What Companion Care Costs by the Hour

What Companion Care Costs Nationally

Nationally, companion care through an agency costs a median of about $33 an hour, based on a 44-hour care week, close to the $34 an hour median for hands-on personal care — and two out of three agencies now bill the same rate for both 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.National median hourly-equivalent cost of companion/homemaker and personal-care home health aide services for 2024, and that most agencies charge one blended rate across service tiers.. That consumer rate sits well above what the caregiver is actually paid: the median worker wage for home health and personal care aides is about $16.76 an hour, with the bottom 10 percent earning roughly $12.31 and the top 10 percent over $21.25 2Ref 2U.S. Bureau of Labor Statistics (2025).Home Health and Personal Care Aides — Occupational Outlook Handbook.Median hourly worker wage and wage percentile range for home health and personal care aides, used to show the gap between caregiver pay and the consumer billing rate.. The gap between those two numbers is agency overhead, not caregiver pay.

Why Companion and Personal Care Now Often Cost the Same

Two out of three home care agencies now charge one hourly rate regardless of whether a visit is companion-level supervision or hands-on personal care 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.National median hourly-equivalent cost of companion/homemaker and personal-care home health aide services for 2024, and that most agencies charge one blended rate across service tiers., which reflects how the work is actually staffed: the same aide often provides both kinds of help in a single visit, so pricing by task has largely given way to pricing by the hour. The traditional line between the two still matters for what is companion care for seniors and what a specific visit actually includes, but it increasingly does not change the invoice.

For the practical difference in what each tier covers and where the price gap still shows up, see companion care vs personal care cost; the short version here is that the gap has mostly closed.

What Actually Moves the Rate

Rates move for reasons that have little to do with the type of help being provided. Local labor costs vary by state, since wages for home health and personal care aides differ by region and that difference flows straight into the hourly bill. Whether care is arranged through an agency or hired privately matters even more: an agency's rate bakes in recruiting, background screening, supervision, payroll taxes, and liability insurance, while a privately hired caregiver's rate reflects closer to their own wage.

Most agencies also set a minimum booking — a single hour is rarely available on its own, because dispatching a caregiver for a very short visit rarely covers the cost of getting them there and back. That minimum, more than the label 'companion' versus 'personal,' is often what determines the smallest bill a family will actually see.

Who Pays for Companion Care

Most companion care is paid out of pocket, because it is custodial rather than medical and Original Medicare does not cover ongoing custodial care 3Ref 3Administration for Community Living (2025).Costs of Care.That Medicare does not pay for ongoing custodial home care, and that companion-type care is generally paid out of pocket, through Medicaid, or through long-term care insurance.. A handful of other sources can offset the cost for families who qualify.

• Medicaid home- and community-based waivers. Section 1915(c) waivers let states pay for personal care, homemaker, and companion-type services in the home as an alternative to a nursing home, but the benefit must be cost-neutral against institutional care and states may cap enrollment or limit it to specific groups 4Ref 4Centers for Medicare & Medicaid Services (2025).Home & Community-Based Services 1915(c).How Section 1915(c) Medicaid waivers can pay for personal care, homemaker, and companion-type services in the home, subject to cost-neutrality and state enrollment caps..
• Some Medicare Advantage plans. A number of MA plans now offer non-medical in-home support as a supplemental benefit, though federal oversight has found limited data on how many enrollees actually use it, so availability and real-world access vary a great deal by plan 5Ref 5U.S. Government Accountability Office (2023).Medicare Advantage: Plans Generally Offered Some Supplemental Benefits, but CMS Has Limited Data on Utilization (GAO-23-105527).That some Medicare Advantage plans offer non-medical in-home support as a supplemental benefit, but that federal data on actual utilization is limited..
• VA Homemaker and Home Health Aide program. Eligible veterans can get personal-care and daily-living assistance in the home under RN supervision through this VA program, sometimes with a copay tied to service-connected status 6Ref 6U.S. Department of Veterans Affairs (2024).Homemaker and Home Health Aide Care — Geriatrics and Extended Care.The VA Homemaker and Home Health Aide program as a payer source for personal-care and ADL assistance in the home for eligible veterans, including possible copay based on service-connected status..

None of these are automatic, but it is worth checking eligibility for each before assuming the full hourly rate is unavoidable.

Turning an Hourly Rate Into a Monthly Budget

A few hours a week adds up slowly; a full daily shift adds up fast. At roughly $33 an hour, 10 hours a week comes to a little over $1,400 a month, while a daily 8-hour shift, seven days a week, runs closer to $8,000. Households caring for two people at once face their own version of this math too, which is worth working out separately rather than assuming a linear doubling — see home care cost for a couple for how shared-visit scheduling can change the total.

For need at the edges of the spectrum, the arithmetic looks different in each direction: a few hours a week for errands and check-ins prices out very differently from 24/7 home care cost, and it is worth comparing both against part-time home care cost and respite care cost before committing to a weekly schedule.

Getting an Accurate Quote

The fastest way to get a real number, rather than a national median, is to call two or three local agencies and ask for a written quote that states the hourly rate, the minimum booking length, any weekend or holiday premium, and whether the rate changes if the person's needs shift from companion-level to hands-on care mid-visit.

Worth asking about in the same call: - Whether the quoted rate already reflects the blended companion/personal-care pricing common at most agencies - Whether there is a lower rate for a longer weekly commitment - Whether the agency accepts a Medicaid waiver or has a relationship with a Medicare Advantage plan's supplemental benefit, if either applies