Non-medical home care costs a national median of $35 an hour, per the CareScout Cost of Care Survey 2025 published by Genworth — and that single number is where most families' confusion about "companion care" versus "home health" begins. The two phrases get used interchangeably, but they mean very different things, cost differently, and are paid for by different sources. Getting the difference straight is the first real step toward getting your parent the right help.
What companion care and home health actually are
Companion care (sometimes called personal care or custodial care) is help with everyday living. A caregiver comes to the home to prepare meals, keep company, drive to appointments, handle light housekeeping, remind about medications, and — at the personal-care end — help with bathing, dressing, and getting to the bathroom. No medical training is required, though good agencies train and vet their aides carefully.
Home health is skilled medical care delivered at home by licensed professionals: registered nurses, physical or occupational therapists, and speech therapists. It's ordered by a doctor and usually follows a hospital stay, a new diagnosis, or a change in a chronic condition. Think wound care, injections, managing IVs, monitoring vital signs, and rehabilitation exercises.
The simplest way to tell them apart: companion care helps your parent live day to day. Home health treats a medical condition. Many families end up using both — an aide several days a week for company and daily tasks, plus a visiting nurse for a specific medical need.
What it costs and what drives the price
For companion and personal care, most families pay out of pocket by the hour. The national median is $35 an hour, per the CareScout Cost of Care Survey 2025 (Genworth), which the survey notes rose about 3% year over year. Your local rate can sit above or below that depending on where you live, how specialized the help is, and how many hours you need.
A few things push the price up or down: overnight and weekend hours, a caregiver trained in dementia or mobility help, whether you hire through an agency (higher rate, but they handle vetting, taxes, and backup) or privately (lower rate, more work and risk for you), and how many hours per week you commit to. To ground the number: even part-time companion care is a fraction of the $5,000-plus a month that residential care often costs.
What Medicare pays for — and what it doesn't
This is where families lose the most money to wrong assumptions. Medicare does not pay for custodial or personal care that helps with daily living — bathing, dressing, using the bathroom — when that is the only care your parent needs, per Medicare.gov. The same goes for 24-hour care at home, meal delivery, and homemaker services unrelated to a care plan.
Medicare does cover home health when your parent is homebound and needs skilled care. In that case it pays for part-time or intermittent care — generally up to 8 hours a day and 28 hours a week combined — and you pay nothing for covered services, per Medicare.gov. The catch: this is skilled, doctor-ordered, time-limited care tied to a medical need. It is not a long-term aide who comes every day to keep your parent safe and company. That day-to-day help is companion care, and it's on you to arrange and fund.
How to choose the right care and provider
Start with an honest look at what your parent actually needs. Is this about safety, company, and daily tasks — or a specific medical condition that needs a nurse? That answer points you to companion care, home health, or both. Then work through the practical side of picking a provider.
- 1List the specific help needed and roughly how many hours a week — mornings for bathing, midday meals, evening company, or more.
- 2Ask your parent's doctor whether any skilled home health is warranted; if so, get the order and let the agency verify Medicare eligibility.
- 3Get quotes from two or three licensed agencies and ask for their hourly rate in writing.
- 4Confirm licensing, insurance, background checks, and how they handle a caregiver who calls out sick.
- 5Meet the actual caregiver before care begins, and ask how they'll match personality, not just availability.
- 6Start with a trial period, then review together after the first two weeks.
Questions worth asking every agency: Are your caregivers your employees or contractors? Who supervises them? Can we keep the same person consistently? What happens in an emergency? How do you communicate with the family? A provider that answers these clearly and patiently is showing you how they'll treat your parent.
Warning signs and common mistakes
- An agency that won't put its rate or its license in writing.
- Pressure to sign a long contract before you've met the caregiver.
- No plan for backup coverage when the regular aide is out.
- Vague answers about background checks and supervision.
- Assuming Medicare or a medical alert device replaces the human presence of daily care — they serve different purposes.
- Waiting for a crisis. It's far easier to set up a few hours of help early than to scramble after a fall or a hospital stay.
How daily connection fits alongside care
Even with a good aide a few days a week, most parents living alone spend long stretches on their own. That's where a daily check-in has a place. Call Mabel is a warm phone call every day for a parent who lives alone — someone to talk to, a gentle way to notice when something's off, and a quick note back to the family. It's a companion, not a caregiver: it doesn't bathe, drive, or do wound care, and it isn't medical or emergency monitoring. But between the hours a human aide is there, it keeps your mom or dad connected and gives you a small, steady window into their day. It complements the people doing the hands-on work — it never replaces them.
- ✓Match the care to the need: companion care for daily life, home health for medical care, often both.
- ✓Budget companion care as an out-of-pocket cost — around a $35/hour national median (Genworth, 2025).
- ✓Use Medicare where it applies: part-time skilled home health for a homebound parent, at no cost for covered services.
- ✓Vet providers hard — licensing, backup coverage, and meeting the caregiver before you commit.
- ✓Fill the quiet hours with a daily check-in so your parent stays connected between visits.