What Home Care Costs in South Carolina

The hourly number, and why a South Carolina average hides more than it tells

Two national medians anchor everything else here. In 2024 the median annual cost of a home health aide was $77,792 and of homemaker services $75,504, each measured on a 44-hour week across 52 weeks 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median cost of in-home care — $77,792/year for a home health aide and $75,504/year for homemaker services, both computed on 44 hours a week for 52 weeks — the finding that about two-thirds of agencies now bill one rate for both service types, and that labor is the leading cost driver. Every hourly, monthly, and break-even figure on this page is arithmetic on those two annual medians.. Divide them back out and the implied rates are $34.00 and $33.00 an hour. Those are national midpoints. South Carolina's own midpoint is a figure no public source prints, and an agency will not name one before it has assessed the case.

The dollar separating those two services is nearly gone in practice. Around two-thirds of home care agencies now bill a single rate whether the visit is housekeeping or hands-on personal care 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median cost of in-home care — $77,792/year for a home health aide and $75,504/year for homemaker services, both computed on 44 hours a week for 52 weeks — the finding that about two-thirds of agencies now bill one rate for both service types, and that labor is the leading cost driver. Every hourly, monthly, and break-even figure on this page is arithmetic on those two annual medians. — so the old strategy of buying cheap homemaker hours for the laundry and expensive aide hours only for the shower has stopped working in most of the market.

Where the money goes. The aide is not paid the rate you are quoted. Federal occupational data puts the median home health or personal care aide's own earnings at $34,900 a year, roughly $16.76 an hour 2Ref 2U.S. Bureau of Labor Statistics (2025).Home Health and Personal Care Aides — Occupational Outlook Handbook.The median home health and personal care aide's own earnings of $34,900 a year (about $16.76 an hour) and the lowest tenth earning under $25,600 a year — used to separate worker wage from consumer bill rate, and to show that the bottom of the aide wage distribution sits far above the federal minimum wage..

the median aide earns about $16.76 an hour 2Ref 2U.S. Bureau of Labor Statistics (2025).Home Health and Personal Care Aides — Occupational Outlook Handbook.The median home health and personal care aide's own earnings of $34,900 a year (about $16.76 an hour) and the lowest tenth earning under $25,600 a year — used to separate worker wage from consumer bill rate, and to show that the bottom of the aide wage distribution sits far above the federal minimum wage.; the median in-home bill rate works out to $34.00 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median cost of in-home care — $77,792/year for a home health aide and $75,504/year for homemaker services, both computed on 44 hours a week for 52 weeks — the finding that about two-thirds of agencies now bill one rate for both service types, and that labor is the leading cost driver. Every hourly, monthly, and break-even figure on this page is arithmetic on those two annual medians..

The difference is the employer function: payroll taxes, workers' compensation, liability cover, background screening, the coordinator who writes and supervises the plan, and a replacement caregiver on the morning yours does not arrive. Every one of those is real, and every one of them lands on the family that hires privately instead.

Then the averaging problem. A state median is the midpoint of markets that may not resemble each other at all. In some states that is a quibble. In South Carolina it is the whole story, because the markets inside the border are further apart than some states are from each other. The genworth cost of care survey publishes state figures; for this state, the state figure is the least useful line in the table.

Three South Carolinas, three different rates

South Carolina's home care market is not one market. It is at least three, and they barely touch each other. The coast — Charleston, the Grand Strand around Myrtle Beach, the Beaufort and Hilton Head end — has pulled retirees in from other states for decades and prices care accordingly. The Upstate corridor around Greenville and Spartanburg is an industrial labor market. Between and below them lie rural counties where the binding constraint is not price at all.

The coast runs on transplanted retirees. People who move to a coastal county at sixty-five arrive with assets and, very often, without adult children within five hundred miles. When the need starts, there is no daughter twenty minutes away to absorb the first two years unpaid. Demand for paid hours is therefore structurally higher per capita than in a county where families aged in place, and an aide there has many buyers to choose among.

The Upstate competes with warehouses, not with hospitals. A caregiver in Greenville or Spartanburg is choosing between a care job and a distribution-center or plant job that pays comparably and asks less of them emotionally. When a large non-care employer raises starting pay, home care agencies must follow or lose their staff. That is a cost driver with nothing to do with health care, and it will not appear anywhere in a brochure.

In the rural counties, the problem is not the rate. Along the I-95 corridor and through the Pee Dee, an agency with no caregiver living within thirty miles of your parent does not quote a high price. It declines the case, or offers a schedule that does not fit the need. The scarcity is people, and no amount of money reliably solves it.

The workforce data explains why. About 3.2 million home care workers nationally earn a median near $26,000 a year, with roughly half of them relying on some form of public assistance and turnover that stays chronically high 3Ref 3PHI (Paraprofessional Healthcare Institute) (2025).Direct Care Workers in the United States: Key Facts 2025.The scale and economics of the home care workforce — roughly 3.2 million home care workers, median earnings near $26,000 a year, roughly half relying on public assistance, and chronically high turnover — used to explain why agencies do not discount and why thin rural markets stay thin.. A workforce that poorly paid has no slack in it — which is why agencies do not discount, and why thin markets stay thin.

in rural South Carolina, the constraint on home care is not the hourly rate — it is whether there is anyone to send.

South Carolina has no minimum wage law of its own

South Carolina is one of a small handful of states with no state minimum wage statute at all. The federal floor of $7.25 an hour applies by default, and state law additionally bars South Carolina cities and counties from setting anything higher. So the legal bottom of every wage in the state, a caregiver's included, is set entirely in Washington — and it has not moved since 2009.

Here is the part that surprises people: that floor is not what sets caregiver pay, and understanding why is genuinely useful.

Nationally, the lowest-paid tenth of home health and personal care aides earns under $25,600 a year 2Ref 2U.S. Bureau of Labor Statistics (2025).Home Health and Personal Care Aides — Occupational Outlook Handbook.The median home health and personal care aide's own earnings of $34,900 a year (about $16.76 an hour) and the lowest tenth earning under $25,600 a year — used to separate worker wage from consumer bill rate, and to show that the bottom of the aide wage distribution sits far above the federal minimum wage.. A full-time job at the federal minimum pays about $15,080. Even the bottom decile of this occupation sits far above the legal floor, which means the statute is not the thing holding the wage up. Something else is.

What actually sets it is competition for people who could work anywhere. Retail, food service, warehousing, hospitality — every employer that will hire someone without a degree is bidding for the same workers. On the coast that bidding has a season to it, and it is worth asking an agency directly whether its staffing or its rates move across the year, because the hospitality sector there is enormous and it hires from the same pool.

this is why a South Carolina agency's rate can rise in a year when no law changed. The number tracks the local labor market, not the statute.

The practical consequence for a family: do not expect the absence of a state wage law to make care cheap here, and do not expect a rate quoted in one season to be the rate offered in another. Ask what the quote is anchored to and how long it holds.

Pulling your metro's row instead of the state's

The Bureau of Labor Statistics publishes wage estimates for home health and personal care aides — the occupation is coded 31-1120 — at both the state and the metropolitan level 4Ref 4U.S. Bureau of Labor Statistics (2025).Occupational Employment and Wage Statistics: 31-1120 Home Health and Personal Care Aides.The existence and structure of federal state-level, metropolitan, and nonmetropolitan hourly wage estimates for home health and personal care aides (SOC 31-1120), and their use for reading within-state and state-to-state variation in aide wages — which are worker wages, not agency charge rates.. For South Carolina, the state row is the one to skip. The metro rows carry the information, because they pull apart the markets the state average blends together: Charleston, Columbia, Greenville, Myrtle Beach and the rest each get their own line.

One warning sits over the whole table. It reports what the aide is paid, not what you are billed. Those are two different numbers with an entire business sitting between them.

How to read a row. Each gives a mean and the 10th, 25th, 50th, 75th, and 90th percentiles. The 50th is the median — the aide in the middle. The gap between the 10th and the 90th is the more revealing measure: a wide spread means agencies in that metro have room to pay up for the hard shifts, the nights, the two-person transfers, the dementia cases. That room is funded out of your rate.

Rural counties are not in any metro row. They fall into the nonmetropolitan estimates, and that is precisely where the published figure tells you least — because a wage estimate cannot tell you whether anyone is available to work at it. A confident-looking number attached to a county with no agency coverage is worse than no number.

Why the wage row still predicts the bill. Labor is the single largest cost driver in home care 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median cost of in-home care — $77,792/year for a home health aide and $75,504/year for homemaker services, both computed on 44 hours a week for 52 weeks — the finding that about two-thirds of agencies now bill one rate for both service types, and that labor is the leading cost driver. Every hourly, monthly, and break-even figure on this page is arithmetic on those two annual medians.. A metro whose aides are paid above the national median has agencies whose largest input costs more, and that shows up in the rate. The table will not hand you a state home care hourly rate you can budget against. It will tell you which direction your metro sits from the national median, and roughly how far — which is more than you will get by phone.

What a monthly budget actually buys

Agencies quote by the hour. Families budget by the month. Translating between the two is where most plans fail, because an hourly rate that sounds survivable becomes a mortgage payment somewhere around the twentieth hour. A month is 4.33 weeks, so weekly cost times 4.33 is the monthly number — and it is the only number worth putting in front of a sibling.

Run in reverse, at the national median aide rate of $34.00 an hour 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median cost of in-home care — $77,792/year for a home health aide and $75,504/year for homemaker services, both computed on 44 hours a week for 52 weeks — the finding that about two-thirds of agencies now bill one rate for both service types, and that labor is the leading cost driver. Every hourly, monthly, and break-even figure on this page is arithmetic on those two annual medians.:

the survey's benchmark schedule — 44 hours a week, the basis for that $77,792 figure — is about six hours a day 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median cost of in-home care — $77,792/year for a home health aide and $75,504/year for homemaker services, both computed on 44 hours a week for 52 weeks — the finding that about two-thirds of agencies now bill one rate for both service types, and that labor is the leading cost driver. Every hourly, monthly, and break-even figure on this page is arithmetic on those two annual medians.. It is help. It is not coverage.

Two things that table does not show. Most agencies impose a minimum shift, commonly three or four hours, because a forty-minute visit cannot pay for the drive plus the scheduling behind it — so a plan needing someone briefly at eight, noon, and six gets billed as three minimum shifts. And the bottom row is theoretical: almost nobody buys 168 hours by the hour for long, because it is the most expensive possible way to purchase time. Live-in arrangements are priced on different rules, and a family that reaches this row is usually looking at a different question than the one it started with.

South Carolina did not expand Medicaid, and that shows up in the private-pay years

Medicare does not pay for ongoing help with bathing, dressing, meals, and supervision. That care is funded out of pocket, by Medicaid for those who qualify financially, or by a long-term care insurance policy purchased years before anyone needed it 5Ref 5Administration for Community Living (2025).Costs of Care.That ongoing custodial home care is not covered by Medicare, and is paid instead out of pocket, by Medicaid for those who qualify financially, or by long-term care insurance.. South Carolina has not expanded Medicaid — a fact that goes wrong the moment you cross the northern border, since North Carolina expanded in 2023.

What expansion does and does not do here. Expansion covers low-income adults on income alone. It is not the long-term-services door. Medicaid coverage of home care runs through a separate eligibility test with its own income and asset limits plus a functional assessment: a person has to be both poor enough and impaired enough, and those are judged independently. So expansion would not, by itself, have paid for anyone's caregiver.

What it changes is everything upstream. In a non-expansion state more people arrive at the long-term-care question later, having gone without the routine care that keeps a need small. South Carolina's Medicaid program is called Healthy Connections, and the practical question for a family is never whether the state has a home-care pathway — it does — but whether there is an open slot in it and how long the assessment takes. Ask that question first and in those words.

The gap between too rich and too poor is where most families sit. For someone with an income above Medicaid's line and well below the cost of care, the useful move is a benefits screen rather than a phone call to an agency. The National Council on Aging runs a free tool that checks eligibility across many programs at once — prescription help, respite, adult day services, Medicaid itself 6Ref 6National Council on Aging (2025).Benefits for Older Adults.The existence of a free benefits screening tool that checks an older adult's eligibility across many programs at once — help with health care, prescriptions, respite, adult day services, and Medicaid — as the practical first step for someone whose income is above the Medicaid line and below the cost of care.. It is the cheapest hour available to anyone in this position, and it is routinely skipped.

the monthly burn rate — not the hourly rate — is what decides how long a private-pay plan lasts.

The insurance door closed years ago. Long-term care insurance is the third payer 5Ref 5Administration for Community Living (2025).Costs of Care.That ongoing custodial home care is not covered by Medicare, and is paid instead out of pocket, by Medicaid for those who qualify financially, or by long-term care insurance., and it cannot be bought once the need exists; underwriting is the entire point of the product. If a policy exists in a filing cabinet, its elimination period and its daily benefit cap are the two numbers to find before anything else is decided.

Where the arithmetic stops favoring home

Every family eventually runs the same comparison, usually later than they should: at what point does buying hours cost more than buying a room? The calculation is one line. Take the facility's quoted monthly price, divide by 4.33 for its weekly equivalent, then divide by your quoted hourly rate. The answer is the hours per week at which the two options are even. Past that, home is the more expensive one.

At the national median rate of $34.00 an hour 1Ref 1Genworth Financial / CareScout (2025).Genworth and CareScout Release Cost of Care Survey Results for 2024.The 2024 national median cost of in-home care — $77,792/year for a home health aide and $75,504/year for homemaker services, both computed on 44 hours a week for 52 weeks — the finding that about two-thirds of agencies now bill one rate for both service types, and that labor is the leading cost driver. Every hourly, monthly, and break-even figure on this page is arithmetic on those two annual medians., a facility quoting $5,000 a month is level at roughly 34 hours a week. At $6,000, roughly 41 hours. At $7,000, roughly 48. Six or seven hours a day is where the money generally stops arguing for home — which lands well below the coverage most families picture when they say they want a parent to stay put.

But in South Carolina the crossover is a question about supply before it is a question about price. In Charleston or Greenville it is a genuine choice: both options exist within a short drive, and the comparison above is the comparison. In a rural county the nearest facility may be an hour away in an unfamiliar town, which quietly converts "move to assisted living" into "leave the community, the church, and everyone who visits." That is not the same decision, even at an identical price. Families in those counties routinely pay past the break-even, and they are not being irrational — they are paying for something the arithmetic cannot see.

Three corrections before anyone acts on the numbers. A facility's advertised monthly price is tiered by care level, and the brochure figure is not the figure for a person who needs two-person transfers or overnight redirection; ask for the quote at the actual level. An hour at home is not an hour in a facility — a monthly price buys presence and a call bell, not one-to-one attention, so eight paid hours at home may be more real help than a facility delivers in a day. And the break-even ignores the house: the taxes, the utilities, the insurance, and the food are being paid anyway on one side of the ledger and are bundled into the other.