How much does home care cost per hour in 2026?

National averages in 2026: homemaker/companion services cost $26–$30 per hour, home health aides cost $27–$34 per hour, certified nursing assistants cost $30–$38 per hour, licensed practical nurses cost $35–$50 per hour, and registered nurses cost $50–$80 per hour. At 44 hours per week, a home health aide costs approximately $68,000 per year.

Is home care cheaper than a nursing home?

It depends on how many hours of care you need. At 20 hours per week, home care costs about $28,000–$35,000 per year — far less than a nursing home ($104,000–$116,000). At 44 hours per week, home care costs $61,000–$68,000 — still cheaper. But once you need 24/7 care (live-in or around-the-clock shifts), home care can cost $144,000–$250,000+ per year, making a nursing home the more economical choice.

Does Medicare cover home care costs?

Medicare covers home health care (skilled nursing, physical therapy, occupational therapy, speech therapy) if you are homebound and have a doctor's order. Medicare does NOT cover non-skilled home care services like bathing, dressing, cooking, housekeeping, or companionship — which is what most people mean by 'home care.' Medicaid may cover some non-skilled home care through waiver programs in many states.

Home Care Costs in 2026: What In-Home Care Really Costs by Type & State

Home care lets you receive help with daily tasks in your own home — from light housekeeping to skilled nursing. For most people, it’s the preferred way to age, and at moderate hours it’s the most affordable form of long-term care.

Quick answer: In 2026, a home health aide costs about $27–$34/hour nationally. At 44 hours per week, that’s roughly $68,000/year. Home care is cheaper than a nursing home ($104,000–$116,000) for most care levels, but once you need 24/7 care, it becomes the most expensive option at $144,000–$250,000+/year. Medicare covers only skilled home health care (nursing, therapy), not non-skilled personal care (bathing, meals, housekeeping).

Types of Home Care and Their Costs

Type of Caregiver	What They Do	Hourly Rate	20 hrs/wk (Annual)	44 hrs/wk (Annual)
Companion/sitter	Conversation, supervision, light housekeeping	$22–$28	$23,000–$29,000	$50,000–$64,000
Homemaker	Cooking, cleaning, laundry, errands	$24–$30	$25,000–$31,000	$55,000–$69,000
Home health aide (HHA)	Personal care (bathing, dressing, toileting), medication reminders	$27–$34	$28,000–$35,000	$62,000–$78,000
Certified nursing assistant (CNA)	Personal care + basic vital signs, higher training	$30–$38	$31,000–$40,000	$69,000–$87,000
Licensed practical nurse (LPN)	Wound care, medication administration, IV therapy	$35–$50	$36,000–$52,000	$80,000–$114,000
Registered nurse (RN)	Complex medical care, assessments, care planning	$50–$80	$52,000–$83,000	$114,000–$183,000

Home Care Costs by State

State	Homemaker ($/hr)	Home Health Aide ($/hr)	HHA Annual (44 hrs/wk)
Alabama	$21	$22	$50,000
Alaska	$34	$36	$82,000
Arizona	$26	$29	$66,000
Arkansas	$21	$23	$53,000
California	$30	$34	$78,000
Colorado	$28	$30	$69,000
Connecticut	$28	$30	$69,000
Delaware	$26	$28	$64,000
Florida	$24	$27	$62,000
Georgia	$22	$24	$55,000
Hawaii	$30	$32	$73,000
Idaho	$25	$27	$62,000
Illinois	$26	$28	$64,000
Indiana	$24	$27	$62,000
Iowa	$25	$27	$62,000
Kansas	$24	$26	$60,000
Kentucky	$22	$24	$55,000
Louisiana	$20	$22	$50,000
Maine	$28	$30	$69,000
Maryland	$25	$27	$62,000
Massachusetts	$30	$33	$75,000
Michigan	$25	$27	$62,000
Minnesota	$30	$34	$78,000
Mississippi	$20	$22	$50,000
Missouri	$22	$24	$55,000
Montana	$27	$29	$66,000
Nebraska	$26	$28	$64,000
Nevada	$25	$27	$62,000
New Hampshire	$28	$30	$69,000
New Jersey	$27	$29	$66,000
New Mexico	$24	$26	$60,000
New York	$28	$30	$69,000
North Carolina	$22	$24	$55,000
North Dakota	$28	$30	$69,000
Ohio	$23	$25	$57,000
Oklahoma	$22	$24	$55,000
Oregon	$28	$32	$73,000
Pennsylvania	$25	$27	$62,000
Rhode Island	$28	$30	$69,000
South Carolina	$21	$23	$53,000
South Dakota	$25	$27	$62,000
Tennessee	$21	$23	$53,000
Texas	$22	$24	$55,000
Utah	$24	$26	$60,000
Vermont	$28	$30	$69,000
Virginia	$23	$25	$57,000
Washington	$30	$34	$78,000
West Virginia	$21	$23	$53,000
Wisconsin	$25	$27	$62,000
Wyoming	$27	$29	$66,000

Cost by Hours Per Week

Hours/Week	Homemaker (Annual)	Home Health Aide (Annual)	Comparison to Facility Care
10 hours	$12,500–$15,600	$14,000–$17,700	Much less than any facility
15 hours	$18,700–$23,400	$21,100–$26,500	Much less than any facility
20 hours	$25,000–$31,200	$28,000–$35,400	Less than assisted living ($64K)
30 hours	$37,400–$46,800	$42,100–$53,000	Still less than assisted living
40 hours	$49,900–$62,400	$56,200–$70,700	About equal to assisted living
44 hours	$54,900–$68,600	$61,800–$77,800	Roughly equal to assisted living
60 hours	$74,900–$93,600	$84,200–$106,000	More than assisted living, less than nursing home
24/7 (live-in)	$120,000–$156,000	$144,000–$183,000	Comparable to or more than nursing home
24/7 (shift work)	$175,000–$219,000	$197,000–$248,000	Much more than nursing home

Live-In Care vs. Shift Care

Factor	Live-In Care	Shift Care (24/7)
How it works	One caregiver lives in your home, available 24/7	Two or three 8-hour shifts (3 different caregivers)
Daily cost	$250–$350	$500–$750
Annual cost	$91,000–$128,000	$183,000–$274,000
Sleep	Caregiver sleeps at home; wakes for nighttime needs	Active caregiver awake all 24 hours
Consistency	One person knows your routine	Multiple caregivers with less continuity
Best for	Mostly independent but needs overnight presence	Active nighttime care needs (wandering, incontinence)
Room required	Yes — private bedroom for caregiver	No

Agency vs. Independent Caregivers

Factor	Home Care Agency	Independent Caregiver
Hourly cost	$27–$40+	$18–$28
Annual savings (at 44 hrs/wk)	N/A	Save $15,000–$30,000/year vs. agency
Background checks	Agency conducts them	You must conduct and verify
Backup if caregiver is sick	Agency provides substitute	You must find replacement
Payroll/taxes	Agency handles everything	You are the employer (payroll, workers’ comp, taxes)
Liability insurance	Agency provides	You may need separate coverage
Training/supervision	Agency manages	You manage
Quality control	Agency monitors	You monitor
Scheduling	Agency manages	You manage

Being the Employer: Hidden Costs

Expense	Estimated Cost
FICA employer share (7.65%)	$4,000–$5,500/year
Workers’ compensation insurance	$500–$2,000/year
Unemployment insurance	$200–$500/year
Payroll service (optional)	$50–$150/month
Background check	$25–$100 per caregiver
Total employer cost	$5,000–$8,000/year

Even with employer costs, hiring independently saves $7,000–$22,000/year vs. an agency.

What Medicare Covers (Home Health Care)

Service	Covered?	Requirements
Skilled nursing (RN/LPN)	Yes	Doctor’s order, must be homebound, intermittent care
Physical therapy	Yes	Doctor’s order, must be homebound
Occupational therapy	Yes	Doctor’s order, must be homebound
Speech therapy	Yes	Doctor’s order, must be homebound
Medical social worker	Yes	Part of home health plan of care
Home health aide (with skilled care)	Yes	Only if also receiving skilled nursing or therapy
Home health aide (without skilled care)	No	Not covered by Medicare
Homemaker services only	No	Never covered by Medicare
24/7 nursing care at home	No	Medicare only covers intermittent visits
Meal preparation, housekeeping	No	Never covered by Medicare

Key distinction: Medicare covers skilled, intermittent home health care (a nurse visiting a few times a week for wound care or therapy). It does not cover ongoing personal care (bathing, dressing, meal prep) — which is the expensive, everyday need.

Other Ways to Pay for Home Care

Source	What It Covers	Typical Amount
Long-term care insurance	All home care types per policy	$3,000–$10,000/month
Medicaid HCBS waivers	Personal care, homemaker services	$1,000–$3,000/month (varies by state)
Veterans Aid & Attendance	Home care for qualifying veterans	Up to $2,431/month (veteran + spouse)
PACE (Program of All-Inclusive Care for the Elderly)	Comprehensive home and community care	Covered if Medicaid-eligible
Area Agency on Aging	Subsidized home care, meals, transportation	Income-based sliding scale
State home care programs	Varies by state	Many have waiting lists
Tax deductions	Medical expense deduction for qualifying care	Save 22–37% on costs above 7.5% AGI
Dependent Care FSA / Tax Credit	If caring for dependents	Up to $3,000–$6,000 credit

How Home Care Costs Compare Over Time

Year	Home Health Aide (44 hrs/wk Annual)	Assisted Living (Annual)	Nursing Home Private (Annual)
2015	$48,000	$48,000	$92,000
2020	$55,000	$54,000	$106,000
2026	$68,000	$64,000	$116,000
2030 (projected)	$77,000	$73,000	$132,000
2035 (projected)	$89,000	$85,000	$153,000

When Home Care Makes Sense vs. Facility Care

Your Situation	Recommendation
Need help 10–20 hours/week	Home care — much cheaper than any facility
Need help 30–40 hours/week	Home care still competitive with assisted living
Need help 50+ hours/week	Assisted living is likely more cost-effective
Need 24/7 care	Nursing home is typically cheapest for total care
Have dementia (wandering risk)	Facility care is usually safer and cheaper
Strong preference for home	Home care at any level — if budget allows
Live alone with no local family	Facility may be better for safety and socialization

Tips to Reduce Home Care Costs

Strategy	Potential Savings
Hire independently (not through agency)	Save 20–40% on hourly rate
Combine professional care with family help	Family covers evenings/weekends
Use adult day care during weekdays	$75/day vs. $35/hour for home aide
Apply for Medicaid waiver programs	State may cover 10–30 hours/week
Check Area Agency on Aging programs	Subsidized care, meals, transportation
Use technology (medical alert, smart home)	Reduce hours needed per week
Negotiate with agency for long-term contract	5–15% discount for committing to 6+ months

Bottom Line

Home care is the most flexible and often most affordable form of long-term care — at moderate hours. A home health aide at 20 hours/week costs $28,000–$35,000/year, making it accessible for many retirees. But costs escalate quickly: at 44 hours/week it’s $62,000–$78,000, and 24/7 care can exceed $180,000/year — more than a nursing home. The key is matching the right amount of care to your actual needs and combining professional care with family help, technology, and community programs to keep costs manageable.