On this page
Most people say they want to stay home as they age. It sounds cheaper too — no facility, no room-and-board markup, just some help around the house. Sometimes that is true. Sometimes a few hours of home care a day quietly adds up to more than a nursing home.
The answer depends on how many hours of help you need. Part-time home care is one of the cheapest options in the care world. Round-the-clock home care is one of the most expensive. Here is how the math works with current national numbers.
What home care costs right now
The CareScout Cost of Care Survey tracks two kinds of in-home help. Homemaker services cover non-medical tasks: cooking, cleaning, laundry, running errands. Home health aides handle personal care: bathing, dressing, feeding, and getting in and out of bed.
In the 2024 survey, the national annual medians were:
- Homemaker services: $75,504 a year, based on 44 hours a week
- Home health aide: $77,792 a year, based on 44 hours a week
Two details stand out. First, homemaker rates jumped 10% that year, the biggest increase of any care type alongside assisted living. CareScout found that two-thirds of home care agencies now charge the same rate for homemaker and aide services, even though homemaker work is less clinical. The old discount for “just help around the house” is disappearing.
Second, labor costs are the top driver. Home care is almost entirely wages, and agencies are competing for workers in a tight market. When wages rise, there is no other cost to absorb it.
The 2025 survey added a new category worth knowing about: private duty nursing, meaning skilled nursing delivered at home. The national median runs $90 an hour, or $160 per visit. If a parent needs an actual nurse rather than an aide, the hourly rate roughly triples.
The hours make the price
Home care is sold by the hour, so the weekly schedule decides everything. Using a $33-an-hour blended rate, roughly in line with the survey medians:
- 10 hours a week (light help, a few visits): about $17,000 a year
- 20 hours a week (daily check-ins, meal help): about $34,000 a year
- 44 hours a week (full workday coverage): about $75,000–$78,000 a year
- 24/7 care (168 hours a week): well over $250,000 a year with an agency
At ten or twenty hours a week, home care beats every facility option by a wide margin. At 44 hours a week, it lands right around the cost of assisted living at $74,400 a year nationally. And once you need round-the-clock supervision — common with advanced dementia — a nursing home at $114,975 a year for a semi-private room is often cheaper than staffing a house around the clock.
That crossover surprises people. The intuition is that home is always cheaper. The reality is that a facility spreads staffing costs across many residents, while at home you pay for every hour yourself.
Home care vs nursing home: the honest comparison
A nursing home’s $115,000-a-year median covers room, board, meals, and 24-hour staffing. Home care at 44 hours a week costs roughly $78,000 but covers none of the household’s other expenses — the mortgage or rent, utilities, food, and home maintenance continue on top.
Home care also has gaps a facility does not. An aide who calls in sick leaves a gap unless the agency sends a substitute. Overnight coverage is the hardest shift to fill. And family members usually absorb the unpaid hours around the aide’s schedule, which has a real cost in lost work and burnout even though no invoice arrives.
Where home care clearly wins:
- The need is part-time — under 30 hours a week or so
- The person values staying home enough that the premium is worth it
- Family can cover nights and weekends reliably
- Medical needs are light — no skilled nursing required
Where a facility usually wins on the math:
- Supervision is needed around the clock, especially for wandering or fall risk
- Skilled nursing is required regularly ($90 an hour adds up fast)
- The home itself needs expensive modifications for safety
- Family caregivers are burning out, which happens more often than anyone plans for
Adult day care: the middle option nobody prices
One setting families overlook is adult day health care. The 2025 survey puts the national median at $95 a day, or $24,700 a year for five days a week. That buys supervision, meals, activities, and some health services during working hours. For a family caregiver who works, combining adult day care with a few hours of morning and evening home help can cost far less than full-time home care or a facility.
How people pay for home care
Medicare covers home health only in narrow circumstances — part-time skilled care ordered by a doctor after a hospital stay, and only for a limited period. It does not pay for long-term personal care or homemaker services.
That leaves private pay, long-term care insurance (most policies cover home care, often at the full daily benefit), Medicaid waiver programs for those who qualify financially, and veterans benefits. Because policies and programs treat home care differently from facility care, it pays to check exactly what your coverage includes before you need it.
If traditional long-term care insurance is out of reach, several alternatives can still help cover care costs, from hybrid policies to short-term care insurance designed for exactly this kind of need.
The bottom line
Home care is the cheapest option when the need is part-time and the most expensive when the need is round-the-clock. At about 44 hours a week it costs roughly the same as assisted living; past that, a nursing home usually wins on price. Map the hours honestly, price all three settings, and remember that the house itself still costs money on top of the aide’s invoice.
