Guide
How to pay for home care
Short answer
Most families pay for non-medical home care themselves. Medicare doesn't pay for long-term care like help with bathing and dressing (Medicare.gov). Long-term care insurance, VA Aid and Attendance and Medicaid home and community-based services can cover some or all of it for people who qualify.
Medicare: usually not for daily help
Medicare calls ongoing help with daily activities "long-term care" or "custodial care" and doesn't pay for it, at home or in a facility. Medigap doesn't either (Medicare.gov: long-term care).
Medicare does cover part-time skilled home health care for people who are homebound and need skilled care, and it doesn't cover personal care when that is the only care you need (Medicare.gov: home health services). See Does Medicare cover home health?
Private pay
Most families pay by the hour. CareScout's 2025 survey puts the national median for a non-medical caregiver at $35 an hour; state medians range from $24 (Mississippi) to $46 (Wyoming) (CareScout Cost of Care Survey 2025). See national, Texas and California costs; for other states, see CareScout.
Ask each agency for its hourly rate, minimum hours per visit, and whether nights, weekends or holidays cost more.
Long-term care insurance
Long-term care insurance is designed to pay for personal and custodial care at home or in a facility. Policies usually reimburse a daily amount up to a limit and for a set number of years (ACL: What is long-term care insurance?).
- Find the policy and check the daily or monthly benefit, the elimination (waiting) period and whether home care is covered.
- Ask the insurer what proof it needs, such as a care plan or an agency invoice.
Most individual policies require medical underwriting, so people who already need care often can't buy one (ACL).
VA Aid and Attendance
Veterans and survivors who get a VA pension may qualify for an added monthly payment if they need another person's help with daily activities like bathing, feeding and dressing, or meet other conditions (VA.gov). A medical examiner must complete VA Form 21-2680. You can't get Aid and Attendance and Housebound benefits at the same time.
Medicaid home and community-based services
Medicaid programs in every state can pay for help at home for people who qualify financially and medically (Medicaid.gov: HCBS).
Texas: STAR+PLUS covers personal assistance services (help with daily living and household tasks) for people who qualify, and the STAR+PLUS HCBS waiver also covers services such as assisted living, emergency response and minor home modifications (Texas HHS: STAR+PLUS; STAR+PLUS handbook §6118). Medicaid-paid care goes through the state's program, not through a referral service.
Frequently asked questions
Does Medicare pay for a caregiver at home?
Not for ongoing non-medical help. Medicare doesn't pay for long-term or custodial care such as help with bathing, dressing and using the bathroom (Medicare.gov). It does cover part-time skilled home health care if you qualify.
How much does home care cost per hour?
The CareScout 2025 national median for a non-medical caregiver is $35 an hour, and $30 in Texas (CareScout 2025). See our cost summary.
Can a veteran get help paying for home care?
Possibly. VA Aid and Attendance adds a monthly payment to a VA pension for veterans and survivors who need help with daily activities (VA.gov).