If your parent, your spouse or you need help at home, the question usually comes down to money before anything else. Is it cheaper to pay a caregiver to come to the house, or to move into assisted living?
The honest answer is that it depends on hours. Home care is billed by the hour. Assisted living and nursing homes are billed by the month. So there is a point, measured in hours of care per week, where home care stops being the cheaper option. We call that the break-even point, and it is different in every state.
This guide works that number out for all 50 states using the 2025 Cost of Care Survey from CareScout, the long-running survey formerly published under the Genworth name.
The national numbers
CareScout surveyed long-term care providers across the country between July and November 2025. Here are the national medians:
| Type of care | 2025 national median | Monthly equivalent |
| Home care (non-medical caregiver) | $35 per hour | $6,673 at 44 hours a week |
| Assisted living | $6,200 per month | $6,200 |
| Nursing home, semi-private room | $315 per day | about $9,581 |
| Nursing home, private room | $355 per day | about $10,798 |
| Adult day health care | $95 per day | about $2,058 at 5 days a week |
At the national level, the break-even points work out like this:
- Home care vs assisted living: about 41 hours a week
- Home care vs a shared nursing home room: about 63 hours a week
- Home care vs a private nursing home room: about 71 hours a week
In plain terms, if someone needs a caregiver for a few hours a day, home care is usually cheaper. Once care passes roughly six hours a day, seven days a week, assisted living tends to cost less. Round-the-clock care at home (168 hours a week) costs well over double what a nursing home charges in nearly every state.
How we calculated the break-even point
The math is simple, and you can redo it with a quote from a local agency:
- Take the monthly cost of the facility.
- Divide it by the hourly home care rate. That gives the number of care hours per month you could buy for the same money.
- Divide by 4.33, the average number of weeks in a month.
For example, national assisted living at $6,200 divided by $35 an hour is about 177 hours a month. Divided by 4.33, that is about 41 hours a week.
Break-even hours by state
The table below uses CareScout’s 2025 state medians. Home care is the non-medical caregiver rate. The nursing home figure is a semi-private (shared) room.
| State | Home care per hour | Assisted living per month | Nursing home, shared room | Break-even vs assisted living (hrs/wk) | Break-even vs nursing home (hrs/wk) |
| Alabama | $27 | $4,425 | $8,334 | 38 | 71 |
| Arizona | $38 | $6,250 | $8,365 | 38 | 51 |
| Arkansas | $25 | $4,637 | $7,452 | 43 | 69 |
| California | $40 | $7,000 | $12,167 | 40 | 70 |
| Colorado | $42 | $6,584 | $10,159 | 36 | 56 |
| Connecticut | $36 | $9,118 | $15,208 | 58 | 97 |
| Delaware | $35 | $7,600 | $14,494 | 50 | 96 |
| Florida | $32 | $5,610 | $10,342 | 40 | 75 |
| Georgia | $32 | $5,300 | $8,821 | 38 | 64 |
| Hawaii | $41 | $12,096 | $15,473 | 68 | 87 |
| Idaho | $38 | $5,175 | $10,494 | 31 | 64 |
| Illinois | $36 | $6,219 | $8,304 | 40 | 53 |
| Indiana | $35 | $5,380 | $8,942 | 37 | 59 |
| Iowa | $41 | $5,380 | $9,277 | 30 | 52 |
| Kansas | $34 | $5,975 | $8,669 | 41 | 59 |
| Kentucky | $32 | $5,528 | $9,718 | 40 | 70 |
| Louisiana | $26 | $5,162 | $7,604 | 46 | 67 |
| Maine | $44 | $8,205 | $13,976 | 43 | 73 |
| Maryland | $35 | $9,600 | $12,927 | 47 | 85 |
| Massachusetts | $40 | $9,600 | $14,448 | 55 | 83 |
| Michigan | $35 | $5,818 | $11,254 | 38 | 74 |
| Minnesota | $44 | $6,572 | $10,646 | 34 | 56 |
| Mississippi | $24 | $4,369 | $9,581 | 42 | 92 |
| Missouri | $33 | $5,400 | $6,741 | 38 | 47 |
| Montana | $38 | $6,075 | $8,973 | 37 | 54 |
| Nebraska | $36 | $6,480 | $8,377 | 42 | 54 |
| Nevada | $37 | $6,241 | $11,786 | 39 | 74 |
| New Hampshire | $40 | $8,025 | $12,243 | 46 | 71 |
| New Jersey | $38 | $8,710 | $12,775 | 53 | 78 |
| New Mexico | $30 | $5,950 | $9,125 | 46 | 70 |
| New York | $35 | $7,110 | $15,528 | 47 | 102 |
| North Carolina | $30 | $6,496 | $9,733 | 50 | 75 |
| North Dakota | $34 | $4,729 | $11,528 | 32 | 78 |
| Ohio | $34 | $6,102 | $9,186 | 41 | 62 |
| Oklahoma | $33 | $6,150 | $7,026 | 43 | 49 |
| Oregon | $40 | $6,874 | $16,760 | 40 | 97 |
| Pennsylvania | $34 | $6,350 | $11,954 | 43 | 81 |
| Rhode Island | $40 | $7,780 | $12,106 | 45 | 70 |
| South Carolina | $31 | $5,350 | $9,034 | 40 | 67 |
| South Dakota | $44 | $4,900 | $9,444 | 26 | 50 |
| Tennessee | $31 | $5,845 | $9,429 | 44 | 70 |
| Texas | $30 | $5,666 | $5,627 | 44 | 43 |
| Utah | $39 | $5,475 | $8,669 | 32 | 51 |
| Vermont | $45 | $8,597 | $14,113 | 44 | 72 |
| Virginia | $35 | $6,945 | $10,250 | 46 | 68 |
| Washington | $45 | $7,600 | $13,155 | 39 | 67 |
| West Virginia | $30 | $6,340 | $12,836 | 49 | 99 |
| Wisconsin | $36 | $6,540 | $10,646 | 42 | 68 |
| Wyoming | $46 | $5,325 | $9,916 | 27 | 50 |
Source: CareScout Cost of Care Survey 2025, state median tables. Break-even hours are our calculation. Alaska is left out because a state home care median was not available.
What the table tells you
A few patterns stand out.
In most states, the line sits between 35 and 50 hours a week. That is roughly five to seven hours of help a day. If your family member needs help with bathing, meals and medications for a few hours in the morning and evening, home care is likely to cost less.
In expensive assisted living markets, home care stays cheaper for longer. Hawaii, Connecticut and Massachusetts have assisted living medians above $9,000 a month, which pushes the break-even point to 55 hours a week or more.
In a few states, the line comes early. South Dakota, Wyoming, Iowa and Idaho combine relatively high home care rates with lower assisted living costs. There, a move to assisted living can make financial sense at around 30 hours of care a week.
Texas is an outlier. Its shared nursing home rooms are among the cheapest in the country at about $5,627 a month, which is slightly less than assisted living in the same state. Families in Texas with heavy care needs should price both.
Costs the averages leave out
The break-even point is a starting place, not the full picture. Each option has costs that do not show up in the median.
Home care
- Housing is still yours to pay. The mortgage or rent, property taxes, insurance, utilities and repairs continue. Assisted living rent already includes most of these.
- Food and household supplies are extra.
- Home changes such as grab bars, a stair lift or a walk-in shower can cost a few hundred to many thousands of dollars.
- Minimum shifts. Many agencies require three or four hours per visit, which can raise the real hourly cost if you only need a short check-in.
- Overnight care is often billed differently. Some agencies charge a flat overnight rate, others charge every hour.
Assisted living
- Care levels. The base monthly fee often covers rent, meals and light help. Extra help with bathing, dressing or medications is usually priced in tiers that can add hundreds or thousands a month.
- Community or entrance fees may be charged once at move-in.
- Memory care costs more than standard assisted living.
Nursing homes
- A nursing home provides 24-hour skilled nursing care, which neither home care aides nor most assisted living communities offer. The comparison is only fair when someone truly needs that level of care.
Who actually pays for this?
Many families assume Medicare will cover long-term care. For the most part, it does not.
- Medicare pays for short-term skilled nursing or home health care after a qualifying hospital stay or when a doctor orders skilled services. It does not pay for ongoing custodial care, meaning help with daily activities like bathing, dressing and eating. It does not pay assisted living rent.
- Medicaid does pay for long-term nursing home care for people who meet its income and asset limits. Most states also run home and community-based waiver programs that can pay for home care or some assisted living services, though many have waiting lists and rules vary by state.
- Long-term care insurance pays for home care, assisted living or nursing home care, depending on the policy, once you need help with at least two daily activities or have a cognitive impairment.
- Veterans and surviving spouses may qualify for VA Aid and Attendance benefits, which can help pay for care at home or in assisted living.
- Private savings and home equity cover the rest. Most families end up using a mix.
If you are in your 40s or 50s and helping a parent, this is also the moment to look at your own plans. The cost of care you see today is what you will be budgeting for in 20 or 30 years, likely at higher prices.
A worked example
Say your mother lives in Ohio and needs help about four hours every morning and three hours every evening, seven days a week. That is 49 hours of care a week.
- Home care: 49 hours times $34 an hour times 4.33 weeks is about $7,214 a month, plus her existing housing costs.
- Assisted living in Ohio: about $6,102 a month, plus any added care-level fees.
On paper, assisted living is about $1,100 a month cheaper, before counting her current housing costs, which would go away with a move. But if the community charges an extra $1,000 to $1,500 a month for her care level, the two options end up close. The right answer then depends on what matters most to her: staying in her own home, or having staff and company around the clock.
Now say she only needs 20 hours a week. Home care would be about $2,944 a month, less than half the price of assisted living. In that case staying home is almost always the cheaper route.
How to use this for your own family
- Write down the real number of hours. Track a typical week of the help your family member needs, including what family members already do for free. Unpaid family care often hides the true number.
- Get two home care quotes and two assisted living quotes. Ask agencies for their hourly rate, minimum visit length and overnight rates. Ask communities for the full monthly cost at your family member’s care level, not just the base rent.
- Run the break-even math with those quotes. Local prices can sit well above or below the state median.
- Add the housing costs that come with staying home. Then compare totals.
- Plan for change. Care needs usually grow over time. An option that is cheaper today may not be in two years.
Frequently asked questions
Is home care cheaper than assisted living? Usually yes, up to about 41 hours of care a week based on 2025 national medians. Beyond that point, assisted living tends to be cheaper. The exact line depends on your state and the care level charged by the community.
How much does 24-hour home care cost? At the 2025 national median of $35 an hour, round-the-clock care works out to about $25,000 a month. Some agencies offer live-in arrangements at a lower daily rate, so ask about that option.
Does Medicare pay for home care? Medicare covers part-time skilled home health care when a doctor orders it and you are homebound. It does not cover ongoing help with daily activities such as bathing and dressing.
How much does assisted living cost per month? The 2025 national median was $6,200 a month. State medians ranged from about $4,400 in Alabama and Mississippi to more than $12,000 in Hawaii.
Sources
- CareScout, Cost of Care Survey 2025, national results and state median tables (published March 2026)
- Medicare.gov, “Long-term care” and “Home health services” coverage pages
- Medicaid.gov, Home and Community-Based Services overview
- U.S. Department of Veterans Affairs, Aid and Attendance benefits
Costs shown are medians. Prices in your area may be higher or lower. This article is for general information and is not financial or medical advice.
