The national average is $34 per hour. But where you live can shift that number by 30 percent or more. Here is what drives home care pricing and what it actually costs in your area.
The number families most often hear is $30–$38 per hour. That is the national range from the Genworth Cost of Care Survey, the most widely cited source for home care pricing. It is accurate as a national average. It is not accurate as a local quote.
A home care agency in Seattle is going to quote you $45–$55 per hour. One in rural Alabama might quote $18–$22. Both are correct for their markets. The difference comes down to local caregiver wages, state labor law, and how competitive the agency market is in that zip code.
This guide covers the national numbers, the local variation, and what actually determines the rate you get quoted when you call an agency.
National median for daytime home care aide, 2024. Source: Bureau of Labor Statistics Occupational Employment and Wage Statistics, SOC 31-1120, adjusted for typical agency markup.
| Care type | Typical hourly or daily rate | Monthly at common schedules |
|---|---|---|
| Daytime aide (4–8 hrs/day) | $30–$38/hour | $2,600–$7,600/month |
| Evening / overnight | $44–$50/hour | Varies by hours needed |
| Live-in care | $250–$350/day | $7,500–$10,500/month |
| 24-hour awake care | $450–$600/day | $13,500–$18,000/month |
Live-in means an aide who sleeps in the home and is paid for a full day but is not expected to be awake all night. 24-hour awake care means two or three aides rotating shifts so there is always someone awake. The second is significantly more expensive and is typically needed only for patients with dementia or serious fall risk who cannot be left unmonitored at any hour.
The tool below looks up the typical agency rate range for your metro area, based on Bureau of Labor Statistics caregiver wage data for your region. It covers 18,000+ zip codes across the US.
When you call an agency and get a rate, that number reflects four things.
Local caregiver wages. This is the biggest driver. Agencies pay their aides at or above local minimum wage, then add payroll taxes, workers' compensation insurance, and benefits. In states with high minimum wages (California, Washington, New York), the floor is higher and the rates families pay are higher. In states with federal minimum wage or just above it, rates are lower.
Agency overhead and margin. Agencies typically charge families 1.8 to 2.5 times what the aide earns per hour. That spread covers recruiting, training, scheduling, supervision, insurance, and profit. Larger franchise agencies (Home Instead, Comfort Keepers, BrightSpring) tend to run toward the higher end of the range. Smaller independent agencies sometimes offer lower rates but with less infrastructure behind them.
Hours and schedule. Most agencies have minimum shift requirements, typically 3 or 4 hours. Short shifts cost more per hour because of travel time for the caregiver. A consistent schedule (same days, same hours each week) is usually cheaper per hour than sporadic or last-minute requests.
Level of care needed. A companion who provides company and light housekeeping costs less than a certified home health aide who does personal care. An aide with dementia-specific training or post-surgical experience commands a premium. Be specific about what your parent needs when you call, because the rate quote changes based on the care level.
Most families underestimate the monthly cost because they think in hourly rates, not in total hours. At the national median of $34 per hour, here is what common schedules cost.
| Schedule | Hours/month | At $30/hr | At $34/hr | At $42/hr |
|---|---|---|---|---|
| 4 hrs/day, 5 days/week | 80 hrs | $2,400 | $2,720 | $3,360 |
| 6 hrs/day, 5 days/week | 120 hrs | $3,600 | $4,080 | $5,040 |
| 8 hrs/day, 5 days/week | 160 hrs | $4,800 | $5,440 | $6,720 |
| 8 hrs/day, 7 days/week | 224 hrs | $6,720 | $7,616 | $9,408 |
| Live-in (7 days) | Full time | $7,500–$10,500/month (daily rate) | ||
Families almost always start with fewer hours than they end up needing. A parent who seems to need 4 hours of help per day at discharge is often needing 8 hours within three months as their condition evolves. Budget for that increase when you're projecting costs.
For part-time needs, home care is dramatically cheaper than a nursing home. For full-time supervision needs, the costs converge.
| Care setting | National median monthly cost | Best for |
|---|---|---|
| Home care (part-time, 4 hrs/day) | $2,700–$3,400/month | Stable parents who need daily help but not constant supervision |
| Home care (full-time, 8 hrs/day) | $5,400–$7,600/month | Parents who need significant daily care but can safely be alone at night |
| Assisted living | $5,500–$7,000/month | Parents who need 24-hour availability but not skilled nursing |
| Memory care | $6,000–$9,000/month | Dementia patients needing a secured environment |
| Nursing home (semi-private) | $8,000–$10,500/month | High-acuity needs requiring skilled nursing on site |
The case for home care is strongest when your parent can be safely alone for some portion of the day and night. The case for a facility gets stronger when supervision needs are continuous. Many families delay the facility transition too long because home care feels more humane and cheaper on paper, but 24-hour awake home care ($13,500–$18,000/month) is more expensive than most nursing homes.
Medicare does not cover personal home care. The daily help with bathing, dressing, meals, medication reminders, and companionship that most families picture when they think of a home care aide is entirely private pay.
What Medicare does cover: skilled home health services, meaning nursing care, physical therapy, occupational therapy, and speech therapy. These are clinical visits, not personal care. They stop when your parent no longer needs skilled intervention. The personal care needs continue after that, and you pay for them.
For detailed coverage rules, see our essay on the difference between home care and home health.
Three other funding sources worth knowing:
Long-term care insurance. If your parent purchased a policy before their diagnosis, it almost certainly covers home care. Benefit amounts vary but typically cover $150–$300 per day in care costs. Review the policy and file a claim before paying out of pocket.
Medicaid. For qualifying low-income individuals, Medicaid covers limited home care hours in most states. Eligibility and benefit levels vary significantly by state. It is worth checking even if your parent has modest assets, because the rules are more nuanced than most people expect.
Veterans benefits. The VA's Aid and Attendance benefit can pay $1,000–$2,000 per month toward in-home care for eligible veterans and surviving spouses. The application process is slow but the benefit is real.
A few approaches actually work.
Hire fewer hours strategically. An aide for the highest-risk hours (morning routine, medication time, mealtime) costs a third of what a full-day aide costs. If your parent can manage safely during the middle of the day, structure the schedule around the times when help is actually needed.
Negotiate a consistent schedule. Agencies discount for predictable, recurring schedules. A commitment to 5 days per week at the same hours is cheaper per hour than calling when you need someone. Ask the agency directly about their rates for a committed weekly schedule vs. as-needed care.
Ask about the agency's minimum shift. Some agencies require 4-hour minimums, others 3 hours. If you only need 2 hours of help, the minimum still applies. Compare minimums when you're calling multiple agencies.
Consider private hire for stable, long-term situations. Hiring an aide directly (not through an agency) cuts out the agency markup and can reduce costs by 30–40%. The tradeoff: you become the employer. You handle payroll taxes, workers' compensation, backup coverage when they're sick, and the replacement process if things don't work out. For families with the bandwidth to manage this, it is a legitimate cost reduction strategy. For families in crisis mode, it usually creates more problems than it solves.
The national median for daytime home care is $34 per hour, with most families paying $30–$38. Overnight care runs $44–$50 per hour. Rates vary significantly by location. Use the zip code tool above to look up rates for your metro area.
No. Medicare does not cover personal home care — bathing, dressing, meals, or companionship. It covers skilled home health services (nursing and therapy visits) when ordered by a doctor and the patient is homebound. Personal home care is private pay. Long-term care insurance and Medicaid (for qualifying individuals) can help cover costs.
Home care rates track local caregiver wages. In states with high minimum wages (California, Washington, New York), agencies pay aides more, and families pay more. A market like Seattle runs 25–35% above the national median. Rural areas and lower-wage states run 15–25% below. The zip code tool above shows the range for your area.
At the national median of $34 per hour, a 4-hour-per-day, 5-day-per-week schedule costs roughly $2,720 per month. Eight hours per day, 7 days per week runs about $7,600. Full-time live-in care at $300 per day is roughly $9,000–$9,300 per month.
For part-time care, yes — significantly. A nursing home runs $8,000–$10,500 per month nationally. Part-time home care (4 hours per day) runs $2,700–$3,400. But 24-hour awake home care ($13,500–$18,000 per month) costs more than a nursing home. The cost comparison depends entirely on how many hours of supervision your parent needs.
Home health — skilled nursing and therapy visits ordered by a doctor — is covered by Medicare when you qualify, so the cost to families is typically $0. Home care — personal assistance with bathing, meals, and daily activities — is private pay at $30–$38 per hour. Most families end up paying for home care while Medicare covers the clinical visits. See our guide on home care vs. home health for details.
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