Home Care Costs: Facts and Figures

home-care-costsFor many seniors living at home is a priority, as they don’t want to leave familiar surroundings and they want to maintain their independence. Home care enables seniors to maximize their independence through the use of caregivers to cover specific areas of assistance.

The cost of home care is primarily determined by the number of hours worked by the caregiver per day and the other services and supplies required. The services provided by home health aides include assistance with activities of daily living and homemaker services.

Home Care Costs by State

Home care costs vary nationwide. In the 2015 Cost of Care Survey conducted by Genworth Financial, home care costs showed an increase of 1.27% compared to the 2015 costs and the national median monthly rate is $20 per hour. Senior who use home care to supplement their independence can typically expect a 1.03% annual increase in their base rate.

The table below shows the range of hourly rates by state in 2015* for a home health aide providing personal care, not medical care.

StateMinimumMedianMaximum
Alabama$13$17$27
Alaska$24$26$29
Arizona$14$20$25
Arkansas$11$17$21
California$12$23$35
Colorado$13$22$31
Connecticut$16$22$33
Delaware$18$22$25
District of Columbia$19$22$23
Florida$10$19$29
Georgia$8$18$33
Hawaii$18$25$30
Idaho$17$20$26
Illinois$15$22$33
Indiana$13$20$28
Iowa$18$23$30
Kansas$15$20$35
Kentucky$16$19$24
Louisiana$8$16$31
Maine$16$22$34
Maryland$11$20$27
Massachusetts$16$25$34
Michigan$10$21$28
Minnesota$16$25$35
Mississippi$15$17$25
Missouri$10$19$28
Montana$21$23$25
Nebraska$20$23$26
Nevada$17$22$25
New Hampshire$21$24$29
New Jersey$11$21$26
New Mexico$11$20$28
New York$10$23$36
North Carolina$9$18$25
North Dakota$18$27$30
Ohio$16$20$30
Oklahoma$17$20$27
Oregon$18$23$28
Pennsylvania$13$21$28
Rhode Island$24$25$29
South Carolina$16$19$27
South Dakota$20$23$40
Tennessee$12$18$28
Texas$8$19$35
Utah$15$21$30
Vermont$11$22$28
Virginia$14$19$28
Washington$16$24$38
West Virginia$14$16$24
Wisconsin$16$22$35
Wyoming$19$22$24
*From the Genworth Financial 2015 Cost of Care Survey.

The states with the most expensive median hourly home care costs are:

  1. North Dakota - $27
  2. Alaska - $26
  3. Hawaii, Massachusetts, Minnesota, Rhode Island - $25

The states with the least expensive median hourly home costs are:

  1. Louisiana, West Virginia - $16
  2. Alabama, Arkansas, Mississippi - $17
  3. Georgia, North Carolina, Tennessee - $18

How are Home Care Costs Calculated

A potential client will receive an estimate of home care costs based upon the outcome of a comprehensive assessment of needs conducted by a licensed nurse with the home care agency. In some cases, home care agencies charge an assessment fee that may or may not be refundable upon provision of a set number of care hours. There are several ways a client may be charged.

  • Hourly Rates: Home care costs are most commonly assessed at an hourly rate, particularly for clients who remain independent in the majority of their activities of daily living but would benefit from companionship and/or limited assistance. In almost all cases, home care agencies establish a minimum number of hours per day such as two or four hours for staffing purposes.
  • Daily Rates: This method of billing is used when a client requires around-the-clock assistance and/or supervision. Instead of charging an hourly rate, home care agencies determine a daily rate that remains equitable given the fact that breaks and sleep are required for the caregiver. Home care costs based on a daily rate typically range from $200.00 per day to $350.00 per day, once again depending upon the cost of living within a particular region.
  • Overnight Rates: Overnight rates are also offered by home care agencies to ensure safety and security of clients who may get up frequently during the night or wander due to dementia or Alzheimer’s disease. This option is particularly helpful to family caregivers and/or couples when one spouse acts as the primary caregiver and desperately needs to sleep well during the night. Rates for overnight care range from $120.00 to $200.00 and typically consist of a 10 to 12 hour caregiver shift.

How do Families Pay for Home Care

While Medicare covers some home health care costs, as these services are medically necessary, personal care services are not covered. Therefore, home care services are typically paid for privately or by long-term care insurance policies.

For this reason, home care can often become cost prohibitive for seniors who require a significant amount of assistance and/or supervision. In such cases, assisted living communities that provide daily meals, housekeeping and activities of daily living may be a more affordable option to consider.

Written by gerontologist Sara Shelton and Andrea Watts.