For many Central Texas families, the first question isn't whether Mom or Dad wants to stay home.
They usually do.
The harder question is:
Can we afford enough help to make staying home safe and sustainable?
A few hours of help several days a week may fit comfortably into a family's budget. Eight or twelve hours of daily care is a very different financial commitment. Around-the-clock paid care can quickly become one of the most expensive long-term-care options.
And before comparing costs, families need to understand an important distinction: home care and home health are not the same thing.
This Senior Industry Services guide explains what private home care actually includes, what Medicare may cover, what families in Central Texas should consider budgeting, how long-term care insurance or VA benefits may help, and when it makes sense to compare staying home with other senior-care options.
What Private Home Care Actually Includes
Families use terms such as home care, home health, private-duty care, caregiver and home health aide interchangeably.
Professionally, they can mean very different things.
Home Care vs. Home Health: An Important Difference
Home care generally refers to non-medical assistance that helps someone continue living at home.
Depending on the person's needs, that can include:
- Bathing
- Dressing
- Grooming
- Toileting
- Mobility and transfers
- Meal preparation
- Light housekeeping
- Medication reminders or permitted assistance
- Transportation
- Companionship
- Supervision
- Respite for family caregivers
Texas Health and Human Services describes personal assistance services as help that enables someone to perform activities of daily living and function independently in a residence.
Home health, by comparison, generally involves medically necessary skilled services delivered at home under an appropriate plan of care.
Examples may include:
- Skilled nursing
- Wound care
- Physical therapy
- Occupational therapy
- Speech-language pathology
- Certain injections or treatments
- Monitoring of a medical condition
This difference matters because Medicare coverage is very different for skilled home health versus ongoing personal care.
For a deeper explanation, see our SIS guide, Home Care vs. Home Health vs. Palliative Care vs. Hospice: A Central Texas Family Guide.
Private Pay Home Care vs. Medicare: What's Covered?
This is one of the biggest sources of confusion we see when families are preparing for a hospital discharge.
A family may hear:
"Home health has been ordered."
That does not necessarily mean someone will be at Mom's house for eight hours a day helping with meals, toileting, bathing, medications and supervision.
Medicare covers qualifying home health services when specific eligibility requirements are met.
According to Medicare, a person generally must need part-time or intermittent skilled services and meet Medicare's definition of homebound. A physician or other permitted healthcare provider must also assess the need and order the care, and services must be provided through a Medicare-certified home health agency.
When Medicare Pays—and When It Doesn't
When eligibility requirements are met, Medicare-covered home health may include:
- Part-time or intermittent skilled nursing
- Physical therapy
- Occupational therapy under qualifying circumstances
- Speech-language pathology
- Medical social services
- Certain medical supplies
- Limited home health aide services when the person is also receiving qualifying skilled services
Medicare specifically states that it does not cover:
- 24-hour-a-day care at home
- Meal delivery
- Homemaker services unrelated to the care plan
- Custodial or personal care such as bathing, dressing or toileting when that is the only care needed
Review Medicare's current home health coverage rules.
Watch Out
Do not assume "home health" means someone will be there whenever your parent needs assistance.
A discharge plan may address skilled medical needs without solving the family's need for several hours of daily supervision or personal care.
Before leaving the hospital, ask:
"Exactly who is coming to the home, how often will they come, what will they do, and what care are we responsible for arranging ourselves?"
What Does Home Care Cost in Central Texas?
There isn't one Central Texas home-care price.
Rates depend on location, schedule, minimum shifts, level of assistance, provider, caregiver availability and whether specialized care is required.
However, current cost data gives families a useful planning benchmark.
The 2025 CareScout Cost of Care data puts the Texas median for a non-medical in-home caregiver at approximately $30 per hour. A current Austin-metro benchmark using CareScout data estimates approximately $2,947 per month for 20 hours per week and $5,893 per month for 40 hours per week.
These are planning estimates—not quotes.
Actual rates in Austin, Lakeway, Cedar Park, Bastrop, Marble Falls, Georgetown, San Marcos, Temple, Waco, New Braunfels and other Central Texas communities can vary substantially based on local caregiver availability and the services required.
What Could Different Amounts of Home Care Cost?
This is where the affordability conversation becomes more useful.
At approximately $30 per hour, the cost changes dramatically as care hours increase.
10 hours per week
Approximately $1,300 per month
This might provide a few scheduled visits for bathing, errands, meals, companionship or respite.
20 hours per week
Approximately $2,600–$2,950 per month
This may provide several hours of support on most weekdays.
40 hours per week
Approximately $5,200–$5,900 per month
This is roughly the equivalent of a full-time workweek of paid assistance.
60 hours per week
Approximately $7,800 per month
At this point, the family is purchasing substantial daily support.
Around-the-clock paid care
At a simple $30-per-hour calculation, 168 hours per week would exceed $21,000 per month.
Actual 24-hour care arrangements can be structured and priced differently, so families should obtain written quotes rather than multiplying an hourly rate and assuming that will be the final price.
The Question Isn't Just "What's the Hourly Rate?"
Ask instead:
How many hours of paid care will my parent actually need?
That number usually matters much more than whether one provider charges a few dollars more or less per hour.
What Drives the Price Up or Down?
Hours of Care
This is usually the biggest factor.
Someone needing help three mornings a week has a very different care budget from someone who cannot safely be left alone.
Minimum Shifts
Many home-care companies require a minimum number of hours per visit.
A family needing only an hour of help in the morning and another hour at night may discover that the actual bill is based on longer minimum shifts.
Nights, Weekends and Holidays
Rates may be higher for less desirable or harder-to-staff schedules.
Dementia and Supervision Needs
A person may be physically capable of bathing or walking but still require supervision because of wandering, poor judgment, medication concerns or other cognitive changes.
That can dramatically increase the number of hours of care required.
Mobility and Transfer Needs
Someone requiring substantial assistance with transfers or mobility may need a different level of caregiver training or potentially more than one person for certain tasks.
Where You Live
Caregiver supply differs across Central Texas.
Finding coverage in Austin may present different challenges than arranging consistent care in a smaller community in the Highland Lakes, east of Austin, or farther north toward Temple and Waco.
Agency vs. Direct Hire
Hiring an individual caregiver directly may appear less expensive.
But hourly wage is only one part of the comparison.
Families also need to consider taxes, screening, supervision, insurance, scheduling and what happens when the caregiver cannot work.
A Practical Way to Compare Home Care Quotes
Do not compare agencies based only on the advertised hourly rate.
Ask each provider for a written explanation of:
- Hourly or shift rate
- Minimum visit length
- Minimum weekly hours
- Overnight rates
- Weekend rates
- Holiday rates
- Higher-acuity charges
- Transportation or mileage charges
- Registration or assessment fees
- Cancellation policies
- Care-plan supervision
- Backup coverage
- How rate increases are handled
- What happens when the regular caregiver calls out
Pro Tip
Ask this question:
"If our regular caregiver calls out tomorrow morning, what happens?"
A care plan is only as reliable as its backup plan.
Can Long-Term Care Insurance Help Pay for Home Care?
Possibly.
Long-term care insurance policies vary considerably.
Depending on the policy, benefits may help pay for qualifying home care when the insured person meets the policy's benefit triggers.
Those triggers frequently involve needing assistance with activities of daily living or having qualifying cognitive impairment, but families should review the actual policy rather than assuming coverage.
Ask the insurance company:
- What triggers benefits?
- Is there an elimination period?
- Does the policy cover home care?
- Must the caregiver come through an agency?
- What documentation is required?
- What is the daily or monthly benefit?
- Is there a lifetime benefit limit?
- Are there restrictions on family caregivers?
If you have an older long-term care policy sitting in a filing cabinet, pull it out before paying privately for months of care.
Can VA Aid & Attendance Help?
Some qualifying Veterans and surviving spouses may be eligible for VA Pension benefits that include an increased Aid and Attendance amount.
Eligibility is not based simply on having served in the military.
VA Pension and Aid and Attendance involve service, medical, income, asset and other eligibility requirements.
For the current benefit period, the VA publishes different Maximum Annual Pension Rates depending on circumstances such as dependents and Aid and Attendance eligibility. The VA also applies income and net-worth rules and considers certain unreimbursed medical expenses when determining pension benefits.
Review current Veterans Pension and Aid & Attendance rates directly from the VA.
Families who want to explore whether Aid & Attendance may apply can review current eligibility and benefit information directly through the VA. For additional help understanding the application process, AidandAttendance.com can also provide an eligibility screening tool and application software. AidandAttendance.com is not affiliated with the Department of Veterans Affairs, and only the VA determines eligibility.
Families should verify eligibility rather than assuming a Veteran or surviving spouse automatically qualifies.
Are There Medicaid or Other Public Programs?
Some Texans may qualify for Medicaid-funded home and community-based services or other assistance programs.
Texas programs can include personal assistance with activities of daily living and instrumental activities of daily living for eligible individuals. Eligibility and available services vary by program.
Texas Health and Human Services also works with Aging and Disability Resource Centers and Area Agencies on Aging to help Texans identify available long-term-care resources.
Find Texas aging and long-term-care resources through Texas HHS.
How to Vet a Home Care Agency or Private Caregiver
Price matters.
So does knowing who is coming into your parent's home.
Before hiring a provider, ask:
- How are caregivers screened?
- Are criminal background checks performed?
- How is training verified?
- Who supervises caregivers?
- How are complaints handled?
- How are incidents documented?
- Is backup coverage available?
- How does the provider handle caregiver turnover?
- Who develops and updates the care plan?
- What insurance coverage does the agency maintain?
- How are caregivers matched with clients?
- Can the provider meet your parent's specific mobility or cognitive needs?
If licensed clinical services are being provided, verify the appropriate professional credentials.
Agency-Employed vs. Direct Hire: Understand the Difference
Hiring a caregiver directly can sometimes reduce the hourly cost.
But families need to understand what responsibilities they may be taking on.
The IRS says a caregiver working in someone's home may be considered a household employee when the person hiring them controls not only what work is performed but how it is performed. Health aides and private nurses are among the types of workers that may fall under household-employment rules.
For 2026, federal Social Security and Medicare employment-tax requirements may apply when cash wages paid to a household worker reach the applicable IRS threshold.
That is why families should not automatically assume:
"We're paying her directly, so she's an independent contractor."
The facts of the working relationship matter.
IRS Publication 926: Household Employer's Tax Guide.
If you are uncertain about your responsibilities, consult an appropriate tax or legal professional.
A Care Agreement Protects Everyone
Whether working with an agency or hiring someone directly, get the arrangement in writing.
A useful agreement should address:
- Duties
- Schedule
- Pay rate
- Payment process
- Transportation expectations
- Medication-related responsibilities
- Confidentiality
- Supervision
- Schedule changes
- Callouts
- Termination
- Emergency procedures
Written expectations reduce misunderstandings for both the family and caregiver.
Are Home Care Expenses Tax Deductible?
Sometimes—but this is an area where families should avoid blanket assumptions.
IRS Publication 502 explains that certain nursing services may qualify as medical expenses even when the person providing the service is not a nurse, provided the services are of the type generally performed by a nurse.
The IRS also distinguishes qualifying nursing or medical services from ordinary household services. In some circumstances, certain qualified long-term-care personal-care services may also be includable as medical expenses.
Eligibility depends on the circumstances, and medical-expense deductions are subject to federal tax rules and thresholds.
IRS Publication 502: Medical and Dental Expenses.
Talk with a qualified tax professional about your specific situation.
When Does Staying Home Make Financial Sense?
There isn't a universal break-even number.
Home care can work extremely well when someone:
- Wants to remain at home
- Needs only several hours of assistance
- Has significant family support
- Has an accessible and safe home
- Can be alone safely for portions of the day
- Has long-term care insurance or another benefit helping with costs
- Values one-on-one assistance
- Has a spouse or family caregiver filling some of the unpaid hours
For these families, paying for targeted support may be both financially manageable and consistent with the older adult's wishes.
When Should We Compare Other Senior Care Options?
The comparison becomes more important as paid care hours increase.
For example, a parent who originally needed four hours of help three days a week might later need assistance every morning and evening.
Then overnight supervision.
Then someone nearby most of the day.
The hourly rate may not have changed much.
The number of hours did.
When paid home care approaches 40, 60 or more hours each week, families may want to compare the total cost of remaining home with other senior-care options.
That does not mean moving is automatically better.
It means the comparison is worth doing.
Consider:
At home
- Mortgage or rent
- Property taxes
- Utilities
- Home maintenance
- Food
- Transportation
- Home modifications
- Medical alert systems
- Paid caregivers
- Family caregiving
- Overnight supervision
- Socialization
In a senior living setting
- Monthly housing
- Meals
- Utilities
- Personal-care services
- Transportation
- Activities and socialization
- Medication services
- Additional care-level charges
- Community or move-in fees
- Other optional services
Then compare what the senior actually receives, not merely two monthly prices.
A $6,000 home-care bill and a $6,000 senior-living bill do not necessarily include the same things.
If your family reaches this point, Oasis Senior Advisors Austin & Central Texas provides free, confidential guidance to help Central Texas families understand and compare assisted living, memory care, residential care homes, independent living and other senior living options based on care needs, preferences and budget.
The Hardest Cost to Measure: Family Caregiving
There is another expense that does not always appear on a spreadsheet.
Family time.
A daughter may leave work early three days a week.
A spouse may stop sleeping through the night.
A son may drive across Austin every morning before work.
Someone may give up weekends.
Someone else may manage medications, groceries, appointments and emergencies.
Family caregiving can be an extraordinary gift.
But unpaid does not mean cost-free.
When deciding whether home care is affordable, include the effect on the entire family—not just the invoice from the caregiver.
Frequently Asked Questions
How much does home care cost in Central Texas?
Costs vary by provider, schedule, location and care needs.
The 2025 CareScout data puts the Texas median for non-medical in-home care at approximately $30 per hour. Current Austin-metro planning data is approximately $2,947 per month for 20 hours per week and $5,893 for 40 hours per week.
Actual provider quotes may be higher or lower.
Does Medicare pay for a caregiver at home?
Medicare does not generally pay for ongoing custodial or personal care when that is the only assistance someone needs.
For eligible beneficiaries, Medicare home health can cover qualifying intermittent skilled nursing, therapy and certain home health aide services when Medicare's requirements are met. Medicare does not cover 24-hour-a-day home care.
What's the difference between home care and home health?
Home care generally helps with everyday personal needs such as bathing, dressing, meals, mobility, companionship and supervision.
Home health involves skilled healthcare services provided at home, such as nursing or therapy, when applicable requirements are met.
Can long-term care insurance pay for home care?
Many policies can provide benefits for qualifying home care, but coverage depends entirely on the policy, benefit triggers, elimination period and other provisions.
Review the actual policy and contact the insurer before assuming a service will or will not be covered.
Can VA Aid & Attendance help pay for care at home?
Some qualifying Veterans and surviving spouses may receive increased VA Pension benefits based on Aid and Attendance eligibility. Income, net worth, service history, medical needs and other requirements apply.
Is hiring a caregiver directly cheaper than using an agency?
The hourly wage may be lower, but families should compare the entire arrangement.
A direct hire can potentially make the family responsible for screening, scheduling, backup care, supervision, insurance considerations and household-employment tax obligations.
When does home care become too expensive?
There is no universal number.
The better question is:
How many hours of care does my loved one need to remain safe—and what does that entire plan cost?
Once extensive daily or around-the-clock paid care is needed, comparing the total cost and services of home care with assisted living, memory care or a residential care home can help families make a more informed decision.
Related Central Texas Senior Care Resources
24-Hour Home Care in Central Texas: Services, Costs and Medicare Coverage
Learn what around-the-clock care involves and why its cost structure differs substantially from part-time home care.
Home Care vs. Home Health vs. Palliative Care vs. Hospice: A Central Texas Family Guide
Understand four services families frequently hear about when an older adult's needs begin changing.
How to Navigate Hospital Discharge for Seniors: A Central Texas Family Guide
Practical questions and resources for families preparing for a transition following hospitalization.
So, Can I Afford Home Care?
Start with the number of hours your loved one actually needs, not the number of hours you hope will be enough.
Then determine:
- What Medicare or insurance may cover
- Whether long-term care insurance is available
- Whether VA or public benefits may apply
- What family members can realistically provide
- What paid care will cost
- Whether those needs are likely to increase
- What it costs to maintain the home
- What alternative care options would provide and cost
For some Central Texas families, a few hours of home care can be exactly the support needed to keep someone safely at home.
For others, increasing care needs eventually make it worthwhile to compare assisted living, memory care, residential care homes or other options.
There isn't one right answer.
The goal is to understand the real care need, the real cost and the available options before a crisis makes the decision for you.
Reviewed by John Brown, CSA
Founder, Senior Industry Services
Owner & CEO, Oasis Senior Advisors Austin & Central Texas
John works with families, healthcare professionals, hospitals, rehabilitation providers and senior-care organizations throughout Central Texas to help families better understand senior living, care options, costs and transitions of care.
Last reviewed: October 1, 2026
Senior Industry Services provides educational information and connections to senior-care resources. Information on this page is for general educational purposes and should not be considered medical, legal, tax, financial, insurance or benefits advice. Costs are planning estimates and do not represent provider quotes. Coverage, eligibility, regulations, benefits and pricing can change. Families should verify information with the appropriate provider, government agency, insurer or qualified professional.