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How Much Does Home Care Cost? A State-by-State Guide

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Written by Claire Samuels

Reviewed by: Leslie Fuller – Leslie Fuller, LMSW, owns Inspired Senior Care, providing coaching to senior living communities and dementia care.

Elderly woman with figure of house and coins at table, closeup. Concept of payment for utility services

Many older adults prefer to age at home without assistance, but sometimes this isn’t possible due to declining health or dementia. One option to help aging adults remain in their homes longer is in-home care, a type of nonmedical help with day-to-day life provided by trained aides in the comfort of a senior’s own home. But how much does home care cost, and is it the right next step for your loved one?

How Is the Cost of In-Home Care Calculated?

The cost of in-home care for the elderly depends on the number of hours senior spends with a caregiver, as well as the services they need and the supplies necessary to support them.

Home care is a very individualized service, with cost fluctuations specific to the region, agency, and services provided. To plan for your loved one’s care, it’s important to understand the help they need.

The Math Behind Home Care Costs

In July and August of 2021, CareScout, a Genworth Financial company, contacted 4,195 home care providers. Put together, their collected data paints a picture of how home care costs look across the country.

  • More than 90% of home care agencies charge by the hour, though some offer discounted rates for monthly contracts.
  • The median cost of home care in the U.S. was $27 an hour in 2021. This means half of home care agencies charged less than $27 an hour, while half charged more.
  • In-home care costs vary based on a variety of factors, including geographic location, licensing requirements, and level of care required.
  • The monthly median cost of in-home, full-time care for seniors is $5,148. This is based on 44 hours of care a week, the industry standard.
  • From 2004 to 2021, the cost of in-home care services had a five-year annual compound growth rate of 5.39%. This includes an increase of 10.6% between 2020 and 2021 due to a surge in demand.

Costs of In-Home Care Vary by Need

How much will your family pay for home care based on the data above? The cost ultimately depends on a few factors, including what home care services your relative needs and how often they need support.

Before beginning your search for in-home care, consider how much help your loved one requires. Do they live alone independently but want assistance with a few chores? Or do they require full-time help due to changes in physical or cognitive abilities?

Agencies will work with each individual family to perform a needs assessment. Services that require a higher level of training or care may cost more than lower-level or more generalized care.

The family and home care aide or agency will develop a plan that can range from simple companionship to hands-on personal care and help with activities of daily living (ADLs), like dressing and bathing.

How Are Rates Structured?

Most home care aides and agencies are priced by the hour. They often have a minimum number of contracted hours — generally two to four hours a day or seven hours a week — to cover transportation and staffing costs.

Some home care agencies will offer contracts for weekly or monthly care if a family determines their elderly loved one needs significant assistance throughout the day.

In-Home Care Costs Vary by State

If you live somewhere with a high cost of living, you can expect to pay above the national median for home care. However, if your city has a relatively low cost of living, you’ll probably pay less. State regulations affect the cost of care as well; several states require special certifications, while others have capped costs for elder home care.

Genworth compiled a list of 2021’s hourly, monthly, and annual median costs of home care in each state. These numbers, which informed the following state rankings, are rounded to the nearest cent.

10 Most Expensive States for Home Care

  • Minnesota: $36.25 an hour
  • Washington: $34.50 an hour
  • Colorado: $33.50 an hour
  • New Hampshire: $32.50 an hour
  • California: $32.00 an hour
  • Oregon: $32.00 an hour
  • Rhode Island: $31.25 an hour
  • Massachusetts: $31.00 an hour
  • South Dakota: $31.00 an hour
  • Wisconsin: $30.10 an hour

10 Most Affordable States for Home Care

  • West Virginia: $18.75 an hour
  • Louisiana: $19.50 an hour
  • Mississippi: $20.00 an hour
  • Alabama: $20.20 an hour
  • Arkansas: $22.00 an hour
  • Oklahoma: $22.50 an hour
  • Georgia: $23.00 an hour
  • North Carolina: $23.00 an hourr
  • South Carolina: $23.50 an hour
  • Tennessee: $24.00 an hour

Hourly Home Care Costs in Other States

  • District of Columbia: $29.25 an hour
  • Florida: $25.00 an hour
  • Hawaii: $30.00 an hour
  • Idaho: $28.50 an hour
  • Illinois: $28.00 an hour
  • Indiana: $25.00 an hour
  • Iowa: $29.25 an hour
  • Kansas: $24.50 an hour
  • Kentucky: $25.00 an hour
  • Maine: $30.00 an hour
  • Maryland: $27.00 an hour
  • Michigan: $29.00 an hour
  • Missouri: $25.00 an hour
  • Montana: $28.00 an hour
  • Nebraska: $28.00 an hour
  • Nevada: $27.00 an hour
  • New Jersey: $29.25 an hour
  • New Mexico: $24.40 an hour
  • New York: $29.00 an hour
  • North Dakota: $29.84 an hour
  • Ohio: $26.50 an hour
  • Pennsylvania: $26.00 an hour
  • Texas: $24.00 an hour
  • Utah: $30.00 an hour
  • Vermont: $30.00 an hour
  • Virginia: $25.98 an hour
  • Wyoming: $29.00 an hour

Cost of In-Home Care: A Progression Based on Health

Home care costs increase as a senior’s needs increase — greater need means more hours of care are required. Families who choose in-home care acknowledge that they need more assistance to keep their loved ones home safely for as long as possible.

By starting home care early, seniors may be able to age in place longer without worrying about isolation, nutrition, or household responsibilities. Your home care agency will help you decide how many hours a week will benefit your family, but some common schedules and costs based on care needs are listed below.

Common Home Care Cost Plans

These price estimates, like the others cited throughout the article, are based on Genworth’s median home care cost of $27 an hour.

7 hours a week: $819 a month. Healthy, independent seniors may be able to get all the care they need from several short visits a week. Housework, companionship, meal preparation, and cleaning can be accomplished in this time frame for less than $1,000 a month. Seven hours a week is generally the minimum requirement for home care agencies, though some have higher or lower thresholds.

15 hours a week: $1,775 a month. A two-to-three-hour daily check-in can benefit seniors who need more care but are independently mobile and cognitively sound. Several hours in the morning could provide assistance with bathing, dressing, and preparing meals for the day.

30 hours a week: $3,510 a month. A 30-hour week may be ideal for seniors living with family caregivers who work or who prefer more companionship and stimulation for the elder. Thirty hours a week equates to six hours a day, or much of the time, a senior would otherwise be alone while a family caregiver is at work.

44 hours a week: $5,148 a month. Forty-four hours of care would provide coverage for a family caregiver who works full-time and doesn’t want their senior loved one to be alone. An aide could assist with all ADLs, including toileting, dining, and bathing. For aging loved ones requiring dementia care at home, incontinence assistance, or aid with other chronic conditions that prevent them from being alone safely, 44 hours a week may be an ideal schedule — assuming other arrangements are in place for nights and weekends.

Live-in home care: $10,645 a month. Agencies and private caregivers have different price structures for round-the-clock or live-in home care, depending on the number of care aides, sleeping arrangements, and room and board. How much this type of care costs varies by model. Before hiring a live-in caregiver, create a care contract including responsibilities and fees, since these can vary greatly on a case-by-case basis.

Private vs. agency home care expenses to consider

Families looking for in-home caregivers have two options: hiring a private, independent caregiver or using a licensed home care agency. There are pros and cons to hiring both independent and agency caregivers.

Private In-Home Caregiver Considerations

There’s no specific payment structure for hiring a private caregiver. These hires are contracted by the family — often through caregiver databases — and all fees, payments, and taxes are determined contractually between the caregiver and the client.

Hourly private pay home care costs in 2022 will generally be lower than agency care costs. However, it’s worth considering more than hourly rates when deciding who to hire.

*** Additional costs for the family may include conducting background checks or having an attorney review contracts. Private caregivers may not have worker’s compensation insurance, making any accidents on the job potentially costly to families.

Note: BRC maintains dependable insurance coverage for General Liability/ Surety Bond Coverage for the caregiver in the home, Worker’s Compensation coverage for our caregivers as protection for accidents and hospitalizations of caregivers. We are state licensed – so we conduct health and criminal background checks for all our caregivers. Plus, we provide training from Home Care Pulse to ensure our team is meeting the standards set by the Illinois Department of Public Health.

Agency In-Home Caregiver Considerations

Though agency care is generally slightly more expensive, it removes scheduling and paperwork burdens from families. Italso provides peace of mind: If a caregiver is sick or otherwise unable to work, the agency will provide another aide, which prevents gaps in care.

Families typically pay more for agency caregivers than for private caregivers. Agencies(like BRC) pay salaries for multiple employees as well as workers’ compensation and liability insurance, and they take care of the costs associated with taxes and payroll overhead. Plus, agencies often provide continued training for care aides or may require aides to be certified nursing assistants or companions.

Contracts, insurance, and taxes are generally already included in-home care agency costs. If your loved one uses Medicare, you’ll want to ask if the in-home care agency is Medicare-approved. Although our costs are not covered by Medicare, we are affiliated with a well-known Medicare-certified home health agency in the Chicagoland area.

Post-surgical Home Care Costs

After surgery, home care costs may differ. That’s because post-surgical home care and home health care can be more involved than standard care.

After surgery, home care costs may differ. That’s because post-surgical home care and home health care can be more involved than standard care. If your loved one has specific medical care needs, a home health care aide may be able to provide assistance and nursing in their home. This may include wound care, medication administration, regular monitoring of vital signs, and more. The median hourly cost for home health care aides is $27 an hour and may increase based on nursing degrees or level of skill.

Cost of Home Care vs. Nursing Homes and Assisted Living

A Place for Mom’s data and Genworth’s survey cite the monthly median costs of assisted living and nursing homes in 2021 at $4,640 and $8,910, respectively.[02] Compare the costs and benefits of these care types.

In-Home Care vs. Assisted Living

At $4,640 a month, the cost of assisted living is slightly lower than the $5,148-a-month cost of 44 hours a week of in-home care. It’s worth noting that these numbers have been more similar in previous years, but home care costs rose far more steeply than assisted living costs between 2020 and 2021.

These two types of care offer similar services, from help with ADLs to housekeeping and transportation. Neither is designed for seniors who need extensive medical care.

There are a few differences between assisted living and home care pricing:

  • Assisted living includes restaurant-style meals and snacks. Home care aides help with meal prep but don’t generally cover the cost of groceries.
  • Assisted living communities have on-site nighttime staff in case of an emergency.
  • Assisted living includes maintenance-free living, with costs of housing, utilities, repairs, and housekeeping included. While home care includes household tasks and chores, homeowners may still have a mortgage or rent. If they do have a mortgage, they must cover taxes and maintenance costs. They also have to arrange for maintenance independently.

In-Home Care vs. Nursing Homes

Nursing homes provide comprehensive medical care in addition to personal care services. That’s why, at about $8,910 a month for a private room, nursing homes tend to be the most expensive senior care option.

  • Nursing homes offer round-the-clock care for one inclusive price, while home care costs are hourly.
  • Nursing homes employ licensed medical professionals to assist with chronic conditions, wound care, and therapy, while home care aides generally aren’t qualified to provide medical assistance.
  • Home care aides provide one-on-one assistance, while nursing homes often have a large, rotating staff.

How to Find Home Care Near You

If you think home care may be the right choice for your aging loved one, reach out to BRC Access Care for a consultation about home care options near you.

We’ll be able to answer your questions about home care costs and benefits, and they’ll help you explore the next best steps — all at no cost to your family.

Call Sam at 224-386-5122 for information about home care in Chicagoland. Email: sam@betterresidentialcare.com

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