiring an agency instead of hiring someone directly.
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
As a ballpark figure, 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 health 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.
[READ 7 Myths About Caregiving and Home Care Costs]
Nonmedical vs Medical Caregivers
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.
A nonmedical aide, for instance, 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.”
Medical aides, such as certified nursing assistants or CHHAs, can also help with daily tasks as well as provide services such as medication management, changing bandages and working with doctors on individualized care plans.
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.
[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 Austin has looked into in-home senior care for her mother in the past, 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.
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.
Other ways to pay for caregiving help
Medicaid may provide coverage for home health aides, “but eligibility and coverage will vary from state to state,” Loverde says.
She adds 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.
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How Much Do In-Home Caregivers Cost? originally appeared on usnews.com
Update 06/12/25: This story was previously published at an earlier date and has been updated with new information.
