How Much Does Home Care Cost in the United States? A 2026 Guide for Families

Quick Answer: What Does Home Care Cost?

The national median cost of nonmedical home care is $35 per hour, according to the 2025 CareScout Cost of Care Survey released in March 2026. At 44 hours of care per week, that equals approximately:

• $6,673 per month
• $80,080 per year

Costs vary considerably by location. State median rates range from $24 per hour in Mississippi to $46 per hour in Wyoming. The number of hours required usually has an even greater effect on the final bill: a senior who needs 10 hours of weekly assistance might spend about $1,517 per month, while continuous 24-hour care can cost $25,000 per month or more.

These figures refer to nonmedical caregivers, not nurses. The national median rate for a private-duty nurse is substantially higher at $90 per hour or $160 per visit. CareScout collected more than 25,000 provider-reported rates between July and November 2025.

Why Planning for Home Care Matters

Most families do not expect an older parent to need help until something changes: a fall, hospitalization, new diagnosis, medication error, missed meal, or noticeable decline in memory.

But the possibility of needing long-term support is not remote. Federal modeling from the U.S. Department of Health and Human Services estimates that 56% of Americans turning 65 will eventually develop a disability serious enough to require long-term services and supports. About 22% will need that assistance for more than five years.

HHS estimates that the average person turning 65 will incur approximately $120,900 in future paid long-term-care costs, measured in 2020 dollars. Families are projected to pay 37% of those costs out of pocket. Among people who actually use paid long-term services and supports, the projected average cost rises to $245,400. Read the HHS long-term-care risk and financing report.

The cost is only part of the story. The United States increasingly depends on family members to fill gaps in paid care. The 2025 Caregiving in the U.S. report found that approximately 63 million Americans—one in four adults—are family caregivers. Nearly one-quarter provide at least 40 hours of care each week, while 47% report negative financial effects from caregiving. National Alliance for Caregiving and AARP research.

Paid home care can therefore serve two people at once: the senior receiving assistance and the family caregiver who needs a sustainable way to continue being a spouse, daughter, son, or friend.

Home Care, Home Health Care, and Private-Duty Nursing Are Not the Same

The language surrounding care at home can be confusing. Before comparing prices, families should make sure they are comparing the same type of service.

Nonmedical home care

Nonmedical caregivers help older adults remain safe and independent with services such as:

• Bathing, dressing, grooming, and toileting
• Walking and transferring assistance
• Meal preparation
• Medication reminders
• Light housekeeping and laundry
• Grocery shopping and errands
• Transportation and appointment assistance
• Companionship and social engagement
• Supervision for someone experiencing memory loss
• Respite for family caregivers

This is the type of care represented by the national $35 hourly median.

Medicare-certified home health care

Home health care is short-term or intermittent clinical care ordered by a healthcare provider. It can include skilled nursing, physical therapy, occupational therapy, speech therapy, medical social services, and limited home health aide assistance.

It is commonly used after an illness, surgery, hospitalization, or significant change in condition. It is not a substitute for ongoing daily personal care.

Private-duty nursing

Private-duty nurses provide extended or task-specific medical care in the home. Services may include complex medication administration, feeding-tube care, ventilator support, injections, wound care, or monitoring of an unstable medical condition.

CareScout reports a 2025 national median of:

• $90 per hour
• $160 per nursing visit

A family may use both skilled and nonmedical services—for example, a visiting nurse for wound care and a caregiver for meals, bathing, mobility, and supervision.

What Home Care Costs at Different Schedules

The following examples use the national median of $35 per hour. They are planning illustrations, not agency quotes.

*The 24/7 calculation simply multiplies 168 weekly hours by the national median rate. Actual continuous-care pricing may be higher because of overtime, overnight-awake care, holidays, shift differentials, local employment laws, and the need to schedule multiple caregivers. Some live-in arrangements may be priced differently, but live-in care is not the same as having an awake caregiver available every minute.

Home Care Costs by State

The following state medians come from the CareScout 2025 Cost of Care national and state tables. Monthly figures assume 44 hours of nonmedical care per week.

A statewide median is a useful benchmark, but it is not a guaranteed local rate. Prices may be much higher in major metropolitan areas, remote communities, or locations with severe caregiver shortages. Families should request estimates from several properly licensed providers serving their ZIP code.

Why Home Care Prices Vary

Location and caregiver availability

Care is labor-intensive. Local wages, transportation costs, housing expenses, state employment rules, and the number of available caregivers all influence pricing.

A rural area is not necessarily less expensive. Long travel distances and a smaller workforce can make caregivers harder to recruit and shifts harder to cover. That helps explain why some less densely populated states have surprisingly high median rates.

Workforce pressure is likely to continue. The Bureau of Labor Statistics projects employment of home health and personal care aides to grow 17% between 2024 and 2034, with approximately 765,800 openings per year when replacement needs are included. BLS home health and personal care aide data.

Number and length of shifts

Many agencies require a two-, three-, or four-hour minimum visit. A family requesting one hour of care may still be billed for the agency’s minimum shift.

Short and fragmented schedules can also be harder to staff. A predictable five-hour visit may be easier to cover than two separate one-hour visits during high-demand morning and evening periods.

Time of day and day of the week

Rates may increase for:

• Overnight-awake care
• Weekends
• Holidays
• Last-minute requests
• Split shifts
• High-demand morning or evening hours

Ask whether the quoted rate is the standard weekday rate or the actual rate for the schedule your family needs.

Care complexity

Some agencies use one rate for all nonmedical services. Others charge more when a client requires:

• Two-person transfers
• Extensive mobility assistance
• Advanced memory-care supervision
• Behavioral support
• Specialized disease-related training
• Frequent transportation
• Higher-acuity personal care

A nurse should assess the person’s needs before a family relies on a quoted price.

Agency care versus hiring privately

An independent caregiver may advertise a lower hourly rate, but the family may become responsible for screening, taxes, payroll, workers’ compensation, liability, scheduling, supervision, and replacement coverage.

A home care agency’s rate commonly supports:

• Caregiver wages
• Payroll and employment taxes
• Background screening
• Workers’ compensation coverage
• Liability insurance
• Training and supervision
• Scheduling and care coordination
• On-call support
• Substitute caregivers when the regular caregiver is unavailable

The BLS reports a median worker wage of $16.78 per hour for home health and personal care aides as of May 2024. That cannot be directly compared with the $35 median consumer rate because the consumer rate includes far more than the caregiver’s paycheck.

Is Home Care Less Expensive Than Assisted Living?

Sometimes—but not always.

The answer depends primarily on how many hours of supervision and hands-on assistance a person needs.

At first glance, assisted living appears less expensive than 44 hours of weekly home care. But it is not a direct comparison.

Home care pricing generally does not include the home itself, utilities, food, property taxes, or maintenance. Assisted living pricing generally includes housing and meals—but the advertised base rate may not include medication management, personal care, memory support, transportation, or higher care levels.

Home care may be financially attractive when:

• The person owns the home or has manageable housing costs.
• Only several hours of daily assistance are needed.
• A spouse or relative can safely cover some hours.
• Remaining at home is a strong personal priority.
• Moving would create medical, cognitive, or emotional disruption.

Assisted living may become comparatively less expensive when a person needs extensive daytime and overnight supervision. Nursing home care may be necessary when medical and functional needs cannot safely be supported at home.

The right comparison is therefore not simply “hourly rate versus monthly rent.” Families should calculate the complete cost of each workable care plan.

Does Medicare Pay for Home Care?

Medicare generally does not pay for ongoing nonmedical home care or custodial assistance when that is the only care a person needs.

Medicare explicitly excludes:

• 24-hour care at home
• Ongoing homemaker services unrelated to a skilled care plan
• Meal delivery
• Custodial or personal care when it is the only required service

Medicare may cover qualifying home health services when a person is homebound, under a provider’s plan of care, and needs part-time or intermittent skilled nursing or therapy. Limited home health aide assistance can be covered only when the person is also receiving qualifying skilled services.

Medicare states that intermittent skilled nursing and aide services are generally limited to a combined maximum of 28 hours per week, with up to 35 hours possible for a short period when medically necessary. Review Medicare’s home health coverage rules and its separate explanation of long-term-care exclusions.

A hospital discharge order for home health should therefore not be interpreted as approval for unlimited daily caregiving.

Does Medicaid Pay for Home Care?

Medicaid can pay for personal care and other home- and community-based services for eligible individuals. Programs may include:

• Personal care
• Homemaker assistance
• Home health aide services
• Respite care
• Adult day programs
• Case management
• Consumer-directed services
• Certain home modifications or assistive technology

Eligibility and available services vary by state. Applicants may have to meet income, asset, residency, and functional or nursing-home-level-of-care requirements.

States frequently provide services through Medicaid Home and Community-Based Services waivers. Because states may cap enrollment, an eligible person may encounter a waiting or interest list. KFF reported that more than 600,000 people were on Medicaid HCBS waiting or interest lists in 2025, although the way states screen and count applicants varies. KFF Medicaid HCBS analysis.

Families should apply early and should not assume that owning a home automatically disqualifies someone. Medicaid eligibility, spousal protections, estate recovery, and asset-transfer rules are complicated and state-specific.

Can Veterans Receive Help Paying for Home Care?

There are two important—but separate—possibilities.

VA Homemaker and Home Health Aide services

The VA may authorize services from a contracted home care organization for an enrolled veteran who meets the clinical criteria and is eligible for community care. Services may include bathing, dressing, grooming, toileting, transferring, eating, and grocery shopping.

Availability and authorized hours vary by location and assessed need. A VA social worker can help determine eligibility. VA Homemaker and Home Health Aide Care.

Aid and Attendance

Aid and Attendance is an additional monthly amount added to a qualifying VA pension. It is not a stand-alone home care insurance program.

A veteran or eligible survivor must first qualify for a VA pension and meet additional requirements, such as needing help with daily activities, being largely bedridden, residing in a nursing home because of disability, or meeting specified vision limitations.

Income, unreimbursed medical expenses, assets, dependents, and a three-year asset-transfer lookback may affect eligibility. Official VA Aid and Attendance information.

Families should work with a VA-accredited representative and avoid organizations that charge improper fees or recommend transferring assets without explaining the consequences.

How Long-Term Care Insurance Pays for Home Care

A traditional long-term care insurance policy may reimburse some or all qualifying home care expenses. Coverage depends on the contract.

Important provisions include:

• Benefit trigger: Often the inability to perform at least two activities of daily living or the need for substantial supervision because of cognitive impairment.
• Daily or monthly maximum: The most the policy will pay during a covered period.
• Benefit pool: The total amount available over the policy’s life.
• Elimination period: The number of calendar or service days the policyholder must pay before benefits begin.
• Inflation protection: Whether benefits grow over time.
• Reimbursement versus cash benefit: Whether payment depends on documented expenses.
• Provider requirements: Whether the caregiver must work for a licensed or policy-approved agency.
• Covered services: Whether companion care, homemaker care, respite, care coordination, or home modifications qualify.

The National Association of Insurance Commissioners warns that an elimination period may be counted by calendar day or only on days when covered paid care is received. That distinction can substantially change a family’s out-of-pocket expense. NAIC Shopper’s Guide to Long-Term Care Insurance.

Before starting care, request the complete policy—not merely a benefits summary—and open a claim with the insurer.

Can Home Care Be Tax Deductible?

Some home care expenses may qualify as medical expenses, but ordinary household help is not automatically deductible.

According to IRS Publication 502, qualified long-term-care services can include maintenance and personal care when:

1. The individual is certified as chronically ill by a licensed healthcare practitioner; and
2. Services are provided under a prescribed plan of care.

For this purpose, a person may qualify when they are expected to need substantial assistance with at least two activities of daily living for at least 90 days or require substantial supervision because of severe cognitive impairment.

For 2025 federal returns, only qualifying unreimbursed medical expenses exceeding 7.5% of adjusted gross income are generally deductible on Schedule A. Dependency, reimbursement, allocation between personal and household services, and documentation rules also apply. IRS Publication 502.

Families should obtain tax advice before treating the entire home care bill as deductible.

A More Sustainable Way to Build a Care Plan

Families often approach home care as an all-or-nothing decision. A better starting point is to identify the hours when help will have the greatest effect.

For example:

• Morning assistance may address bathing, dressing, breakfast, and medications.
• Midday visits may provide meals, movement, errands, and companionship.
• Evening assistance may reduce fall risk and help establish a safe bedtime routine.
• Overnight care may be reserved for periods of wandering, repeated toileting, or unsafe transfers.
• Adult day services can provide lower-cost daytime supervision while family members work.
• Respite visits can give a family caregiver protected time for sleep, appointments, work, or personal responsibilities.

A blended plan might combine 20 hours of paid care, two days of adult day programming, help from relatives, meal delivery, transportation services, and home-safety improvements. This can be safer and more sustainable than waiting until one exhausted relative can no longer manage the situation.

Questions to Ask Before Hiring a Home Care Provider

A low hourly rate is not necessarily a low total cost—and the highest rate does not automatically guarantee the best care. Ask each provider:

1. What is the regular hourly rate for the schedule we need?
2. Is there a minimum number of hours per visit or week?
3. Are weekends, overnight shifts, and holidays priced differently?
4. Is the assessment free?
5. Are caregivers employees or independent contractors?
6. Are payroll taxes, bonding, and workers’ compensation handled by the agency?
7. What background and reference checks are completed?
8. How are caregivers trained and supervised?
9. How does the agency handle call-offs and replacement coverage?
10. Can the agency support transfers, incontinence, memory loss, or other specific needs?
11. Who updates the care plan when needs change?
12. Are there deposits, cancellation charges, mileage fees, or rate increases?
13. Will the agency help document claims for long-term care insurance?
14. Is the provider licensed or registered as required by the state?
15. How quickly can care hours be increased after a hospitalization or decline?

Request a written rate sheet and service agreement before care begins.

The Bottom Line

Home care in the United States has a 2025 national median rate of $35 per hour, but no single number captures what a family will actually spend. Location, schedule, care complexity, minimum shifts, overnight needs, and caregiver availability all matter.

The most reliable budget begins with three questions:

• What tasks require assistance?
• During which hours is the person unsafe or unsupported?
• Which family, community, insurance, Medicaid, Medicare, or VA resources can legitimately cover part of the plan?

Starting with a focused schedule can make home care more affordable. Starting the conversation before a crisis can make every available option easier to evaluate.

Cost figures are national or statewide medians, not provider quotes. Benefits, eligibility rules, taxes, and legal requirements vary. Families should consult appropriate financial, tax, benefits, and elder-law professionals when making significant care-planning decisions.

Recommended Sources

Home-care and long-term-care costs

1. CareScout 2025 Cost of Care Survey Current national median costs for nonmedical home care, private-duty nursing, adult day care, assisted living, and nursing homes. Includes survey methodology and state-level resources.
2. CareScout Cost of Care Calculator Local and state cost comparisons for different types of senior care.
3. HHS: Long-Term Services and Supports—Risks and Financing Federal research on the likelihood of needing long-term care, expected duration of care, lifetime costs, and how Americans pay.

Medicare, Medicaid, and payment options

1. Medicare: Long-Term Care Coverage Explains why Medicare generally does not cover ongoing nonmedical or custodial home care.
2. Medicare: Home Health Services Defines the limited circumstances in which Medicare covers skilled nursing, therapy, and home health aide services.
3. Medicaid: Home- and Community-Based Services Federal information on Medicaid HCBS programs and state-administered home-care benefits.
4. KFF: Medicaid Home Care and HCBS in 2025 Accessible analysis of Medicaid home-care eligibility, spending, waiting lists, workforce issues, and differences among states.
5. VA Aid and Attendance and Housebound Benefits Official eligibility and application information for veterans and surviving spouses who may need help paying for care.
6. IRS Publication 502: Medical and Dental Expenses Official guidance on when qualified long-term-care services, insurance premiums, and certain caregiving expenses may be tax deductible.
7. NAIC: A Shopper’s Guide to Long-Term Care Insurance Consumer guidance on long-term-care insurance benefits, exclusions, inflation protection, costs, and policy comparisons.

Workforce and availability

1. Bureau of Labor Statistics: Home Health and Personal Care Aides National and state data on caregiver wages, employment, duties, projected demand, and workforce shortages.
2. Caregiving in the United States 2025 AARP and National Alliance for Caregiving research on unpaid family caregivers, hours of care, financial strain, employment effects, and caregiving intensity.

Aging population and future demand

1. U.S. Census Bureau: Demographic Turning Points, 2020–2060 Population projections showing the growth of the older population and the changing ratio of working-age adults to retirees.
2. ACL: National Plan on Aging Strategic Framework Federal perspective on aging in place, caregiver support, housing, healthcare, and long-term services.
3. Eldercare Locator Federal directory for Area Agencies on Aging, state assistance programs, caregiver support, transportation, meals, and local aging resources.