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My Mom (in Connecticut) was paying for a daily (24 hr where caregiver slept 8 hours) rate approximately half the cost of hourly rate for two 12-hour shifts where the overnight caregiver was awake. She got help thru an agency called Comfort Keepers. The aid had a place to sleep and was guaranteed 1 meal paid for or provided by Mom. The aid stayed 7 days, then alternated with another aid for 7 days. It was wonderful. This was private pay, and her long term care insurance reimbursed her.
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Reply to JanPeck123
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From my experience you pay out of pocket for in home care. You can use agencies to find a person(s) you pay the agency and they handle paying the employee etc. Hourly costs depends on what level of care you need, hours etc. It was cheaper for me to place mom in 24/7 care at asst living otherwise it would have cost up to +5k a month. Everyone's needs are different.
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BurntCaregiver Jul 25, 2024
I own a homecare agency. We bill Medicare and Medicaid all the time. Long Term Care insurance policies too. All of them pay for homecare hours if it is ordered by a doctor. Live-in caregivers or round-the-clock 24-hour caregivers are not paid for by Medicare or Medicaid. Some Long Term Care policies do pay for live-in but it's only a percentage. There will be out-of-pocket cost.
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If the person needing care has a Long Term Care insurance policy then you can hire an agency to help with care needs. The agency has the responsibility to pay the caregiver. Fortunately my parents have a LTC insurance policy and in our case we were able to engage an agency to provide a caregiver allowing my parents to stay in their own home. My dad had a caregiver 8-12 hours a day till he passed and now my mom has one for 8 hours a day. We pay the agency and then the LTC insurance reimburses us. It can cost anywhere between $8K-$10K a month. The only time Medicare was involved was in getting medical equipment for my dad and providing home health care visits with a doctor and nurse monthly as well as physical therapy. As for Medicare paying, we were told they step in when a person enters Hospice.
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squirrel13 Jul 25, 2024
Curious to know if your parents had separate long term insurance for each or did one policy kick in for the other spouse. I would think to be able to have that amount of money reimbursed, they had money to afford a really good LTC plan. I understand today, LTC, is much more expensive, complicated and there is many pros and cons. You were very lucky with your parents care and their investment in LTC. I would say about 80% of the baby boomers have no such thing. Many people think Medicare will cover it and it won't.
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Jimmy58: The answer that you're looking for may be dependent on your locality. Neither Medicare nor Medicaid pay for custodial care.
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LIVE-IN CAREGIVERS: I researched this for my friend-companion years ago. It is not as cut and dry as one might think.

Not only do I believe Medicare/Medicaid would need to know, I believe on a form(s) you must provide, they ask you who else lives in the house? You have to tell them. In addition, consider:

Be very careful about 'live-in' caregivers as they are considered an EMPLOYEE and you have to pay all their wages, report taxes, and likely provide workers' compensation, vacation, and break times, and specify hours. You have to track everything / keep accurate records.

There is no such agreement 'free rent for care services.'

This isn't a 'trade' situation. There are very clear 'rules and regulations' hiring employees, even when they live in your property.

In addition, there are times when you may want them to leave and THEY (may not) / do not want to leave ... which means you would need to call the sheriff to physically move them and/or cite them, too.

However you manage this, require a criminal check (fingerprinting) at their cost, copy of driver's license, car insurance, TB and Covid tests (if you want). And always ask for references.

If you do not follow clear tax employee-employer guidelines, they can also sue you. They can try to sue you anyway. Be very careful. I researched this at a law library years ago.

Gena / Touch Matters
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BurntCaregiver Jul 25, 2024
@Touch

Have you actually ever been a caregiver live-in or otherwise? I did private-duty independent homecare for years before I went into business. I took out my own taxes and paid my own liability insurance.

The employer doesn't have to do this. If you're independent then it's your responsibility. I worked for a few families who did it for their caregiver employees, but not many.

I worked agency help also. Places in my state don't have to pay workman's comp to part-time employees. This is why most businesses keep the help under full-time hours. Part-timers are also not given vacation time or over-time pay. It finally got past that part-time employees do get some sick time now. That was only done last year though.

My company will not provide 'live-in' care for just the reasons you stated. Never allow caregivers to make your home their legal address. We'll do 24-shift but not live-in.

Live-in caregivers do not get paid hourly and often people get talked into paying them hourly which they should not do. Live-ins get salary and it is not based on minimum wage requirements. It is similar to waitstaff and hairdressers do not have to be paid minimum wage. Live-in caregivers do not have to be either. Even 'Sleep Duty' aides who are people that basically just go to sleep at a care client's house for the purpose of just having someone else in the house, don't get minimum wage either. They get a set amount per shift.

Free room and board is factored in as part of the wages for a live-in caregiver. It does not replace the actual wages though.
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10,000 a month for my parent, through an agency. No other choice for us other than facility which isnt much less in that east coast area (8k-9k by my research). So 120k a year, all from cash. Lucky to have it for now but won't last forever....
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BurntCaregiver Jul 25, 2024
@SammyRose

That's way too expensive. You can hire two private caregivers that either split the week, work one week on one week off, or two on two off and save a lot every month.

I'm in CT which is a very expensive state to live in. Go to care.com and interview a few private-duty caregivers. You can save a lot this way.
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To find out how much a live in caregiver costs in your area, you can:
1. Search Online: Look for local caregiving agencies in your area and check their websites for pricing information. Websites like Care.com and Home Instead can provide estimates.
2. Contact Agencies Directly: Call local home care agencies and ask for a quote. They can provide detailed information based on your specific needs.
3. Ask for Recommendations: Reach out to local senior centers, healthcare providers or community groups for recommendations and insights on costs.
4. Use Cost Estimaters: Websites like Genworth’s Cost of Care Survey offer tools to estimate the cost of in home care based on your location.

Regarding payment through Medicare or Medicaid: Medicare generally does not cover long term in home caregiving services. It may cover short term care if you meet specific conditions, such as needing skilled nursing care after a hospital stay. Medicaid may cover in home caregiving costs if you qualify under your state’s Medicaid program. Coverage and eligibility vary by state, so it’s best to check with your state’s Medicaid office.

For additional information, you can contact your local Area Agency on Aging, which can provide guidance on costs and financial assistance options.
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My mom recently had a caregiver come in for 24 hour care. It took spelling out to my mom that she would be out of money in a very short time at a cost of over $300K a year for her to realize she didn't really need someone there to sit around with her 24 hours a day. We are in an expensive part of California where the going rate is $35 an hour for a caregiver who does not drive.
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BurntCaregiver Jul 25, 2024
Live-in caregivers do not get paid hourly. Never let anyone talk you into paying them hourly.

In fact, their pay is salary and not even based on minimum wage requirements.
Free room and board while it is not a replacement for actual wages, is part of the live-in caregiver's salary.

Hire privately. I was a private caregiver in northern California when I lived out there. You'll save money hiring privately.
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Jimmy58, welcome to the forum. When you get a chance please fill out the Profile, that will help us to better understand. Example, are you the person who needs a live-in caregiver, or is it for someone else? Your home, or their home?


Here is something else you need to think about.... if you (or whomever) hires a live-in caregiver and that person is not from an Agency (where the Agency does the payroll), please note you would need to contact your (or whomever) homeowner's insurance carrier about Workman Comp Insurance. Workman Comp helps cover the employee should he/she gets hurt on the job.


Here's more info why Workman Comp is important: www.care.com/hp/nanny-workers-compensation-insurance This article also refers to "caregivers". (I tried to find an article that wasn't tied to a company or law firm but had zero luck).
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Reply to freqflyer
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Let’s do some basic math. How much per hour do you think someone should get paid for a job. Skilled caregiver with training. $40 per hr or more. That’s about 83k per year for 8 hr shifts. There are 3 8hr shifts per day. That’s 249k per year. That’s a good starting point. Now ask yourself are you willing to work 7 days a week 24 hrs a day? Perhaps you need a team.
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BurntCaregiver Jul 25, 2024
@Sample

Live-ins do not get paid hourly. They are salary. The free room and board is considered part of their wages.

If someone is willing to pay $40 an hour, why go with a homecare worker? You can hire an actual nurse for that. No homecare worker ever got $40 an hour. I own a homecare agency and even though homecare is expensive, no one is paying upwards of a quarter mil a year for it.
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Without giving specific numbers because those can vary wildly depending on the area, I will say it has been my experience that paying for caregivers for 24-7 care in the home will significantly exceed the cost of placing someone in a facility. As others have mentioned, neither Medicare nor Medicaid will cover the cost of caregivers.
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BurntCaregiver Jul 25, 2024
No, homecare is cheaper if you know what you're doing.
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I worked with a lawyer who knew employment law for my state to draw up a contract. I already had a caregiver identified who was working with my mom who wanted to have the live-in arrangement. Her rent/utilities are covered and she receives a weekly salary. She had weekend time off that I had to find coverage for as well as vacation time that requires coverage. She is a W-2 employee so taxes are paid, but I’ve seen other arrangements where live-in caregivers are 1099.

Setting this contract up and payment was a lot of work. I’ve been managing this for over a year and it’s not easy, but has allowed my mom to remain in her home.

There is an option to post a job on one of the care sites for live-in.

This is all paid for with savings. I see the article that was linked by another member mentioned how insurance may pay for some portion, but that hasn’t been my experience.
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Reply to Lakegirl2
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There are a couple of articles on this site addressing your question like this one
at https://www.agingcare.com/articles/24-hour-in-home-care-cost-477984.htm.
There's no date on the article; but look for the Genworth Cost of Care Survey link in the references at the end to see the latest cost estimates for your area.
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Reply to ravensdottir
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All of your answers vary tremendously by state and area. Live in caregivers are few, and will always need regular time off as well as coverage for their own emergencies and vacations. Medicare and Medicaid are state specific, call your state agencies for information on what programs are available for caregivers
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Reply to Daughterof1930
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Neither Medicare nor Medicaid pay for "custodial" care. They cover medical needs. This is why they both have "medi" in their names.

Some states have special or waiver programs where Medicaid pays for care in the home, but one has to qualify per their criteria, both medically and financially, and it is usually never full time and never more than minimum wage. Sometimes a family caregiver can get paid, but again, they have to apply and qualify, and then it is usually not enough to cover all the care needs.

You will need to research it for your home state, which you don't mention.
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