How Much Does Home Care Cost? What Affects the Price and How to Pay

Most non-medical home care is billed by the hour. According to the 2025 Cost of Care Survey from CareScout (formerly Genworth), the national median rate for a non-medical caregiver is about $35 per hour. At 44 hours of care a week, that works out to roughly $80,000 a year.

That number is a national midpoint, not a fixed price. Hourly rates run from around the low $20s to the mid $40s depending on the state, the cost of living in that area, and the local labor market.

Skilled care costs more. When a licensed nurse provides care in the home, often called private duty nursing, the national median runs closer to $90 per hour because it requires clinical training.

These are benchmarks to plan around. Your actual cost comes down to a few key variables, which we will walk through next.

Learn more about the types of in-home care.

Four factors shape most of what you will pay.

Because most care is billed hourly, your weekly schedule affects the total more than anything else.

• Non-medical care covers help with daily activities like bathing, dressing, meals, and light housekeeping. This is the most common and least expensive type of home care. 
• Skilled care, such as nursing or physical therapy, is provided by licensed professionals and costs more per hour. Many people need mostly non-medical support with occasional skilled visits, a mix that’s common for in-home care for disabled individuals and their families.

Home care rates follow local wages and cost of living. Care in a major metro area or a higher-cost state can run well above the national median, while rates in some rural and southern areas fall below it. 

How you arrange care affects the cost too. A traditional home care agency sets the rate, assigns the caregiver, and builds its overhead and profit into what you pay. 

With self-directed care, you hire your own caregiver, sometimes a friend or family member who is already helping, and more of the funding goes toward the caregiver instead of agency overhead. 

We cover this comparison in more detail in our blog on self-directed vs. agency care.

Very few families cover the cost of home care services from a single source. Most combine a few. Here are the main ways home care gets paid for.

Private pay means covering costs yourself, usually through income, savings, or contributions from family. Some people also draw on home equity or other assets. Private pay offers the most flexibility in who you hire and how, but it is also the most expensive route because you are absorbing the full rate.

Medicaid is the largest payer of long-term care in the United States, and for many families it is the primary way home care gets funded. Because Medicaid is run jointly by the federal government and each state, what it covers varies significantly depending on where you live.

In most states, Medicaid pays for home and community-based services (HCBS) through waivers or state plan personal care programs. These are designed to help eligible people receive care at home instead of in a facility. Eligibility is generally based on both financial need and a functional assessment of the help you require.

Many state Medicaid programs also allow self-direction, which lets you choose and manage your own caregiver rather than going through an agency. Program names, rules, and what can be self-directed differ from state to state, so it is worth checking the specifics for your area.

Confused by the word waiver? Learn more about Medicaid waivers and how they help pay for home care.

If you or a loved one bought a long-term care insurance policy, it may reimburse the cost of home care. Coverage depends entirely on the policy. Most have a daily or monthly benefit limit, a waiting period before benefits begin, and specific rules about what qualifies. Review the policy terms, or ask the insurer directly, to understand what home care it will pay for.

Wartime veterans and surviving spouses may have options through the U.S. Department of Veterans Affairs. 

• Aid and Attendance is a tax-free pension benefit, paid monthly, that helps cover personal care at home. Under the rates effective December 2025, the maximum for a veteran with no dependents is $29,093 a year, which works out to about $2,424 a month. The actual amount depends on your income, and the VA adjusts these figures each year.
• Veteran-Directed Care is a separate program that gives eligible veterans a flexible budget to hire and manage their own caregivers, much like self-direction. Details and eligibility are available at VA.gov. 

Medicare is sometimes confused with Medicaid for an in-home care benefit, but it generally does not pay for long-term help with daily activities. Because Medicare is a federal program, this rule is consistent across all states. 

Medicare can cover short-term, part-time skilled home health care, such as nursing or therapy, for people who are homebound and meet its conditions, and it pays nothing out of pocket for those covered services. 

What it does not cover is ongoing custodial care, meaning help with bathing, dressing, meals, and companionship when that is the only support needed. For that kind of care, most families turn to Medicaid, private pay, long-term care insurance, or veterans benefits.

For families using Medicaid, self-direction is often the option that stretches funding the furthest. Instead of paying an agency to assign a caregiver, you hire someone you choose, including a friend or family member in many states, and manage the relationship yourself.

If you are the employer, who handles payroll, taxes, and paperwork? This is the responsibility of your Financial Management Services (FMS) provider. An FMS provider processes payroll, withholds and files taxes, verifies caregiver documentation, and helps you stay compliant with program rules, so you can focus on care instead of administration. You can learn more in our blog: What is a Financial Management Services Provider? 

If paying for in-home care feels overwhelming, self-direction may be worth a closer look, especially if you qualify for Medicaid. It can give you more control over who provides care and help your funding go further. Not sure whether it fits your situation? Take PPL’s short self-directed care questionnaire to find out.

Take the Questionnaire

To see which programs are available in your state, visit PPL’s state programs page.

Explore Programs by State

PPL (Public Partnerships LLC) is a Financial Management Services company focused entirely on self-directed care. PPL is not a home care agency and does not assign caregivers or provide direct care. Instead, PPL handles the administrative side of self-direction, including payroll, taxes, enrollment paperwork, and compliance, so participants and the caregivers they choose can focus on care. PPL supports around 50 self-directed programs across the country and has managed more than 700,000 participant and caregiver relationships.

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