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How Much Does 24/7 In-Home Care Cost?

Written by Kevin Ryan
 about the author
8 minute readLast updated May 23, 2023
Reviewed by Michael FerrainaMichael Ferraina is a home health care executive skilled in creating and implementing organic and acquisition growth strategies, business development initiatives, and guiding teams to deliver results. He has served as a director or executive in numerous organizations and is the chief growth officer for AmeriBest Home Care based in Philadelphia.

More and more Americans are choosing to age at home, which has made in-home care an increasingly popular option. Approximately three-quarters of adults over 50 would like to remain in their homes for as long as they are able, according to the 2021 Home and Community Preferences Survey conducted by AARP. Many older adults will require assistance as they age. Understanding how costs vary by care type and location is key to ensuring your parents are prepared for the care they need.

Key Takeaways

  1. 24/7 in-home care can be expensive. Most insurance policies do not cover 24/7 in-home care, leaving families to pay the median cost of nearly $20,000 per month out of pocket.
  2. The cost of 24/7 in-home care depends on where a senior lives. Costs of care vary by state due to differing regulations and caregiver requirements.
  3. Caregivers work in shifts to provide round-the-clock care. Two or three caregivers work consecutive eight- or 12-hour shifts so a senior client always has someone available to meet their needs.
  4. Home health care can be provided around the clock for seniors who require medical supervision. However, the cost of 24/7 home health care can be even higher and is rarely covered by health insurance.

What is 24-hour in-home care?

An alternative to senior living communities, 24/7 in-home care may be a good fit for seniors who require round-the-clock care but prefer to remain in their own homes. Caregivers provide assistance with activities of daily living (ADLs), such as bathing, dressing, and mobility. In-home caregivers can also help with tasks like cooking meals and light housekeeping in addition to providing companionship. For seniors who require a high level of skilled care, like someone might receive in a nursing home, 24-hour home health care is also an option.

How does 24/7 in-home care work?

Multiple caregivers work alternating shifts so they are available to meet their client’s needs day and night. Home care agencies work with families to help them create the schedule that best fits their loved one’s needs but common shift variations include:
  • Three caregivers working consecutive eight-hour shifts
  • Two caregivers working back-to-back 12-hour shifts

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How much does 24/7 in-home care cost per month?

The median cost of 24/7 in-home care in the U.S. is approximately $19,656 per month.[01] With this model of care, caregivers are awake throughout the night and actively supporting their client, even as they sleep.
Home care pricing varies depending on where a senior lives. Some states require home care providers to have specific training or certifications, which can affect the cost of care. It’s also common for families to pay more for care in areas with a higher cost of living.
The figures below illustrate how widely the costs of 24/7 in-home care vary from state to state.[01]
StateMedian monthly cost of 24/7 in-home care
District of Columbia$20,385
New Hampshire$23,661
New Jersey$21,802
New Mexico$17,762
New York$21,840
North Carolina$16,743
North Dakota$21,722
Rhode Island$22,749
South Carolina$17,109
South Dakota$22,569
West Virginia$13,650

What affects the costs of 24 hour in-home care?

The primary factor affecting the cost of in-home care is where a senior lives. State-specific certification and training requirements for caregivers affect the cost of care as do state wage laws. It’s also common to pay more for care in areas with a higher cost of living.
Some home care agencies offer flexibility in the way they structure caregiver shifts, which can help families reduce costs. For example, an agency may offer a “sleeping shift” option that is often billed at a flat-rate as opposed to the normal hourly rate. The overnight caregiver on a sleeping shift is allowed to sleep, but remains available to respond to a senior’s needs.
Individual circumstances make estimating the price of 24/7 home health care difficult, but because care is provided by medical professionals, costs are usually much higher.

Paying for 24/7 in-home care

Families typically pay for 24/7 in-home care out of pocket, which can include personal savings, Social Security benefits, and other sources of income. Private health insurance, veterans benefits, long-term care insurance, and public health insurance options such as Medicare and Medicaid may help cover some in-home care costs.[02] However, most do not cover 24/7 in-home care.

Comparing 24/7 in-home care to other care types

Few alternatives to 24/7 in-home care allow a senior to live in the comfort of their own home while receiving one-on-one care. However, it’s important to consider that other senior living options may provide a safer environment and more comprehensive care for your loved one.

24/7 in-home care vs. live-in care

Live-in caregivers — like 24/7 in-home care — offer care to a senior in their own home, but there are differences in the way care is provided. A live-in caregiver lives with their client and must be provided a private room with a bed to sleep in. They also get waking breaks, sleeping breaks, and days off, which leaves gaps in care compared to the rotating team approach with 24/7 care.[03]
The national median monthly rate for live-in home care is approximately $10,500, which is less expensive than 24/7 in-home care.[04]

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24/7 in-home care vs. assisted living

Both 24/7 in-home care and assisted living provide round-the-clock supervision in addition to assistance with activities of daily living, transportation, and help with common household tasks such as laundry and cooking.
Despite the similar services, the national median cost of assisted living is $4,640 per month.[04] This is considerably less than 24/7 in-home care. Assisted living costs also include housing whereas a senior receiving 24/7 in-home care is still responsible for rent or mortgage payments, property taxes, and home maintenance.

24/7 in-home care vs. nursing homes

For seniors with serious health conditions or limited mobility, a nursing home can offer the round-the-clock assistance and medical attention they need. Nursing homes are staffed by nurses, therapists, and other licensed medical professionals. The national median cost of a private room in a nursing home is around $9,034 per month.[01]
By comparison, the same level of care in a senior’s home is called home health care and needs to be ordered by a doctor. While nursing home care may be covered by Medicare (temporarily) and Medicaid for qualified individuals, 24/7 home health care is not.[05]

Support with exploring in-home care options

Planning for the care of a senior loved one can be complicated, but understanding the options and associated costs is a helpful step. For assistance exploring home care options for your loved one, contact a Senior Care Advisor. They can provide information and connect you to home care agencies that fit your loved one’s needs and budget.


  1. Genworth. (2021). Genworth cost of care survey.

  2. A Place for Mom. (2021). Proprietary cost of care data.

  3. Centers for Medicare & Medicaid Services. Home Health Services.

Meet the Author
Kevin Ryan

Kevin Ryan is a copywriter at OurParents. He has written about Medicaid and Medicare, and focuses on creating content for caregivers. Previously, Kevin worked as a freelance writer, a special education teacher, and a counselor for adults with developmental disabilities. He earned a bachelor's degree from the University of Colorado Boulder.

Edited byKristin Carroll
Reviewed byMichael Ferraina

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