How much does in-home care for older adults cost?

As parents and loved ones age, they may need a little more support from their families. Providing quality care for older adults can be challenging on your own. In some cases, your senior loved one can remain at home with the right help. In-home care can be a great option for those who need assistance with activities of daily living (ADLs) or medical care like taking medications regularly.

The cost of in-home care for older adults can be expensive. Let’s explore the types of in-home care and their costs so you can make an informed decision that’s best for your family.  

What is in-home care?

In-home care, or just home care, describes a range of services provided to people who need some assistance with ADLs in their own home, including personal care like bathing, dressing, and preparing meals, and/or medical care. 

In-home care doesn't necessarily always include medical care. Home care and home health care are different things. In-home health care often requires hiring a medical professional so they can help with activities like dispensing medication. Most individuals can provide regular home care to a loved one themselves if they choose.

Types of in-home care

There are many types of in-home care based on an individual's needs. Generally, you can break in-home care into three buckets: homemaker services, personal care assistance, and home health care. Each type of care has different associated costs and may be the right choice depending on the situation.

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Homemaker services

Homemaker services encompass non-medical assistance with ADLs. This may include an in-home caregiver who provides a person with support like cooking, tidying the house, grocery shopping, laundry, and transportation to and from appointments. This is typically the most affordable type of in-home care.

Personal care assistance

Personal care assistance provides non-medical help with ADLs like going to the bathroom, bathing, dressing, grooming, walking, and eating.  

Home health care

Home health care includes medical services provided by certified professionals and comes in various forms.

Home nursing care is when a registered nurse, in consultation with a doctor, sets up and administers a care plan depending on a patient's needs. They can help administer medication, check vital signs, and monitor and treat chronic illnesses. Home therapy is when a medical professional uses in-home physical, occupational, or speech therapy to help an individual manage a specific health issue. Home health care does not typically include help with ADLs or homemaker services.

Some people opt to pay for 24/7 live-in medical professionals, but this is more expensive than paying a nurse or therapist to visit periodically throughout the day or week.

Average cost of in-home care

In-home care for older adults in the United States can be expensive. The cost of care can vary depending on your location and the type of care needed. It’s always best to research different services and agencies, create a financial plan, and see what services might be covered by Medicare or Medicaid. 

Hourly rates

According to a 2024 study by A Place for Mom, the national average hourly rate for in-home care is $30 per hour — but, costs can range anywhere between $21 per hour to $50 per hour, with Mississippi being the least expensive and Maine the most expensive.

The ten most expensive states for in-home care are Maine, Alaska, Delaware, Minnesota, Montana, Washington, Colorado, Arizona, California, and Idaho. The ten most affordable states for in-home care are Mississippi, Louisiana, West Virginia, Alabama, Texas, Kansas, Pennsylvania, Florida, Georgia, and Nevada. States where incomes and cost of living are lower tend to have lower in-home care costs.

When budgeting for a home care provider, it might help to look at the total monthly to get a better sense of long-term financial planning. 

Monthly costs

Genworth's Cost of Care Survey found that the national median cost for homemaker services is $5,720 per month, while the median cost for home health aides is $6,292 per month. 

In many cases, Genworth found that in-home care can cost more than community and assisted living. For example, adult day care, which provides activities and services for older adults in a supervised setting, costs an average of $2,058 per month, while residential assisted living facilities cost an average of $5,350 per month. A private room in a nursing home typically costs an average of $9,733 per month — and a shared room may cost less. 

Remember: monthly costs depend on location and the level of care required.

How to pay for in-home care services

In-home care may have some unexpected costs, so it's not quite as straightforward as paying an in-home caregiver or health aide an hourly rate. Paying for in-home care services can be a source of stress, so it's important to develop a plan ahead of time if you know an older loved one wants to stay at home.

Some common ways people pay for in-home care services include:

• Personal funds: Many families pay out of pocket for in-home care, using funds from the patient's retirement accounts, savings, or the sale of other assets like homes, jewelry, or stocks.

• Trusts: Some families may opt to move money into a trust years ahead of time to accumulate value until the money is needed for care.

• Long-term care insurance: Private healthcare insurance doesn’t typically cover in-home care. Instead, you may opt for long-term care insurance, which covers costs associated with in-home care and assisted living. Insurance providers require that you purchase a policy before you begin administering in-home care.

• Medicare: The federal government's health insurance plan partially covers medically necessary home health care.

• Medicaid: In some states, Medicaid may help pay for home care. Consult an elder law attorney who specializes in Medicaid to understand your options.

• VA programs: Veterans may be eligible for financial assistance for home care through the United States Bureau of Veteran Affairs (VA).

In-home care services can quickly add up, so it's important to explore all your financial assistance options before you begin using services.

Does Medicare and Medicaid cover in-home health services?

Medicare and Medicaid may support some in-home health services. Each program has different eligibility requirements and services covered.

Medicare

Medicare covers some home health care for eligible, homebound older adults who require part-time or intermittent skilled services. These services may include skilled nursing, therapy, and durable medical equipment.

It's important to note that Medicare doesn't cover 24-hour care, meal delivery, homemaker services, or personal care. 

To qualify for in-home care coverage through Medicare, a patient must:

• Be currently under the care of a doctor or health care provider

• Be homebound

• Require intermittent skilled nursing care (other than drawing blood), physical therapy, speech-language pathology services, continued occupational therapy, or home health aide services

Medicaid

Medicaid is the nation's healthcare support for low-income individuals, but services and eligibility requirements vary by state. Generally, older adults must be at up to 100% of the federal poverty level to qualify, but it’s important to consult an expert, such as an elder law attorney, to walk you through the types of Medicaid (community or institutional) and how your senior loved one may qualify.

Medicaid covers some costs of in-home care for those who need assistance to remain living at home. This may include nursing home care, adult day care, chore assistance, and homemaker services.

In some states, Medicaid offers consumer-directed care, which allows recipients to hire relatives or spouses as paid caregivers to offset the costs of home care. 

Understanding the cost of in-home care

In-home care is an empathetic way to give loved ones the support they need as they age. Naturally, you want to provide the best in-home care possible, which is why it's important to understand the cost of caring for older adults.

Costs may vary significantly based on the type of care required and your location. Planning ahead financially can help you prepare to meet the costs associated with the care of older adults. That means having conversations with your loved ones about their financial, medical, and living preferences so you can make a game plan with the whole family to contribute to their care.

For more family resources, visit Greenlight®’s Learning Center.