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The Costs of Home Health Care

It can be hard to watch yourself or a loved one begin to face difficulties with mobility, self-care, and other parts of daily life. But home health care services can help. By providing the care and support you need right from your own home, home care services make it possible to age in place and remain as independent as possible. 

That sounds great, you might think, but how on Earth can I pay for something like that? Below, we explore the costs of home health care to help you make an informed decision about what’s best for you.

Key Takeaways

  • Most home health care services cost between $20 – $30 each hour, depending on the type of care received.
  • Monthly costs for care can range from approximately $3,000 – $10,000. 
  • The average cost of in-home senior care differs from state to state. Different insurance options may likewise cover some services but not others.
  • Some states, including New York, may have unique options that you can utilize to get financial support.

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Types of In-Home Caregiver

When you start investigating your home care options, you’ll likely find that there are many to choose from – so many that you might feel like you’re taking a shot in the dark. It helps to first familiarize yourself with the pros and cons of each type of in-home caregiver.

  • Family Caregivers: These are often family members who provide free care and support to their loved ones in the comfort of their own homes. Family caregivers can range from spouses and children to siblings and more.
  • Independent Caregivers: This category includes caregivers not employed by any agency or organization. Instead, they offer freelance in-home caregiving services directly to each care recipient.
  • Private Duty Caregivers: These caregivers are usually found working for agencies, but some are also hired privately by clients. They can offer all kinds of personal care, medication management, and companionship.
  • Informal Caregivers: Similar to family caregivers, informal caregivers may be friends, neighbors, or community members who step in to help. As the name implies, these caregivers may not have formal training or certifications.
  • Professional Caregivers: These are, indeed, professionals. They are trained and certified to work for agencies or healthcare facilities. They may be home health aides, certified nursing assistants (CNAs), or registered nurses (RNs). 

The amount caregivers receive for their work is a major factor shaping home health care costs. The more experienced and trained a caregiver is, the more their services tend to cost. Check out these estimates of the average amount you can expect to pay for an hour of care in each category. 

Type of CaregiverCost Range – Hourly (range nationally)
Family CaregiversVaries; may be $0 or mimic hourly rates for other types of care
Independent Caregivers$25 – $27
Private Duty Caregivers$24 – $27
Informal CaregiversVaries; may be $0 or mimic hourly rates for other types of care
Professional Caregivers$23 – $29

Home Care Agencies vs. Direct Hire

Even once you’ve narrowed down the type of in-home care that’s best for you, there’s still another big decision to make: choosing between home care agencies or direct hire. Both are good options, but your care needs and financial limitations will likely make one a better fit than the other.

Home Care Agency

The cost of in-home care through an agency can fluctuate based on factors like location, level of care needed, and the specific services required. The median hourly cost for home care through an agency in the United States is around $27. 

Home care services may be a lot more expensive in metropolitan areas, where living expenses are higher. 

The complexity of care is another factor to think about. Home care agencies may be able to offer more robust services and resources than independent caregivers. What does your loved one need? You might only need to hire a companionship service, or you might need something more complicated, like around-the-clock care or homemaker services. 

In cases where unique or intensive needs are present, it may be wise to rely on an agency to help you navigate the care you need.

Direct Hire

When hiring a caregiver directly, the cost can be more flexible and may be negotiated. According to the Bureau of Labor Statistics, the average hourly pay for home health care workers is only about $14.51. Without the overhead and additional costs agencies present, directly hired workers may charge lower rates. Still, plenty of exceptions exist.

As mentioned, things such as the complexity of care, hours of care, and location all affect the total cost. Direct care is often cheaper than home care agencies, but again, this depends on the factors above. You might pay less for a direct-hire, but you may also be more limited in terms of the kind of care you can receive.

What Factors Impact the Cost of Home Health Care?

Home health care costs can vary based on a senior’s geographic location. Different regions and states may have varying regulations and reimbursement rates for home health care services, which can affect the amount you pay. 

The nature of your health services should also be considered. Expect a higher bill for things like specialized medical care, physical therapy services, or complex day care.

As mentioned before, there’s a price difference between choosing an agency or a direct hire. You’re likely to pay more when working with an agency, but that doesn’t mean that doing so is the wrong move. Both types of care providers can be a big help. 

Insurance and Home Health Care

With a better idea of what to expect from your home health care options, you might be wondering how to pay for all that. If you can’t navigate care costs on your own, don’t worry – many health insurance options are here to help.


Medicare is a reliable option for older adults and has many parts that can help you cover important costs. Medicare Parts A (hospital insurance) and B (medical insurance) cover some home health care services, including:

  • Skilled nursing care
  • Physical therapy
  • Occupational therapy
  • Part-time or intermittent home health aide services
  • Some medical supplies and durable medical equipment

Medicare Advantage plans are another option that can cover care costs. They’re offered by private insurance companies and often have additional benefits beyond what Original Medicare covers.

If you’re eligible for Medicare and receive its benefits, you’ll also need to meet the following criteria to qualify for home health care coverage. You must:

  • Require skilled nursing care or therapy services.
  • Have a plan of care from a doctor.
  • Be homebound, meaning it is difficult to leave the home without help.

Will I Still Pay Out-Of-Pocket?

Unfortunately, Medicare isn’t the holy grail of insurance plans. There may still be out-of-pocket costs, including premiums, deductibles, copayments, and coinsurance. If you’re not sure what you might have to pay, try talking to your provider. Your insurance policy may come with specific requirements and limitations that are relevant to you.


Since Medicaid is a federal and state program, different areas may present different costs and coverage options. Across the nation, though, those seeking home health care can turn to Medicaid Home and Community-Based Services (HCBS) waivers for help. These can help cover the costs of a range of services, including:

  • Personal care
  • Skilled nursing care
  • Home health aide services
  • Adult day care

The eligibility criteria for Medicaid HCBS waivers vary by state but generally consider income, assets, age, and disability status. In New York, Medicaid-funded home care can come in the form of:

  • Personal care, including home attendant and housekeeping services for those having difficulty with one or more activities of daily living (ADLs)
  • Managed long-term care, including case management, home health aides, nursing, physical therapists, and more
  • Assisted living programs, which offer long-term residential care
  • Long-term home health care, which includes medical and rehabilitative home care provided to individuals eligible for placement in a nursing home

Another option is New York’s Consumer Directed Personal Assistance Program (CDPAP), which gives you the freedom to pay family and informal caregivers for their hard work.

Will I Still Pay Out-Of-Pocket?

While Medicaid generally covers the cost of home health care services for eligible individuals, there can still be some out-of-pocket costs.  These costs may pop up for non-covered services or cost-sharing. Still, the amount you’ll pay largely depends on the type of service you receive.

Private Insurance

Private insurance plans cover medically necessary home health care services. This coverage often includes the services covered by the previous options. However, some private insurance providers may offer some extra coverage. Others might have different requirements you’ll need to meet to receive financial support. What you can expect is mainly determined by the type of insurance plan you use. 

Will I Still Pay Out-Of-Pocket?

While private insurance can cover quite a lot, there’s a good chance you’ll need to manage occasional out-of-pocket costs. Not all home health care services may be covered by private insurance, so you’ll need to review your policy documents carefully to learn about your options. 

Likewise, some private insurance plans may require policyholders to pay co-payments, deductibles, or coinsurance for covered services.

Long-Term Care Insurance

Long-term care insurance policies are better for non-medical home health care services, like personal care, assistance with activities of daily living (ADLs), custodial care, and so on.This coverage can be a huge help and peace of mind if you need assisted living services for a prolonged period.

Will I Still Pay Out-Of-Pocket?

You might still have to face costs from long-term care insurance, like premiums, deductibles, and coverage limits. You can minimize these costs by operating within your network and following the rules your policy has laid out.

States With the Highest Hourly Wages for Home Health Aides

Where you live is one of the largest factors influencing the cost of home health care. Below is a snapshot of states with the highest hourly wages for home health aides – this insight gives you a better picture of what to expect.

States With the Highest Hourly Wages for Home Health Aides
StatesHome Health Aide Median Monthly Cost (2023)
New Hampshire$6,574.00
Rhode Island$6,321.00
South Dakota$6,271.00
West Virginia$3,793.00
North Carolina$4,652.00
South Carolina$4,754.00

Hourly Wages for Home Health Aides: All States

Hourly Wages for Home Health Aides: All States
StatesHome Health Aide Median Monthly Cost (2023)Five Year Projection* (2028)
New Hampshire$6,574.00$7,622.00
New Jersey$6,058.00$7,023.00
New Mexico$4,935.00$5,721.00
New York$6,068.00$6,800.00
North Carolina$4,652.00$5,393.00
North Dakota$6,035.00$6,997.00
Rhode Island$6,321.00$7,328.00
South Carolina$4,754.00$5,511.00
South Dakota$6,271.00$7,270.00
West Virginia$3,793.00$4,397.00

At the end of the day, choosing home care services is a very personal decision, and it requires a lot of thought. Take the time you need to consider your options so you can make the right choice for you or your family. 


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