What Home Care Costs in Illinois

What does home care cost in Illinois?

Two numbers describe Illinois home care, and confusing them is where most family budgets go wrong. The first is the wage. Illinois aides earn a median of $18.30 an hour and a mean of $18.37, and about 134,100 of them work in the state 1Ref 1U.S. Bureau of Labor Statistics (2025).Occupational Employment and Wage Statistics: 31-1120 Home Health and Personal Care Aides.Illinois state-level estimates for home health and personal care aides: employment of about 134,100, median hourly wage $18.30, and mean hourly wage $18.37. Used for the state's aide wage level and the scale of its home care workforce. These are worker wages, not agency charge rates., which makes this one of the largest home care workforces anywhere in the country. The second is the price, and no one collects it at state level.

The national benchmark is the closest thing available. The 2024 Genworth Cost of Care Survey put the median annual cost of a home health aide at $77,792 and homemaker services at $75,504, each built on a 44-hour week over 52 weeks 2Ref 2Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median consumer cost of in-home care: home health aide $77,792/year and homemaker services $75,504/year, both computed on 44 hours a week for 52 weeks, which yield the $34 and $33 hourly bill rates used in this page's schedule table; and the finding that two-thirds of home care agencies now charge the same rate for both service types.. Behind those totals sit 2,288 hours, which makes the hourly bill $34 and $33 respectively. Two-thirds of agencies now price both service types identically 2Ref 2Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median consumer cost of in-home care: home health aide $77,792/year and homemaker services $75,504/year, both computed on 44 hours a week for 52 weeks, which yield the $34 and $33 hourly bill rates used in this page's schedule table; and the finding that two-thirds of home care agencies now charge the same rate for both service types., so asking for the cheaper category is mostly a conversation that no longer exists.

The worker's side of that same year is the useful comparison. The national median wage for the occupation was $34,900, roughly $16.76 an hour 3Ref 3U.S. Bureau of Labor Statistics (2025).Home Health and Personal Care Aides — Occupational Outlook Handbook.The national median annual wage of $34,900 for home health and personal care aides in May 2024, about $16.76 an hour, used as the national worker-wage benchmark against which the national consumer bill rate is compared to establish the roughly two-to-one ratio between what a family pays and what an aide earns.. The family pays about two dollars for every dollar the aide receives.

The second dollar is not somebody's profit margin. It buys the employer's payroll taxes, workers' compensation, liability cover, a supervisor, a scheduler, and the guarantee that a replacement appears when the regular aide is ill.

In Illinois that second dollar buys something extra, because Illinois asks more of a home care employer than most states do. The rest of this page is about what.

Illinois has two minimum wages, and Chicago's domestic workers get the higher one

The Illinois minimum wage reached $15.00 an hour on 1 January 2025, the top of a multi-year schedule, and it stands at $15.00 through 2026. Chicago runs its own, higher floor: $17.05 an hour from 1 July 2026 for employers with four or more employees.

Then comes the provision that catches families out. In Chicago, domestic workers must be paid the Chicago minimum wage regardless of how many employees their employer has. The four-employee threshold that shelters small businesses does not shelter a household. A family in Chicago employing exactly one caregiver, in one home, owes the city rate from the first hour.

That matters because the household is precisely the employer most likely to assume the rules are for somebody else. A family hiring privately in Rogers Park is not a small business with a payroll department. Under this ordinance it is treated as an employer all the same, and being the only person on the payroll is not an exemption.

Federal law sits underneath all of it as a floor rather than a ceiling. Home care workers employed by an agency are owed federal minimum wage and overtime 4Ref 4U.S. Department of Labor, Wage and Hour Division (2016).Fact Sheet #25: Home Health Care and the Companionship Services Exemption Under the FLSA.That agency-employed home care workers are entitled to federal minimum wage and overtime; that the companionship services exemption does not apply where a third-party employer such as an agency is involved; and that live-in domestic service employees may be exempt from overtime, though not minimum wage, when employed directly by the household. Used for the federal floor beneath Illinois's higher state and city wage floors, and for the overtime cost of concentrating hours on one caregiver., but at $7.25 the federal number has been irrelevant in Illinois for years. The binding figure is $15.00, or $17.05 inside the city limits.

The same caregiver, doing identical work, carries a wage floor $2.05 an hour higher in Chicago than in Rockford. Over a 40-hour week that is $82, and over a year about $4,264.

Downstate and city quotes are not really the same product priced differently. They are built on different legal floors.

The Domestic Workers' Bill of Rights changed what hiring privately means here

Illinois passed one of the first state-level domestic workers' bills of rights in the country, effective 1 January 2017, and it became the template other states copied, among them Massachusetts, Connecticut, Nevada, New Mexico, New York, Oregon, Virginia, and Washington. If a family is thinking about hiring a caregiver directly to save the agency markup, this law is the thing that most changes the calculation.

It reaches domestic workers regularly employed at least eight hours a week for one employer, which is a very low bar. Two mornings a week clears it. Once it applies, the household is carrying real obligations:

• The Illinois Minimum Wage Law applies, so the state floor governs, and the city floor governs in Chicago.
• The worker is owed at least 24 consecutive hours of rest in every seven-day period.
• A meal period of at least 20 minutes is owed for every 7.5-hour shift.
• Reasonable bathroom breaks are required.
• The Illinois Human Rights Act extends to domestic workers, which brings harassment and discrimination protections into a private home.

The Illinois Department of Labor finalised rules under the act in 2025, so this is live and administered law rather than a dormant statute.

The agency markup that looks like pure overhead is partly the price of somebody else carrying this compliance. Hiring directly does not remove the obligations. It moves them onto the family.

None of which is an argument against hiring privately. Plenty of families do it well and the continuity of one trusted person is worth a great deal. It is an argument against believing the hourly difference is the whole difference.

Chicago requires a written contract with your caregiver

Since 1 January 2022, Chicago has required every employer of a domestic worker to provide a written contract, and the requirement holds regardless of whether the worker is classified as an employee or an independent contractor. It sits at section 6-120-020 of the Municipal Code and applies to anyone whose primary duties include housekeeping, nanny services, caregiving, personal care, or home health services.

The contract has to state the agreed wage and the agreed work schedule, and it must be provided in the worker's preferred language. The city's guidance is that it should be reviewed and signed in person by the worker, the employer, and a witness, and the Office of Labor Standards can fine a non-compliant employer $500. The city publishes sample contracts through its domestic worker initiative.

The interesting thing is how much of the ordinary trouble this prevents. Most disputes between a family and a private caregiver are not about wickedness on either side. They are about a schedule nobody wrote down, a rate that drifted, holiday expectations that were never discussed, and what happens when a shift is cancelled at short notice. A document specifying wage and schedule forces those conversations to the front, where they are cheap.

Families outside Chicago are under no such obligation. Many of the ones who do this well write the contract regardless, because the discipline is the point and the legal requirement is only the prompt.

What an Illinois home services agency licence covers, and the check behind it

Illinois licenses non-medical home care, which is not universal, and the licence has real machinery underneath it. Agencies providing personal care, homemaker, and companion services need a home services agency licence from the Illinois Department of Public Health under the Home Health, Home Services, and Home Nursing Agency Licensing Act, with the rules at 77 Illinois Administrative Code 245.

Illinois licenses more than one shape of the business. A home services agency and a home services placement agency are separate licences, and the category an agency holds describes how it is structured. Worth asking directly, then, rather than inferring from a website: which licence do you hold, and does the caregiver work for you or for me? The answer determines who carries the payroll taxes, the workers' compensation, and the liability if something goes wrong on your stairs.

Behind the licence sits the Health Care Worker Background Check Act, which covers unlicensed people working as home health aides, nurse aides, personal care assistants, and private duty nurse aides. Anyone with direct client contact undergoes a criminal background check, and it is fingerprint-based through the Illinois State Police rather than a name search. The State Police report results to the Department of Public Health, which passes them to the employer and updates the state registry. Licensed agencies must keep written policies on background checks, on abuse, neglect and financial exploitation, and on complaints, along with records of prior disciplinary action.

A licence still is not a rating. It means an agency is inside a system with an inspector at the end of it, which is worth more than nothing and considerably less than a recommendation.

The Health Care Worker Registry lets you check a caregiver yourself

This is the part of the Illinois apparatus most families never learn about, and it is the most immediately useful thing on this page. The Department of Public Health runs a public Health Care Worker Registry, searchable by anyone, and it is where the results of those fingerprint-based background checks land. A family can look up the person who is about to have keys to their mother's house.

What it shows is whether an individual holds an active credential such as certified nurse aide status, and whether there is a disqualifying finding or disciplinary record against their name. What it does not show is judgement, warmth, whether they will be patient at the fourth repetition of the same question, or whether they will turn up in February. No registry carries any of that.

The registry matters most in exactly the situation where families are least likely to think of it: the private hire. An agency is legally obliged to run these checks, which is a meaningful part of what its rate buys. A neighbour's cousin who is wonderful with people and available on Tuesdays comes with no such obligation attached, and the registry is a free, public way to close part of that gap in about two minutes.

Running the search is not an accusation. It is the same check an agency would have run before sending the same person, and doing it before there are keys is easier than doing it after.

The Community Care Program, the DON score, and the $17,500 line

When savings run out, the question turns from price to payer. Home care in the United States is funded out of pocket, by Medicaid for those who qualify, or through a long-term care insurance policy, because Medicare does not cover ongoing custodial or personal care 5Ref 5Administration for Community Living (2025).Costs of Care.That home care is generally paid out of pocket, by Medicaid for those who qualify, or by long-term care insurance, because Medicare does not pay for ongoing custodial or personal care. Used to open the funding section and frame why the Community Care Program matters once private savings run down.. Medicaid reaches home and community based services by several distinct legal routes, among them 1915(c) waivers, the 1915(i), (j), and (k) state plan options, and Section 1115 demonstrations 6Ref 6Centers for Medicare & Medicaid Services (2025).Home & Community Based Services Authorities.That Medicaid covers home and community based services through several distinct authorities — 1915(c) waivers, the 1915(i)/(j)/(k) state plan options, and Section 1115 demonstrations — which supports the framing of the Community Care Program as one state's chosen route into Medicaid-funded home care among several legally distinct options..

Illinois runs the Community Care Program through the Department on Aging for residents aged 60 and over, and it is the main public door to home care for older adults here. Three gates control it:

• Age and residency. Sixty or older, living in Illinois.
• The Determination of Need score. A functional assessment produces a DON score, and 29 points is the minimum to qualify. Above the threshold the score keeps working: a higher score authorises more hours, so the assessment sets not only whether care is funded but how much of it.
• Assets. Non-exempt assets must fall under $17,500. The home is excluded, and so is one vehicle.

Care Coordination Units run the assessments and manage the plan, and the programme covers in-home care, adult day services, and emergency home response systems. Illinois separately runs a Home Services Program through the Department of Human Services for adults with disabilities under 60, so an adult child researching for a parent and for a disabled sibling is dealing with two different agencies.

That $17,500 figure deserves a hard look before anyone spends down toward it. It is a real threshold with a real cliff, and the sequence in which a family spends savings, and on what, is a question for an elder law attorney rather than for a web page.

The arithmetic: hours, months, and around-the-clock coverage

Rate negotiation is where families spend their energy, and hours are where the money actually is. The bill is a rate multiplied by a schedule, and the schedule has far more range in it than the rate ever will. Working from the national median aide rate of $34 an hour 2Ref 2Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median consumer cost of in-home care: home health aide $77,792/year and homemaker services $75,504/year, both computed on 44 hours a week for 52 weeks, which yield the $34 and $33 hourly bill rates used in this page's schedule table; and the finding that two-thirds of home care agencies now charge the same rate for both service types., the shape of the thing looks like this:

The jump from the fourth row to the fifth is the one that ends conversations. Continuous hourly coverage is not a product anybody purchases; it is the number that explains why other shapes exist. Live-in domestic service employees can be exempt from overtime, though never from the minimum wage, when a household employs them directly, and the companionship services exemption does not apply where a third-party employer such as an agency is in the picture 4Ref 4U.S. Department of Labor, Wage and Hour Division (2016).Fact Sheet #25: Home Health Care and the Companionship Services Exemption Under the FLSA.That agency-employed home care workers are entitled to federal minimum wage and overtime; that the companionship services exemption does not apply where a third-party employer such as an agency is involved; and that live-in domestic service employees may be exempt from overtime, though not minimum wage, when employed directly by the household. Used for the federal floor beneath Illinois's higher state and city wage floors, and for the overtime cost of concentrating hours on one caregiver.. Who signs the cheque changes what the law requires, and that is the whole of the difference.

Overtime deserves its own line in Illinois. Filling a 50-hour week with one caregiver rather than two means ten hours at time and a half 4Ref 4U.S. Department of Labor, Wage and Hour Division (2016).Fact Sheet #25: Home Health Care and the Companionship Services Exemption Under the FLSA.That agency-employed home care workers are entitled to federal minimum wage and overtime; that the companionship services exemption does not apply where a third-party employer such as an agency is involved; and that live-in domestic service employees may be exempt from overtime, though not minimum wage, when employed directly by the household. Used for the federal floor beneath Illinois's higher state and city wage floors, and for the overtime cost of concentrating hours on one caregiver., and on a Chicago floor of $17.05 those premium hours compound quickly. The continuity of one familiar face is genuinely valuable, particularly with dementia. It is also, past 40 hours, a purchase rather than a saving.

The crossover with assisted living is the same sum inverted. No Illinois facility price appears in the federal data, so the honest answer is a method: take one local all-in monthly quote, divide by the hourly rate you have been offered, and the result is how many hours a month buys the equivalent. Divide by 4.3 for a weekly figure. Under that line home is cheaper; over it the gap opens fast, because the facility price barely moves while yours rises with every hour added.

Families near the Wisconsin border sometimes price both sides, and what home care costs in Wisconsin can differ from Illinois for reasons of law as much as of market.