Home care vs. assisted living: what care costs, and how families pay
When a parent needs more help than family can give, the first question is usually what it will cost. Here are the latest national figures, and how families actually pay.
In 2025 the national median cost was $35 an hour for a non-medical home caregiver, $6,200 a month for assisted living, and $315 a day (about $9,600 a month) for a semi-private nursing home room, according to CareScout. Medicare doesn’t pay for long-term custodial care, so most families start by paying privately and then look at Medicaid, VA benefits, and long-term care insurance.
What care costs: 2025 medians
CareScout (formerly Genworth) surveys care providers every year. Its 2025 survey, released in March 2026, found these national medians. California costs more for most types of care.
| Type of care | U.S. median | About per month | California median |
|---|---|---|---|
| Non-medical home caregiver | $35 an hour | $3,033 at 20 hrs/week $6,673 at 44 hrs/week | $40 an hour |
| Adult day health care | $95 a day | $2,058 at 5 days/week | $94 a day |
| Assisted living | $6,200 a month | $6,200 | $7,000 a month |
| Nursing home, semi-private room | $315 a day | $9,581 | $400 a day |
| Nursing home, private room | $355 a day | $10,798 | $499 a day |
Monthly figures are our arithmetic from CareScout’s medians (52 weeks, 365 days, divided by 12). Prices vary widely by city and provider, so get quotes near your parent.
Home care or assisted living?
Cost depends mostly on how many hours of help your parent needs. At the national median of $35 an hour, about 41 hours of home care a week costs the same as a month of assisted living ($6,200). Below that, home care is usually cheaper. Above it, or if your parent needs someone nearby at night, assisted living or another setting often costs less.
- Home care works well when your parent needs help for part of the day (bathing, meals, rides, company) and family can cover the rest.
- Adult day programs give daytime supervision and activities, and give working family members a break, for much less than full-time home care.
- Assisted living makes sense when your parent needs help around the clock or is isolated at home, but doesn’t need ongoing medical care.
- Nursing homes are for people who need skilled nursing care every day.
How families pay
Medicare usually doesn’t
Medicare.gov is direct about this: “Medicare doesn’t cover custodial care if it’s the only care you need.” Help with bathing, dressing, and eating is custodial care. Medicare can cover a limited stay in a skilled nursing facility after a hospital stay, and some home health care, but not long-term help at home or in assisted living.
Medicaid
Medicaid is the largest payer for long-term care. KFF reports that it paid 61% of the $415 billion the U.S. spent on long-term services and supports in 2022, and most people who use it get care at home or in the community rather than in a nursing home. Eligibility depends on income and assets and differs by state (in California, it’s Medi-Cal). An elder law attorney can explain the rules where your parent lives.
VA Aid and Attendance
Veterans and surviving spouses who need help with daily activities may qualify for a pension with Aid and Attendance. From December 1, 2025, the maximum is $29,093 a year for a veteran with no dependents and $18,697 for a surviving spouse with no dependents. The actual payment is that maximum minus the person’s countable income.
Long-term care insurance and private pay
If your parent has a long-term care policy, find it early: most policies pay only after the person needs help with daily activities (often two or more) and after a waiting period. Otherwise, families pay from the parent’s income, savings, and home equity, often with help from adult children.
Tax breaks for adult children
- Medical expense deduction: if your parent is your dependent (or would be, except that their income is too high), you can include the medical and qualified long-term care costs you pay for them. Only the total above 7.5% of your adjusted gross income is deductible, and you have to itemize (IRS Publication 502).
- Dependent care credit or FSA: if your parent can’t care for themselves, lives with you more than half the year, and is your dependent (or would be, except for their income), paying for their care so you can work can qualify. Adult day care counts only if your parent spends at least 8 hours a day in your home (IRS Form 2441 instructions).
Put the plan where the whole family can see it
Once you’re comparing options, write down each one: the provider, the contact, the monthly cost, and where things stand. When everyone is looking at the same numbers, it’s much easier to decide together and to agree on who pays what.
This guide is general information, not legal, tax, or financial advice. Benefit rules and limits change every year, so check the linked sources or talk to an elder law attorney or tax professional about your family’s situation.
Common questions
How much does home care cost per hour?
The national median for a non-medical home caregiver was $35 an hour in 2025, according to CareScout’s Cost of Care Survey. In California the median was $40 an hour.
Is assisted living cheaper than home care?
It depends on hours. At 2025 median prices ($35 an hour for home care and $6,200 a month for assisted living), about 41 hours of home care a week costs the same as assisted living. Fewer hours usually makes home care cheaper; more hours or overnight needs usually favor assisted living.
Does Medicare pay for assisted living or home care?
Not for long-term help with daily activities. Medicare doesn’t cover custodial care when it’s the only care someone needs. It can cover a limited skilled nursing facility stay after a hospital stay and some home health care. Medicaid, VA benefits, and long-term care insurance may help instead.
Sources
- Cost of Care Survey 2025, CareScout (formerly the Genworth Cost of Care Survey), March 2026
- Cost of Care Survey 2025: state data tables, CareScout
- Nursing home care, Medicare.gov
- 10 Things About Long-Term Services and Supports (LTSS), KFF
- Veterans and Survivors Pension Benefit Rates, effective December 1, 2025, Federal Register (Department of Veterans Affairs)
- Publication 502: Medical and Dental Expenses, IRS
- Instructions for Form 2441: Child and Dependent Care Expenses, IRS