If you are looking into senior home care for yourself or a loved one, cost is likely a concern. Fortunately, home care costs are significantly less compared to assisted living facilities, nursing homes and other types of senior care options. There are two primary types of in-home care for seniors: home care aides and home health aides.
Types of In-Home Care for Seniors
Home care aides typically help seniors with their activities of daily living, such as grooming, hygiene, housekeeping and preparing meals. They also can provide companionship for seniors. Home health aide (HHAs) roles can be filled by certified nursing assistants or other medical providers like physical and occupational therapists depending on the person’s needs. These individuals are invaluable for those receiving in-home care who also have medical conditions and need assistance with medications, wound care, vital sign monitoring, IV treatments/feedings and mobility. While home care aides and HHAs are the most common home caregivers, one can also employ private duty nurses and live-in caregivers at a significantly higher rate.
Average Cost of Home Health Care Nationally
With the exception of live-in caregivers, most home health care personnel charge hourly rates. These individuals can be retained through private hires or a home care agency. While utilizing the services of an agency might cost 20-30 percent more than a private hire, agencies have strict regulations and policies. They also handle all of the background checks, financial payments, taxes and can provide backups in case the normal caregiver needs time off. In May 2021 we used Genworth’s Cost of Care survey to determine that the national average for home care is around $24 per hour, depending on the level of care required and the type of aide providing the assistance.
|Caregiver Role||National Hourly Average||National Daily Average / 8 hours||National Monthly Average / 22 days||National Annual Average / 250 days per year|
|Home Care Aide / Homemaker /Companion||$24||$188||$4,136||$47,000|
|Home Health Aide||$24||$192||$4,224||$48,000|
Home Care Costs By State
The average cost of home care depends heavily upon the beneficiary’s demographic location. As of May 2021, costs from state-to-state generally range from $17 to $32 per hour, but this can vary drastically even amid each state depending on the area’s cost of living. This chart lists the national cost of home care by state.
|State||Home Care Median Hourly Rate||Home Care Daily Rate / 8 hours||Home Care Monthly Rate / 22 days|
|District of Columbia||$26||$208||$4,576|
How to Pay for Home Care for Seniors
There are a number of ways to pay for home care for seniors including private payment and governmental and/or local assistance options. Here are some common questions concerning paying for senior home care.
Does Medicare Cover Home Care Costs?
Medicare does not cover any type of non-medical care that is not ordered by a physician or care practitioner. This means that there is no Medicare coverage for those receiving care for ADL’s, but any care related to medical needs are covered. Home health aides, CNA’s, nurses and therapists are covered under Medicare. However, recipients must be declared homebound and have a doctor prescribe this type of care, which is typically limited compared to time spent by a home care aide.
Does Medicaid Cover Home Care Costs?
Medicaid is a state and government sponsored program designed to serve low income persons. Coverage differs drastically from Medicare, as Medicaid does cover non-medical in-home care in addition to medical services. When provided as in-home care, this Medicaid program is referred to as Home and Community Based Services, but there are often state specific waivers that beneficiaries must apply for and receive for maximum coverage.
Do Veteran’s Benefits Cover Home Health Care?
The Department of Veterans Affairs (VA) does provide certain coverages for home health care. In certain cases, the entire cost may be covered, while in other situations this organization helps recompense veterans in order to reduce their expenditures for home health care. These benefits will vary depending on which type of policies are in force: Improved Pension, Aid and Attendance and Homebound.
Self Payment Options
Of course, self payment is always an option for families in need of senior health care. Some options include:
- Life Insurance Policy Conversions
- Reverse Mortgages & HELOCs
- Long Term Care Insurance
- Home Care Loans
Is Home Heath Care Tax Deductible?
Expenses for home care aides and even home health aides is limited. Non-medical related expenses such as assistance with ADL’s is not generally tax deductible. However, those seeking nursing and medical related expenses might qualify for a tax deduction for declaring an additional independent (similar to declaring a child on taxes) or even dependency status. If the primary purpose of the in-home heath care is medically related, then there are tax claim options to accommodate those needs as well. Do note, that only medical expenses are deductible under the medical claim and are limited by law.