In home care costs

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In-Home Care Costs

Depending on the level of care needed and where you live, in-home care costs can be more expensive than the cost of an assisted living community. In-home care usually costs more in urban areas than rural ones, for example, and skilled assistance with bathing or toileting is more expensive than simple help around the house.

Most in-home care costs by caregivers charge between $20 and $40 per hour. The average yearly cost of a full-time home health aide in the U.S. is roughly $46,000, according to Genworth Financial. If you're weighing the pros and cons of in-home care and continuing care (assisted living home, etc.), here are some numbers to think about. In general, pay rates in urban areas are higher than in rural communities and still higher on the east and west coasts than in the central United States. Costs also depend on whether you're looking for homemaker services - defined as "hands-off" care, such as cooking, cleaning, running errands, and general companionship - or home health aide services, which include personal care, such as bathing and dressing.

In home care costs

An annual study of senior care rates in the U.S. conducted in 2016 by Genworth Financial found that average hourly rates for in-home care aides ranged from $16 to $28 across the country. It's important to note, though, that these are only averages, and in some cases the hourly rate may be considerably higher. According to the 2012 Genworth Financial Cost of Care Survey, these are the national averages for senior care:

  • Nursing Homes average $222 a day for a private room; $200 for a semi-private room.
  • Assisted living facilities ("typically include at least two meals per day, housekeeping, and personal care assistance, were obtained for one-bedroom apartments or private rooms with private baths in assisted living communities.") average $3,300 a month. 
  • In-Home Care averages $19 an hour for health aides; $18 an hour for homemaker/companion. Additionally, 82% of home health care agencies provide Alzheimer's training to their employees and 99% don't charge an additional fee for patients with Alzheimer's. Most home care services require a minimum of 4 hours so the minimum cost is $76 /day.

In-home care can certainly be a lower cost solution to assisted living depending on the kind of care you need, and how many daily hours you need this care.

Paying for In-Home Care

There are a number of different ways to pay for in-home care. Some of the most common ways to cover the costs associated with this senior in home care include private insurance, personal and family assets. Other ways to help pay include long-term care insurance, annuities, or life insurance. For those who qualify, veteran’s benefits, Medicare and Medicaid may also help cover the costs of in-home care.

In the year 2000 the total health care costs of Medicare and Medicaid alone require approximately 15% of the GNP.  Health care costs have grown faster than the annual inflation rate for decades. It is now the third largest industry in the U.S. economy. Because of advances in medical technology, home care had become a feasible alternative to long hospitalizations.

Alzheimer's care at home can be affordable and relatively low cost when compared to residential care. Typically, home care providers do not charge additional fees to care for individuals with Alzheimer's. This is not the case in senior living residences where Alzheimer's and dementia care usually costs an additional $1,150 per month. Alzheimer's care at home can be affordable and relatively low cost when compared to residential care. Typically, home care providers do not charge additional fees to care for individuals with Alzheimer's.

This is not the case in senior living residences where Alzheimer's and dementia care usually costs an additional $1,150 per month. Medicaid, an insurance program for low income seniors, pays for non-medical home care, home health care and other in-home supports to help the elderly remain living in their homes. However, Medicaid rules are state-specific and therefore eligibility and benefits change in every state. When Medicaid provides care outside of nursing homes, it is referred to as Home and Community Based Services (HCBS). HCBS can be covered under Regular Medicaid, often called State Plan Medicaid, or under Medicaid Waivers, also called 1915 Waivers or HCBS Waivers. Regular / State Plan Medicaid is an entitlement program, but waivers are not entitlements. A limited number of slots are available and waiting lists are fairly common. Most states cover home care (both non-medical and home health) in both their State Plan and their waivers

There are several forms of assistance from the Department of Veterans Affairs that help veterans afford home care. This may be direct financial assistance or care services that can reduce a veteran's overall need. 

To start, there are three different pension benefits which can be applied towards home care.  Individuals who require more care are eligible for higher benefit amounts. These are the Improved Pension, Homebound and Aid and Attendance. Eligibility requirements and benefit amounts are available here.  Veterans can also get care assistance through Veterans-Directed HCBS, a relatively new program that allow for self-direction of services and the VA Respite Care which can reduce the home care hours a veteran requires. 

Most states have in-home assistance programs for low income seniors who are not eligible for Medicaid.  These programs are intended to prevent or delay the placement of needy individuals in nursing homes and are loosely referred to as "nursing home diversion programs". Eligibility, benefits and even sources of funding varies with each program and some states even have more than one program. As an example of the diversity, some of these programs provide cash assistance, others provide care services and respite and still others provide non-care based in-home support such as assistance with chores, meals and transportation.

Assistance with adult day care and assistance for home modifications to enable aging in place are two other approaches the states use to help. The common thread amongst all of these programs is that they help seniors remain living at home or help families to care seniors in their homes. 

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