Home health care costs a national median of $35 per hour in 2025, which adds up to roughly $6,300 per month if you’re paying for 44 hours of care per week. That’s the baseline for non-medical caregiving, but your actual cost depends on the type of care, where you live, how many hours you need, and how you pay for it.
What the National Averages Look Like
The 2025 CareScout Cost of Care Survey (formerly the Genworth survey, the most widely cited benchmark in the industry) puts the national median for non-medical caregiver services at $35 per hour. That category covers both home health aides, who help with personal care like bathing and dressing, and homemaker services like meal prep and light housekeeping. At 44 hours per week, the standard benchmark for “full-time” home care, the annual tab comes to about $80,080.
Most families don’t need 44 hours a week right away. If you’re hiring someone for 20 hours a week to help a parent who’s mostly independent, you’re looking at closer to $3,000 per month at the national median. On the other end of the spectrum, around-the-clock care (24 hours a day, 7 days a week) can run $24,000 or more per month. That figure alone explains why many families piece together a mix of part-time professional care and family caregiving.
Non-Medical Care vs. Skilled Nursing
The single biggest factor in your cost is the type of care needed. Non-medical caregivers handle daily living tasks: helping someone get dressed, preparing meals, providing companionship, and running errands. This is what most people picture when they think of home care, and it’s what that $35 per hour median covers.
Skilled home health care is a different tier. It involves licensed nurses or therapists performing medical tasks like wound care, medication management, injections, or physical therapy. These services cost significantly more per hour because of the clinical training required. If your family member needs medical attention at home rather than just daily living support, expect to pay a premium over the standard non-medical rate.
How Costs Vary by Location
Where you live can nearly double your home care bill. Based on 2024 survey data from the Federal Long Term Care Insurance Program, the daily cost of six hours of home care ranges from $132 in parts of Alabama to $264 in the Seattle and Minneapolis metro areas. That’s a $132-per-day difference for the same amount of help.
The most expensive markets for home care cluster in the Pacific Northwest, California, Minnesota, and Alaska. Seattle and Minneapolis top the list at $264 per day for six hours, followed by the San Francisco and Sacramento areas at $240. The least expensive markets tend to be in the Deep South and parts of Texas and Arkansas: cities like Anniston, Alabama ($132), Albany, Georgia ($138), and Shreveport, Louisiana ($138). If you’re budgeting for care, start by looking up rates in your specific metro area rather than relying on national averages.
Agency Care vs. Hiring Independently
Families have two basic hiring options, and the cost gap between them is substantial. Home care agencies handle recruitment, background checks, payroll taxes, insurance, and substitute coverage if your caregiver calls in sick. For that convenience, agencies typically charge 30 to 50% more than what an independent caregiver would cost.
Hiring a private caregiver directly can save you 20 to 30% on the hourly rate. But you take on real responsibilities: verifying credentials, running background checks, withholding payroll taxes, carrying workers’ compensation insurance, and finding backup care when your caregiver is unavailable. For families on a tight budget who are comfortable managing those logistics, independent hiring can make long-term care more affordable. For families who want a hands-off arrangement, the agency premium buys genuine peace of mind.
What Medicare Covers (and What It Doesn’t)
Medicare pays 100% of covered home health services with no copay, but the eligibility rules are narrow. You qualify only if a healthcare provider certifies that you need part-time or intermittent skilled care (nursing or therapy, not just help with daily tasks) and you’re considered “homebound,” meaning leaving your home is a major effort due to illness or injury. A face-to-face assessment is required before services begin, and the care must be provided by a Medicare-certified home health agency.
The critical limitation: Medicare does not cover custodial care. That means if the only help you need is bathing, dressing, cooking, or housekeeping, Medicare won’t pay for it. It also won’t cover 24-hour care, meal delivery, or homemaker services unrelated to a medical care plan. Since custodial care is exactly what most families are shopping for when they search for home health care costs, Medicare is often not the answer. You do pay 20% of the Medicare-approved amount for any durable medical equipment (hospital beds, wheelchairs) ordered as part of your home health plan, after meeting the Part B deductible.
Other Ways to Pay
Medicaid is the largest payer of long-term home care in the U.S., but coverage varies dramatically by state. Most states offer Home and Community-Based Services (HCBS) waivers that cover non-medical home care for people who would otherwise need nursing home placement. To qualify, you generally must meet both income and asset limits and demonstrate a nursing-home level of need. Many states have waiting lists for these waivers, sometimes stretching months or even years.
Long-term care insurance, if you already have a policy, typically covers home health care after an elimination period of 30, 60, or 90 days (chosen when you bought the policy) during which you pay out of pocket. Most policies then reimburse your costs up to a preset daily limit until you hit a lifetime maximum. If you’re looking at a potential $6,300 monthly bill and your policy covers $150 per day, that’s $4,500 per month offset by insurance, leaving you responsible for the remainder.
Veterans may qualify for home care through the VA’s Aid and Attendance benefit or the Veterans Directed Care program. And for families paying entirely out of pocket, some agencies offer sliding-scale fees or reduced rates for longer-term contracts.
How Costs Are Trending
Home care costs have been climbing steadily, driven by caregiver shortages and rising wages. The national median hourly rate rose 3% from 2024 to 2025. Federal reimbursement rates for Medicare home health services are set to increase 2.4% in 2026, a figure that reflects a 3.2% baseline increase offset by a productivity adjustment. These numbers suggest families should plan for annual cost increases in the 2 to 4% range for the foreseeable future.
For context, if you’re paying $6,300 per month today, a 3% annual increase puts you at roughly $6,490 next year and $7,300 within five years. Families planning care for a parent in their 70s or 80s should build that escalation into their financial projections rather than budgeting based on today’s rates alone.
Home Care vs. Nursing Home Costs
Full-time home care at the national median runs about $6,300 per month. A semi-private room in a nursing home costs a median of $9,277 per month. That makes home care roughly 32% cheaper for comparable hours of supervision, and most people strongly prefer staying in their own home. The math shifts, though, when care needs are heavy. If someone requires 24-hour supervision, home care can exceed $24,000 per month, making a nursing facility the more affordable option. The break-even point for most families is somewhere around 12 to 16 hours of daily home care, at which point facility costs start to look competitive.