How Much Does Companion Care Cost?
The median cost of companion care can range from around $31 to $34 per hour in 2024, depending on the companion you hire.
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There’s a lot to think about as we head toward our golden years. Are we saving enough of our hard-earned paychecks to enjoy a comfortable retirement? When is the right time to sign up for Social Security? Our to-do list is undoubtedly quite long. Adding the need for companion care can feel overwhelming, especially considering the financial impact. In this article, we’ll explore companion care costs and the factors that affect the total cost of care. We’ll also discuss ways to pay for these expenses and potential tax deductions to tap into.
In this article, we’ll explore companion care costs and the factors that affect the total cost of care. We’ll also discuss ways to pay for these expenses and potential tax deductions to tap into.
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How Much Does Companion Care Cost?
Genworth Financial, Inc. reported that in-home care was on the rise, partially due to the COVID-19 pandemic. According to Genworth’s 2024 Cost of Care Survey, the median hourly cost of homemaker services is $30.90, and the median price of home health aide services is $29.50 per hour.1
Quick Tip: Our senior companion care services guide includes essential questions to ask as you search for a companion care provider.
Companion care costs vary substantially by location. For example, the monthly median cost for homemaker services in the Orlando area is $4,124. In the Los Angeles area, it is $6,873 per month. In addition to location, personal needs and the amount of care time per day are significant factors.
Companion Care Cost Comparison
As you research companion care, it’s essential to understand all available options. Regardless of the chosen care type, independence isn’t lost. Instead, they gain much-needed support. The chart below breaks down common care types (in and out of the home) and estimated costs.
| Care type | In-home care (homemaker services) | In-home care (home health aide) | Assisted living facility | Nursing home facility (private room) |
|---|---|---|---|---|
| Annual median cost in 20241 | $70,699 | $77,769 | $66,126 | $120,304 |
*Homemaker and home health aide in-home care cost based on 44 hours per week. Nursing home facility cost based on a semi-private room.
FYI: There are pros and cons to all types of care. Head to our nursing home vs. home care comparison for an in-depth analysis.
Factors That Impact the Cost of Companion Care
We’ve covered the cost component, but other factors affect your companion care expenses. Your needs are unique, so let’s look at the top four potential factors that impact the cost of companion care.
- Part-time vs. full-time: The amount of companion care hours per day can affect your costs. The price for 24/7 live-in care is higher than employing a sitter for a few hours each day to help with activities of daily living.
- Specialized care: Companion care can be as straightforward as having company during the day and keeping your mind active through brain games and conversation. Specialized care, such as memory care for dementia and Alzheimer’s disease, involves a distinct home-care skill set — at an increased cost.
- At home vs. facility: Both aging in place and moving to an assisted living facility create distinct companion care circumstances. In-home care costs slightly more than assisted living. If remaining at home is feasible financially and safely, at-home care may be the smoothest transition.
- Homemaker vs. nurse: Pay rates for homemakers are lower than for nurses since homemakers do not require a license or certification. If your care needs go beyond average companion care, a licensed nurse (such as a nurse for someone with hearing loss) is preferable.
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How to Pay for Companion Care
Medicaid
Medicaid offers benefits not typically covered by Medicare, such as nursing home care and personal care services.3 Medicaid’s Home- and Community-Based Services give Medicaid beneficiaries opportunities to receive services in their own home.
Medicaid is a joint federal- and state-run program for people with limited income and resources. Benefits vary by state, so contacting your state Medicaid office is a great starting point to explore companion care benefits.
Veterans’ Benefits
The U.S. Department of Veterans Affairs supports eligible veterans and their caregivers through the VA Home and Community-Based Services. Coverage includes:4
- Homemaker and home health aides
- Adult day health care costs
- Home-based primary care costs
- Home hospice care costs
- Respite care for caregivers costs
- Skilled home care costs
Family caregivers may qualify for stipend payments through the Program of Comprehensive Assistance for Family Caregivers.
Long-Term Care Insurance
Home-based long-term care includes health, personal, and support services to help people stay home and live as independently as possible. If you have a long-term-care insurance policy, it may cover paid home care. Contact your policy adjuster to confirm what is covered and how to obtain your long-term-care insurance funds. Check out the video below with our editor-in-chief, Jeff Hoyt, for more details on long-term-care insurance.
Check out the video below with our editor-in-chief, Jeff Hoyt, for more details on long-term-care insurance.
Out-of-Pocket
Paying for companion care out-of-pocket is a common way to cover expenses. Sources include savings, retirement funds, home equity loans, and reverse mortgages. Before cashing in on any of these funds, sit down with a financial planner to ensure you make the best long-term decision for yourself and your family.
Medicare
Companion care falls under Medicare’s home health services category. If it’s the only care you need, Medicare doesn't pay for 24-hour-a-day care at home; homemaker services such as shopping, cleaning, and laundry; or custodial or personal care such as bathing, dressing, and using the bathroom.6
Did You Know? About one in seven U.S. adults provides unpaid care to another. Explore our help for family caregivers of seniors guide for practical ways to make caregiving for your loved one safer, more affordable, and less stressful.
Is Companion Care Tax Deductible?
According to the Internal Revenue Service, you can claim certain aspects of companion care under medical expenses on your tax return. Claiming companion, nursing, and other medical care can be complex and confusing. You may want to seek an accountant’s advice to ensure you’re completing (and maximizing) your return properly.
Below are key takeaways for claiming companion care medical expenses as detailed in the IRS Publication 502: Medical and Dental Expenses.
Household Help
Even if a doctor recommends such support, you can't include the cost of household help. It’s considered a personal expense, which isn't deductible. You may, however, be able to include certain expenses paid to a person providing nursing-type services.
Nursing Services
You can include wages and other amounts you pay for nursing services in medical expenses. The services don’t have to be provided by a nurse as long as they’re the kind a nurse would typically provide. Services can be provided in your home or another care facility. A few examples include services involved with caring for a patient’s condition, such as administering medications and changing dressings, plus bathing and grooming.
Some expenses for household services or the care of an individual to allow you to work may also qualify for the child and dependent care credit.
Long-Term Care Including Maintenance and Personal Care Services
The cost of qualified long-term-care services can be included in medical expenses. The same goes for certain premiums paid for qualified long-term-care insurance.
Did You Know? Older adults may be eligible for free tax return preparation through the IRS’s Volunteer Income Tax Assistance (VITA) and Tax Counseling for the Elderly (TCE) programs.
Genworth. (2024). Cost of Care Survey.
Medicare.gov. (2022). Medicaid.
U.S. Department of Veteran Affairs. (2022). VA Caregiver Support Program.
National Institute on Aging. (2022). What Is Long-Term Care?
Medicare.gov. (2022). Home health services.
Pew Research Center. (2018). Adult caregiving often seen as very meaningful by those who do it.
