What Home Care Costs in New Hampshire

New Hampshire has no state minimum wage, and it changes nothing

New Hampshire repealed its state minimum wage in 2011. Since then the state has defaulted to the federal floor of $7.25 an hour — the only New England state that does. Maine, Vermont, and Massachusetts all sit far above it. And none of that touches home care, because nobody in New Hampshire staffs a home care shift anywhere near $7.25. The statute is a dead letter in this market.

What sets the real number is what sets it everywhere: labor. Nationally, the median in-home care bill runs $75,504 a year for homemaker help and $77,792 for a home health aide. Both are built on the same assumption — 44 hours a week, every week of the year — and labor is the largest component inside them 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median consumer cost of in-home care — $75,504/year for homemaker services and $77,792/year for a home health aide, each computed on 44 hours a week for 52 weeks — from which this page derives the ~$33 and ~$34 hourly figures used in the New Hampshire monthly ladder, and that labor was the top cost driver.. Those figures are 2,288 hours of work each. Do the division and the hourly number is $33 for homemaker help and $34 for an aide.

What the statute does still do. An aide employed by an agency is entitled to federal minimum wage and overtime, and a third-party employer cannot claim the old companionship-services exemption to escape either 2Ref 2U.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 aides are entitled to federal minimum wage and overtime and that a third-party employer cannot claim the companionship-services exemption, while a family hiring an aide directly may in some circumstances — the distinction that explains why an agency live-in quote and a private-hire live-in quote are not the same legal arrangement.. So a New Hampshire agency owes federal overtime past forty hours in a week. It simply owes nothing meaningful in the way of a floor, because the market floor is roughly double the legal one.

In most states the minimum wage is a decent predictor of home care rates. In New Hampshire it predicts nothing, and reading it will mislead a family by about twenty-five dollars an hour.

This is worth saying plainly, because families do reason from it. A New Hampshire family that assumes permissive labor law means cheap labor arrives at the first quote unprepared, and the surprise costs them a week of planning they did not have.

The Boston line, and what it does to a New Hampshire rate

Southern New Hampshire is part of the Boston labor shed. Nashua, Salem, Derry, Londonderry, and most of Rockingham and Hillsborough counties sit inside a commute of Massachusetts employers, and Massachusetts has a $15.00 minimum wage. An aide living in Nashua can drive twenty minutes into a different wage regime. Every New Hampshire agency south of Concord prices against that possibility whether or not it admits to it.

That is the mechanism, and it is why New Hampshire rates behave like a high-cost state's while its statute reads like a low-cost state's.

Where to check the real number. The federal wage table for home health and personal care aides — occupation code 31-1120 — publishes a New Hampshire line and separate lines for its metropolitan areas, including Manchester and Nashua, refreshed every May 3Ref 3U.S. Bureau of Labor Statistics (2025).Occupational Employment and Wage Statistics: 31-1120 Home Health and Personal Care Aides.That state and metropolitan mean and percentile hourly wage estimates for home health and personal care aides (SOC 31-1120) are published and refreshed each May, giving New Hampshire families a free way to read their own state's and metro's aide wage line and its spread — worker pay, not the agency charge rate.. It reports what aides are paid, not what a family is billed. Three things are worth reading: the mean, the 10th percentile, and the 90th. Where the 90th sits well above the mean, agencies are bidding hard for experienced people, and the state home care hourly rate you are quoted will land at the upper end of the national band rather than the middle.

A border effect worth knowing. The pull runs one way. Aides leave for Massachusetts wages; they do not arrive from Massachusetts for New Hampshire ones. That is a structural reason a southern New Hampshire agency can struggle to fill a 6 a.m. weekend shift at any price it can pass along — and a reason the same agency's Concord or Laconia rate may be lower than its Nashua rate for identical work. Two towns, one company, one state, two markets.

Coös County is not Nashua

New Hampshire is small — about 9,350 square miles, a state you can drive across in a morning — and families assume that means one market. It is two. The southern tier is dense, suburban, and inside Boston's economic gravity. The North Country is not. Coös County covers roughly a fifth of the state's land and holds around thirty thousand people, spread through Berlin, Lancaster, Colebrook, and a great deal of forest.

A home care market needs aides who live near clients. Where they don't, the cost shows up as structure rather than as rate:

• Longer minimum shifts. A two-hour visit that is routine in Salem may not be sellable in Pittsburg, because the drive costs more than the visit earns.
• Mileage or trip charges past a radius, or a rate that steps up by town.
• Availability as the actual constraint. North of the notches, the honest question is often not what an hour costs but whether anyone is free Tuesday morning.
• Winter. A mud-season road or a February storm is a coverage risk in Coös in a way it is not in Nashua, and families who plan for it build a backup rather than a schedule.

Coös County holds roughly a fifth of New Hampshire's land area and under three percent of its people.

Lakes Region and Upper Valley families sit in between, and often find their nearest agency is across the river in Vermont — which is a licensing question as well as a driving one, and worth raising before a first visit gets scheduled rather than after.

What each schedule costs a month

Every home care budget is hours times rate, and the monthly column is what decides. At the national median of $34 an hour for a home health aide, the common New Hampshire schedules price out as below — before any overnight, weekend, or holiday differential. The consumer-side benchmark underneath these numbers is the Genworth Cost of Care Survey, which asks agencies what they charge rather than asking employers what they pay 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median consumer cost of in-home care — $75,504/year for homemaker services and $77,792/year for a home health aide, each computed on 44 hours a week for 52 weeks — from which this page derives the ~$33 and ~$34 hourly figures used in the New Hampshire monthly ladder, and that labor was the top cost driver..

The line most families do not see coming sits between rows three and four. Going from "someone comes in the morning" to "someone is here all day" roughly triples the bill, and it is precisely the step a progressing illness forces. Pricing row four while you are still living in row two is the single most useful hour a New Hampshire family can spend in the first month.

Live-in care sits outside this table because a different rule prices it. A live-in caregiver is billed at a flat daily rate, and the reason is federal: the companionship and live-in exemptions in the Fair Labor Standards Act, which an agency can no longer claim as a third-party employer but a family hiring an aide directly sometimes still can 2Ref 2U.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 aides are entitled to federal minimum wage and overtime and that a third-party employer cannot claim the companionship-services exemption, while a family hiring an aide directly may in some circumstances — the distinction that explains why an agency live-in quote and a private-hire live-in quote are not the same legal arrangement.. That distinction matters before anyone compares an agency's live-in quote to a private hire's. They are not the same legal arrangement, and the obligations that come with the cheaper one land on the household.

An old state with a thin bench

New Hampshire is one of the three oldest states in the country by median age, alongside Maine and Vermont. That is the demand side, and it is not going to reverse. The supply side is a workforce that is small, poorly paid nationally, and mobile — which is why the binding constraint on a New Hampshire care plan is usually not the hourly rate but whether the same person keeps showing up.

The national picture explains the local squeeze. There are roughly 3.2 million home care workers in the United States inside a direct-care workforce of about 5.4 million. Their median earnings sit near $26,000 a year; many work part-time and cannot get full-time hours; roughly half rely on some form of public assistance 4Ref 4PHI (Paraprofessional Healthcare Institute) (2025).Direct Care Workers in the United States: Key Facts 2025.The size and economics of the direct-care workforce — roughly 3.2 million home care workers within about 5.4 million direct care workers, median earnings near $26,000/year, widespread part-time work, and roughly half relying on public assistance — which underpins the turnover and continuity problem a New Hampshire family experiences as an unstable schedule.. That is not a workforce with slack in it.

Put the two together in New Hampshire and you get the thing families actually experience — which is not a shocking rate, but a schedule that will not hold. An aide takes a job at a Massachusetts hospital. A Saturday goes unfilled. The person your mother had finally learned to trust is replaced by someone she has to be introduced to again at eight in the morning.

In this state the scarce thing is not money. It is a reliable person — and families who optimize for continuity rather than the last dollar of hourly rate usually spend less over a year.

That has a real budget consequence. The cheapest quote in a market this thin is usually the one with the highest turnover behind it, and turnover costs money: retraining, re-explaining the medication routine, the patchy weeks between people. Paying slightly above the bottom of the range often works out cheaper across twelve months, because you replace the person less often — and because the weeks when nobody comes are the weeks a fall happens.

Choices for Independence, and the door called ServiceLink

Medicare does not pay for ongoing personal care. Long-term help with bathing, dressing, meals, and supervision is paid out of pocket, by Medicaid for those who meet the financial rules, or by a long-term care insurance policy bought years before it was needed 5Ref 5Administration for Community Living (2025).Costs of Care.That Medicare does not pay for ongoing custodial or personal care, and that long-term home care is therefore paid out of pocket, by Medicaid for those who qualify, or by long-term care insurance.. There is no fourth option, and this surprises almost everyone who calls an agency for the first time.

New Hampshire's Medicaid route to home care for older adults is a waiver called Choices for Independence, administered through the Bureau of Elderly and Adult Services. It exists for people who meet a nursing-facility level-of-care standard but want to stay home, and it pays for personal care, adult day, respite, and related supports. Its financial test is strict, and most families do not pass it on the day the need first appears.

The state's front door is ServiceLink, New Hampshire's network of aging and disability resource centers. That is where the eligibility screen starts, and where the non-Medicaid programs live — the ones that sit in the gap between paying privately and qualifying.

What is in that gap. Federal guidance sets out the categories: companion and check-in services, some of them volunteer and free; homemaker and chore help; personal care covering bathing, dressing, grooming, and mobility; and skilled home health, which is a different product for a different purpose. Area Agencies on Aging are the standard way to find them 6Ref 6National Institute on Aging (NIH) (2025).Services for Older Adults Living at Home.The taxonomy of in-home support that fills the gap between private pay and Medicaid eligibility — companion and check-in services (often volunteer and free), homemaker and chore help, personal care with bathing/dressing/grooming/mobility, and skilled home health — and that Area Agencies on Aging are the standard route to arranging them.. Most New Hampshire families end up assembling several rather than buying one.

A family that cannot afford forty paid hours a week is not out of options. It is in the position most families are in, and the assembled version — a few paid hours, a day program, a volunteer driver, and the family — is what home care actually looks like for most people.

No income tax, high property tax, and the home-versus-facility ledger

New Hampshire taxes wages not at all and sales not at all, and makes up the difference on property — the state carries one of the heaviest property tax burdens in the country. That single fact changes the home-versus-facility comparison here in a way it does not change it almost anywhere else.

Run the crossover the ordinary way first. Facilities quote by the month; home care sells by the hour, so the two only compare after one conversion. Put the facility's written all-in figure — including the level-of-care surcharge that is rarely in the advertised rate — over $34, and you have the monthly hours it buys. Over 4.33 again and you have the weekly schedule it is genuinely bidding against.

Then correct for what moving would end. In most states that list is the mortgage, utilities, insurance, and groceries. In New Hampshire the property tax bill is often the largest line on it, and it does not shrink because your mother is only using one room of the house. Families who leave it out of the ledger consistently conclude home is cheaper than it is, and then discover the gap eighteen months in.

The other New Hampshire twist runs the other way. With no state income tax on wages, a family hiring an aide directly rather than through an agency has one fewer payroll obligation to administer — federal withholding, Social Security, Medicare, and unemployment still apply, and workers' compensation is its own question. That is an administrative simplification, not a saving of any size, and it is worth not mistaking one for the other.

Nothing about this decision is really home versus facility. It is a question of how many hours, and the answer only flips when supervision has to be continuous.