In Home care Costs Can Vary Depending on Needs, Location

In home care costs will vary by the type of care needed, the location where the care is being provided, the length of the shift and whether the care provider is a caregiver or a nurse.

A reputable home care and home health agency will provide a written explanation of in home care costs before the care is provided. The agency should also have a meeting with the potential client to discuss available staff, desired hours, and what goals the client has for the care, known as client centered care.

Each year, Genworth releases a “Cost of Care” survey, outlining the various in home care costs for assisted living, nursing home stays and home care costs. The costs tend to rise each year.

In Home Care Costs Defined

In Southern California, hourly rates may range from $33 to $50 hourly, with discounts given for longer shifts that are easier to staff. Longer shifts, such as those between 8 and 24 hours per day, provide more stable employment for caregivers than shorter shifts of less than four hours or quick visits each day. That’s why the in home care costs for those longer shifts will be lower.

Clients pay for in home care costs from long term care insurance policies, VA Benefits, or their own personal savings. Sometimes family members, such as siblings, pitch in to help cover the in home care costs.

The costs of in home care should include worker’s compensation insurance, payroll taxes, bonding, training and background checks.  Caregivers are never independent contractors, so their payroll taxes must be paid and they must receive an actual payroll check on a regular basis, not cash or a personal check.

Potential clients should double check that the agency is licensed. Some, such as At Home Nursing Care, are also accredited, meeting an even higher standard for safety, training and customer service.

Does Medicare cover in home care costs?

Many people think that Medicare will fund the cost of long term in home care, but that is not true.  Medicare funds intermittent visits of a nurse, home health aide, physical therapist, occupational therapist, or speech therapist after a hospital stay or injury.  The visits are short term and the patient must be considered homebound.   Medi-Cal may fund in home care for financially vulnerable seniors, or disabled individuals who meet certain guidelines. 

Veterans may be able to access VA Aid & Attendance monthly benefits to help offset the costs of in home care.  There are specifications and rules to follow and an application to complete.  Contact your local VA office for more information.

Long term care insurance for in home care costs

Long term care insurance also eases the financial burden of the costs of in home care for those who purchased the policies and successfully file a long term care insurance claim.   Those accessing their long term care policies must attest that they require constant safety monitoring due to mild to severe cognitive impairment or assistance with at least two or three activities of daily living. 

Activities of daily living include help with bathing, dressing, incontinence, toileting, ambulation, transferring, or feeding. Often a physician will have to sign a statement for the long term care company proving the condition or diagnosis of the patient. Some long term care companies also send out a nurse to evaluate the client at home and make sure the stated needs are real.

Tips for finding the best agencies and potential tax deductions

Always check that the home health or home care agency that you are hiring is a full employer of its caregivers or nurses so that you are protected from the dangers of illegal pay such as employment liability and potential wage an hour claims from a caregiver based on illegal pay.  Additional liability by using a sub-par company can increase the costs of in home care substantially. In California, consumers can visit the CAHSAH website to search for reputable agencies by zip code.

Also, check with an accountant or tax attorney to see if in home care expenses can be deducted for tax purposes. 

With all the variables related to in home care costs, it’s a good idea to explore a few options, call a few home care agencies and see which solution will work best for you or someone you love.