October 31st 2025
By Ari Parker
Discover the real costs of 24/7 in-home care, including hourly rates, monthly expenses, and insurance coverage options to help you plan and budget for long-term care needs.
By Ari Parker
When a loved one needs constant supervision and assistance, 24/7 in-home care can seem an ideal solution. It allows them to remain in familiar surroundings while receiving the support they need to stay safe. That said, it comes with significant costs.
In-home care costs vary significantly depending on your location, the level of care needed, and the type of caregiver you’re hiring. Knowing what to expect based on your loved one’s needs can help you plan effectively and make the best decisions for your family.
The national median cost for 24/7 home health aid services is approximately $24,753 monthly—but prices vary significantly by location and care level required.
Care costs increase with medical complexity, specialized skills needed, and your location.
Most families use multiple payment strategies to cover 24/7 care, including long-term care insurance, Medicaid waivers, Veterans benefits, and private funds.
24/7 in-home care is constant supervision and assistance within an individual’s home. It’s a strong option for people who can’t safely be left alone due to medical conditions, cognitive impairments, or physical limitations.
With 24/7 in-home care, caregivers work in shifts around the clock to ensure that someone is always on hand to help with Activities of Daily Living (ADLs), medication management, and emergency assistance.
There are different types of professionals who may work together to provide 24/7 in-home care. These roles include:
Personal care aids
Home health aids
Certified nursing assistants
Licensed practical nurses
Registered nurses
Personal care aids do not have medical training but may help with light housekeeping and ADLs.
Home health aids receive some medical training and can monitor the patient’s condition. They may also help with light housekeeping and ADLs.
There are different types of 24/7 in-home care providers, including professional caregivers hired through agencies, independent caregivers, and family caregivers.
When you hire professional caregivers through an agency, they work in rotating shifts to provide continuous coverage. The agency handles scheduling, backup care, and ongoing training. Professional caregiving through an agency is the most expensive, but also the most thorough and stress-free option.
Some families hire caregivers directly, either through personal referrals or online platforms that connect caregivers with clients. This approach reduces hourly costs by eliminating agency overhead fees, but requires families to manage the administrative work.
Many families take care of a loved one themselves, sometimes hiring professional caregivers to fill gaps or provide overnight coverage. This hybrid approach significantly reduces costs and, unfortunately, is the only option for many families.
While costs of in-home care vary significantly due to different situations, knowing national and regional benchmarks can help you prepare a budget and plan for your loved one’s care.
The national median cost for a home health aid is $34 per hour. For 24/7 care, this translates to $816 per day. The median monthly cost for a 24/7 home health aid service is $24,750, with an annual median cost of $297,000 for 24/7 care for a week.
Just like with housing costs, there are significant cost differences between different locations. Generally, areas with a high cost of living will have higher caregiving costs. Locations that require caregivers to travel further (e.g., rural areas) also tend to cost more.
The five most expensive states for in-home care can be found below, with hourly caregiving costs (source):
Minnesota: $43
South Dakota: $43
Vermont: $42
Oregon: $41
Alaska: $40
The five least expensive states are:
Mississippi: $24
District of Columbia: $25
Louisiana: $26
Alabama: $26
Texas: $29
It generally costs more to hire caregivers through an agency, which is why many people choose to take on the administrative burden of hiring and scheduling independent caregivers. Agencies have higher overhead fees that lead to a 20%-30% cost premium.
However, independent caregivers are typically single individuals. They can’t provide 24/7 coverage alone and will also need sick days and time off. Agencies may offer more complex medical services, cover training, and ensure you always have back-up care.
Several factors influence the cost of round-the-clock in-home care. Let’s take a look.
Advanced medical care requirements increase costs, as they require caregivers with medical training who can cater to specific needs.
Examples include:
Specific mobility challenges or assistance requirements
Cognitive impairments that require dedicated monitoring
Chronic conditions that require specialized knowledge
Medical equipment and supplies can increase costs for items not covered by insurance, such as incontinence supplies and over-the-counter medications.
Home modifications for accessibility, such as ramps and shower grab bars, require an upfront investment that can cost thousands of dollars, depending on the extent of renovations needed. Learn more about
If you live in a rural area, you may incur additional surcharges to compensate your caregivers for the commute.
If you’re considering constant in-home care, you may also be evaluating other options like assisted living or skilled nursing homes. Let’s review how the costs compare.
These were the annual median costs for different types of care in 2024:
24/7 care from a home health aid: $297,000
Assisted living community: $70,800
Semi-private room in a skilled nursing home: $111,325
Assisted living communities can help residents with ADLs and tasks like transportation or medication management. Seniors with more complex medical needs may require care from a skilled nursing home. Both types of homes provide services for transportation, homemaking, and food preparation.
While in-home care is often more expensive, it allows seniors to remain in their homes and receive personalized, one-on-one assistance.
You can reduce costs significantly if you combine part-time, in-home professional care with supplemental services and family care.
The annual cost of adult day health care, for example, was $26,000 in 2024. They offer medical, therapeutic, and social services for patients who require specialized medical care and are different from adult day care centers.
Respite care provides professional support in high-demand times, or for a short-term period if you need to recover from surgery or take a trip.
Finally, technology solutions like personal emergency response systems (PERS), remote health monitoring devices, and smart cameras can help reduce the number of caregiver hours needed.
When family or close friends can provide part-time support, it can cut care costs significantly. However, this kind of support requires substantial commitment from family members who could experience caregiver burnout.
Supplemental support can help in high-demand periods, but it can sometimes be difficult to fill unexpected gaps in your schedule.
Many families use a combination of funding strategies to pay for 24/7 in-home care. It’s important to explore all your options, including insurance coverage, Veterans benefits, and private funding.
There are a few things to keep in mind when it comes to insurance coverage and 24/7 in-home care.
Medicare doesn’t cover non-medical home care services, and may cover limited home health services under a few specific conditions:
The person must be homebound
A doctor must certify the need for skilled nursing or therapy
Coverage is part time (fewer than 8 hours daily)
Services are only covered for short durations, often during recovery periods
Medicaid waiver programs may cover some costs. These state-specific programs may cover extensive home care services through Home and Community-Based Services (HCBS) waivers. However, income and assets limits and coverage vary significantly by state.
Long-term care insurance can cover home care expenses, but the benefits vary significantly. Some pre-existing conditions may limit your coverage options, and policies must be purchased before the case is needed.
There are several programs specifically for veterans that may help cover in-home care costs.
The VA Aid & Attendance benefit can provide some funding for veterans or surviving spouses. There are income and asset limits, and you need documentation demonstrating the need for regular assistance with ADLs. This benefit would supplement the VA pension.
There’s also the Veteran Directed Care Program, which allows eligible veterans to manage their care budget and hire caregivers. In many cases, you can hire family members, and programs may provide around 25-30 hours of care per week.
These programs have long application processes, which may take six to twelve months. Military service documentation, medical documentation, and financial information are required.
Many families use private funding to cover the costs of in-home care, which may include:
Reverse mortgages: Homeowners aged 62 and older can convert home equity into tax-free income, which can help cover costs.
Home equity loans: Taking out a loan against your home equity can provide a large lump sum that can help cover costs.
Life insurance conversions: Life settlements, accelerated death benefits, or qualifying riders can provide immediate funds for care.
Family cost-sharing: Multiple family members may contribute to care costs, which can help make overall expenses more sustainable.
Strategic planning can help make continuous care more affordable without compromising quality, which may include:
Take advantage of tax deductions and credits: Qualifying medical expense deductions or the Dependent Care Credit can reduce your tax burden.
Negotiate rates: Some agencies will negotiate rates for long-term contracts; others may provide discounts if you accept caregivers in training.
Hire caregivers strategically: Leverage family care when possible, and hire caregiver services during high-need times when you need them most to reduce overall costs.
Explore your options: It’s often more cost-effective to work directly with a caregiver instead of an agency if you find someone you trust with the availability you need.
When planning for long-term care costs, keep the following in mind:
Review different options: Consult a professional to learn more about how different funding options, tax credits, and insurance could reduce your out-of-pocket costs.
Factor in inflation: While the cost of a home health aid was $34 in 2024, it’s estimated to be $45.69 in 2034, so plan accordingly.
Make allowance for additional costs: Additional medical supplies and equipment—including grab bars or incontinence supplies—can increase your total costs to keep your loved one at home.
The cost of 24/7 in-home care represents a significant financial commitment, averaging $19,000-25,000 monthly nationwide.
Most families use multiple funding sources to make continuous care sustainable. Exploring all available options and planning well in advance will give you the best means to pay for the care you or your loved ones need.
For personalized guidance on navigating care options and payment strategies, consider consulting a care manager who can help assess individual needs and connect you with appropriate resources.
If you have questions about Medicare coverage for caregiving or anything else Medicare related, give us a call at 855-900-2427 or choose a time to chat.
Yes, 24/7 in-home care is often more expensive than a skilled nursing home if you’re relying on skilled home health aids for round-the-clock professional care.
Medicare doesn't cover 24/7 non-medical home care.
It covers limited home health services only when a person is homebound and needs skilled nursing or therapy, typically for just a few hours per week, and only for an intermittent time.
While costs vary significantly based on your location and your loved one’s specific needs, you should budget for at least $34 per hour. Monthly, that cost will be $24,750.
In many cases, yes. Some Medicaid waiver programs, veterans programs, and long-term care insurance policies allow payment to family caregivers. Each program has specific eligibility requirements to consider.
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