How Much Does In-Home Care Cost? Hourly and 24/7 Prices for 2026

Private in-home care costs a national median of $35 an hour, according to the CareScout Cost of Care Survey 2025 (data collected July to November 2025, published March 2026). At that rate, 20 hours a week costs about $3,033 a month, 44 hours a week costs about $6,673 a month, and 24/7 care with caregivers working in shifts costs about $25,480 a month. A live-in caregiver usually costs less than round-the-clock shifts, commonly $300 to $400 or more a day.

This guide covers what drives the price, how live-in care differs from 24-hour shift care, rates in each state, the real costs of hiring a caregiver yourself, what Medicare, Medicaid, the VA and insurance will pay, and the most effective ways to cut the bill.

National in-home care rates (2025 survey)

In its 2025 survey, CareScout reports homemaker services and home health aide services together under one “non-medical caregiver” hourly rate. Both describe hands-on help at home that is not skilled nursing. Homemakers focus on household tasks, meals and companionship, while home health aides also help with bathing, dressing, toileting and moving around.

Service	National median rate	Change vs 2024 survey
Non-medical caregiver (homemaker and home health aide)	$35 per hour	+3%
Private duty nurse	$90 per hour	Not reported
Adult day health care	$95 per day	-5%

Source: CareScout Cost of Care Survey 2025.

For reference, the 2024 survey reported the two services separately: $33 an hour for homemaker services and $34 an hour for a home health aide. The small gap between the two has largely disappeared, which matches what most families see on agency rate sheets: the same aides often provide both types of help.

How much does in-home care cost per month?

Your monthly bill depends mostly on hours. Here is what the $35 national median adds up to at common schedules.

Schedule	Hours per month (avg)	Monthly cost at $35/hour	Annual cost
4 hours a day, 5 days a week (20 hrs/week)	87	$3,033	$36,400
8 hours a day, 5 days a week (40 hrs/week)	173	$6,067	$72,800
44 hours a week (CareScout benchmark)	191	$6,673	$80,080
Live-in caregiver ($300 to $400+ per day)	Day rate	$9,125 to $12,167+	$109,500 to $146,000+
24/7 shift care (168 hrs/week)	728	$25,480	$305,760

Sources: hourly rate from CareScout Cost of Care Survey 2025; live-in day rates as cited by Care.com from home care agency experts. Monthly figures are our calculations (hours per week x 52 / 12).

Many agencies set a minimum visit length, often 3 or 4 hours, and some charge more for evenings, weekends and holidays. Short visits can therefore cost more per hour than the median suggests.

How much does 24/7 in-home care cost per month?

There are two very different ways to get care around the clock, and the price gap between them is large.

24-hour shift care

With shift care, two or three caregivers rotate through the day (for example, two 12-hour shifts or three 8-hour shifts). Every caregiver is awake and working the whole time. You pay the hourly rate for all 24 hours, so at $35 an hour that is $840 a day, or about $25,480 a month. Shift care is the right choice when someone needs help overnight, wanders, falls often, needs repositioning or has advanced dementia.

Live-in care

A live-in caregiver stays in the home for several days in a row, usually 3 to 5 days a week, with a second caregiver covering the rest. The caregiver must get a real sleep period (generally around 8 hours, with a bed provided) and breaks during the day. Because they are not paid as awake and working for all 24 hours, live-in care is billed as a flat day rate. Care.com, citing home care agency experts, reports that agencies typically charge $400 a day or more for live-in care, while families hiring a caregiver directly pay about $300 a day. That puts live-in care around $9,000 to $12,000 or more a month.

Live-in care only works if your loved one generally sleeps through the night. If the caregiver is woken repeatedly, many states require those hours to be paid, and the arrangement may need to switch to shift care. Wage and hour rules for live-in workers differ by state (New York, for example, has its own “13-hour rule” for agency live-ins), so ask the agency how it handles overnight interruptions before you sign.

	Live-in care	24-hour shift care
Caregivers	1 to 2, staying for several days each	2 to 3 per day, rotating
Overnight	Caregiver sleeps; available for occasional needs	Caregiver awake all night
Typical cost	About $300 to $400+ per day	Hourly rate x 24 (about $840/day at $35)
Monthly estimate	About $9,125 to $12,167+	About $25,480
Best for	Needs constant presence but sleeps at night	Frequent overnight help, high fall risk, late-stage dementia
Needs a spare bedroom?	Yes	No

In-home care cost by state

Hourly rates vary by almost $22 between the cheapest and most expensive states. The table below lists 27 states plus the national median.

State	Median hourly rate	Monthly at 44 hrs/week	Monthly 24/7 shift care (est.)
Mississippi (lowest)	$24	$4,576	$17,472
Arkansas	$25	$4,767	$18,200
Louisiana	$26	$4,957	$18,928
Alabama	$27	$5,148	$19,656
Texas	$30	$5,720	$21,840
North Carolina	$30	$5,720	$21,840
Florida	$32	$6,101	$23,296
Georgia	$32	$6,101	$23,296
Missouri	$33	$6,292	$24,024
Oklahoma	$33	$6,292	$24,024
Ohio	$34	$6,483	$24,752
Pennsylvania	$34	$6,483	$24,752
New York	$35	$6,673	$25,480
Illinois	$36	$6,864	$26,208
Connecticut	$36	$6,864	$26,208
Arizona	$38	$7,245	$27,664
New Jersey	$38	$7,245	$27,664
Alaska	$38	$7,245	$27,664
California	$40	$7,627	$29,120
Massachusetts	$40	$7,627	$29,120
Oregon	$40	$7,627	$29,120
Hawaii	$41	$7,817	$29,848
Minnesota	$44	$8,389	$32,032
Maine	$45	$8,485	$32,396
Vermont	$45	$8,580	$32,760
Washington	$45	$8,580	$32,760
Wyoming (highest)	$46	$8,771	$33,488
U.S. median	$35	$6,673	$25,480

Source: CareScout Cost of Care Survey 2025 (hourly and 44-hour monthly figures). The 24/7 column is our estimate: hourly rate x 168 hours x 52 weeks / 12. Maine’s hourly median is $44.50, shown rounded.

Rates also vary within a state. Caregivers in big cities and wealthy suburbs usually cost more than in rural areas, though rural families sometimes have fewer agencies to choose from. You can compare local providers in our home care directory.

Agency vs independent caregiver

You can hire through a home care agency or hire a caregiver directly (sometimes through an online platform). Hiring directly usually costs less per hour, but you take on the responsibilities an agency would normally handle.

	Home care agency	Independent caregiver (you hire)
Hourly cost	Higher; the agency’s rate covers wages, taxes, insurance and overhead	Often noticeably lower, since there is no agency markup
Who is the employer?	The agency	Usually you (a “household employer”)
Payroll taxes	Handled by the agency	You withhold and pay if wages pass IRS thresholds
Background checks and training	Done by the agency (requirements vary by state)	Your responsibility
Liability and injuries	Agency carries insurance and workers’ comp	You may be liable; check homeowners policy and state workers’ comp rules
Backup if caregiver is sick	Agency sends a replacement	You find cover yourself
Supervision	Agency care manager	You or family

Household employer rules if you hire directly

A caregiver you hire, schedule and direct is generally your household employee, not an independent contractor, in the eyes of the IRS. That means:

• Social Security and Medicare taxes: if you pay one household employee $3,000 or more in cash wages in 2026, you must withhold the employee’s share and pay the employer’s share.
• Federal unemployment tax (FUTA): applies if you pay $1,000 or more in cash wages to household employees in any calendar quarter, on the first $7,000 of each employee’s wages.
• Paperwork: you will need an employer identification number, a W-2 for the caregiver and Schedule H with your own tax return. Most states also have unemployment tax and new-hire reporting rules.
• Family exemptions: wages paid to your spouse, your child under 21, or your parent (with some exceptions) are not subject to Social Security and Medicare tax, and do not count for FUTA.
• Minimum wage and overtime: federal and state wage laws can apply, and some states treat home care workers more generously than federal law does.

A household payroll service typically costs far less than an agency markup and takes care of most of this. Rules vary by state, so check with your state labor department or a tax professional.

Non-medical home care vs home health care

These two terms sound alike, but they are different services with different payers.

	Non-medical home care	Home health care
Services	Bathing, dressing, meals, light housekeeping, errands, companionship, supervision	Skilled nursing, physical/occupational/speech therapy, wound care, injections, plus part-time aide help
Who provides it	Caregivers, homemakers, home health aides	Nurses and therapists from a Medicare-certified agency
Doctor’s order needed?	No	Yes
Typical length	Ongoing, often years	Short term, tied to a recovery or condition
Who pays	Mostly private pay, Medicaid waivers, LTC insurance, VA	Medicare, Medicaid, private health insurance

Most families searching for “in-home care” need non-medical care, and that is the $35 an hour figure above.

What Medicare, Medicaid, the VA and insurance pay

Payer	Pays for non-medical home care?	What it does cover
Original Medicare	No (not on its own)	Part-time skilled home health care for people who are homebound and need skilled care, with $0 copay for covered services. Aide help is covered only alongside skilled care.
Medicare Advantage	Sometimes, limited	Some plans offer a small in-home support benefit; check the plan’s Evidence of Coverage
Medicaid	Yes, in every state, through state plan personal care or home and community-based services (HCBS) waivers	Personal care, homemaker services, respite, adult day care; waitlists are common
VA	Yes, for eligible veterans	Homemaker and home health aide care, respite care, Veteran Directed Care, and the Aid and Attendance pension
Long-term care insurance	Yes, if the policy includes home care	Pays a daily or monthly benefit after an elimination period once you need help with 2+ daily activities or have severe cognitive impairment

Medicare

Medicare will not pay for a caregiver to provide only personal care or companionship, and it never pays for 24-hour care at home. It does cover intermittent skilled nursing and therapy at home when a doctor certifies you are homebound. Our guide on whether Medicare covers home health care explains the eligibility rules in detail. If your loved one has a terminal illness, Medicare’s hospice benefit also brings care into the home; see who pays for hospice care at home.

Medicaid

Medicaid is the largest public payer of long-term home care. Each state runs its own programs, with its own financial limits and level-of-care requirements, and many HCBS waivers have waiting lists. Contact your state Medicaid agency or local Area Agency on Aging to apply.

VA benefits

Enrolled veterans who need help with daily activities may qualify for VA Homemaker and Home Health Aide care, VA respite care (at home, in adult day health care or in a nursing home) and Veteran Directed Care, which gives a budget the veteran can use to hire their own caregivers, including some family members. A copay may apply depending on disability rating and income.

Veterans and surviving spouses who pay for care themselves may also qualify for the VA pension with Aid and Attendance. Effective December 1, 2025, the maximum annual rate is $29,093 for a veteran with no dependents (about $2,424 a month) and $34,488 for a veteran with one dependent (about $2,874 a month), with a net worth limit of $163,699. Unreimbursed home care costs can be deducted from income when calculating eligibility. Read more in our VA Aid and Attendance guide.

Long-term care insurance

Check whether the policy covers home care (most newer policies do), whether it requires a licensed agency or allows an independent caregiver or family member, how long the elimination period is, and whether the daily benefit covers your local rate.

In-home care vs assisted living, memory care and nursing home

Part-time home care is usually the most affordable option. Full-time home care is not. Once care needs climb past about 44 hours a week, assisted living often becomes cheaper, and 24/7 shift care costs more than a private nursing home room.

Type of care	National median	Monthly equivalent
Adult day health care	$95 per day	$2,058 (5 days a week)
In-home care, 20 hours a week	$35 per hour	$3,033
Assisted living	$6,200 per month	$6,200
In-home care, 44 hours a week	$35 per hour	$6,673
Memory care	$6,690 per month	$6,690
Nursing home, semi-private room	$315 per day	$9,581
Live-in home care	About $300 to $400+ per day	About $9,125 to $12,167+
Nursing home, private room	$355 per day	$10,798
In-home care, 24/7 shifts	$35 per hour	About $25,480

Sources: CareScout Cost of Care Survey 2025; A Place for Mom 2025 move-in data (memory care); Care.com (live-in day rates). 20-hour and 24/7 figures are our calculations.

Remember that home care costs are on top of normal living costs (housing, food, utilities, home modifications), while assisted living and nursing homes include room and board. For a full picture, see our guides to assisted living costs, memory care costs and nursing home costs, or browse the assisted living directory to compare local prices.

Ways to cut the cost of in-home care

1. Mix home care with adult day care. At $95 a day, adult day health care costs far less than the roughly $280 you would pay for 8 hours of home care at the median rate. Many families use adult day care on weekdays and a caregiver for mornings, evenings or weekends.
2. Use respite care to support family caregivers. Short breaks keep family caregivers from burning out, which is what usually forces a costly move. Medicaid waivers, the VA and many local programs fund respite.
3. Tap the National Family Caregiver Support Program. Run through local Area Agencies on Aging, this federal program offers counseling, training, respite and sometimes supplemental services to family caregivers. Find your local office through the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov.
4. Get paid as a family caregiver through Medicaid self-direction. According to KFF’s 2025 survey of state Medicaid programs, 49 of 50 states allow enrollees to self-direct home care in some programs, and all responding states pay family caregivers in some circumstances. Rules on paying spouses are stricter: they can generally be paid only through waivers and only for care beyond what a spouse would normally provide. Some states also offer “structured family caregiving,” which pays a daily stipend to a family member who lives with the person. Ask your state Medicaid agency which programs are available.
5. Look into PACE. The Program of All-Inclusive Care for the Elderly, available in many areas, combines Medicare and Medicaid to provide medical care, adult day care and in-home help for people 55 and older who need nursing-home-level care but want to stay home.
6. Hire directly and use a payroll service. You avoid the agency markup but stay compliant with tax rules. Factor in your time for screening and backup cover.
7. Batch tasks into fewer, longer visits. Agencies often have 3 to 4 hour minimums, so scheduling around them avoids paying for unused time.
8. Use technology for gaps. Medication dispensers, fall detection devices and video check-ins can reduce the number of paid hours needed for supervision.
9. Claim tax breaks. Qualified long-term care services for a chronically ill person can be deductible medical expenses above 7.5% of adjusted gross income. If you support a parent, you may be able to claim them as a dependent or use a dependent care FSA. Ask a tax professional.

How to estimate your own home care budget

1. List daily needs. Write down when help is needed (mornings, meals, bedtime, overnight) and what kind.
2. Count weekly hours. Be realistic about how many hours family can cover without burning out.
3. Get two or three local quotes. Ask about hourly rates, minimum shifts, weekend and holiday rates, and live-in day rates.
4. Multiply. Weekly hours x hourly rate x 52 / 12 gives your monthly cost.
5. Subtract funding. Deduct any long-term care insurance, VA benefit or Medicaid hours.
6. Revisit every few months. Needs usually grow. When hours pass about 44 a week, compare assisted living or memory care.

FAQs

How much does private home care cost per hour?

The 2025 national median is $35 an hour for a non-medical caregiver, according to CareScout. State medians range from $24 in Mississippi to $46 in Wyoming. A private duty nurse costs a median of $90 an hour.

How much does 24/7 in-home care cost per month?

Around-the-clock shift care costs about $25,480 a month at the $35 national median hourly rate. A live-in caregiver costs much less, roughly $9,125 to $12,167 or more a month at typical day rates of $300 to $400 or more.

What is the difference between live-in care and 24-hour care?

A live-in caregiver stays in the home, sleeps there and is paid a flat day rate. 24-hour care uses rotating shifts of caregivers who are awake and working the whole time, paid hourly. Live-in care is cheaper, but it only suits people who sleep through most nights.

Does Medicare pay for in-home care?

Medicare does not pay for non-medical home care such as help with bathing, meals or companionship on its own, and it never covers 24-hour care. It does cover part-time skilled home health care for people who are homebound and need skilled nursing or therapy.

Will Medicaid pay a family member to be a caregiver?

In most states, yes, through self-directed Medicaid home care programs. Paying spouses is more restricted and usually only allowed under waivers for “extraordinary care.” Rules and waitlists vary by state, so check with your state Medicaid agency.

Is it cheaper to hire a caregiver privately or through an agency?

Hiring privately usually costs less per hour, but you become a household employer. If you pay $3,000 or more in cash wages in 2026, you must handle Social Security and Medicare taxes, and you are responsible for screening, insurance and backup care.

Is home care cheaper than assisted living?

For part-time help, yes. At 20 hours a week, home care costs about $3,033 a month versus a $6,200 median for assisted living. Above about 44 hours a week, home care usually costs more, and you still pay for housing and food separately.

Is home care cheaper than a nursing home?

Up to full-time hours, yes. But 24/7 shift care at home (about $25,480 a month) costs more than double a private nursing home room ($10,798 a month median).

Does long-term care insurance cover home care?

Most policies do, once you need help with at least two activities of daily living or have severe cognitive impairment, and after the elimination period. Some policies only pay licensed agencies, so check before hiring an independent caregiver.

Are home care costs tax deductible?

Qualified long-term care services for someone who is chronically ill can count as medical expenses, deductible above 7.5% of adjusted gross income if you itemize. Ask a tax professional how this applies to your situation.

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Related guides

• Does Medicare cover home health care?
• How much does assisted living cost?
• Who pays for hospice care at home?