Elder Care Cost Comparison: Home Aide vs Assisted Living vs Nursing Home
A full-time home health aide runs ~$6,483/month, assisted living ~$5,900/month, a nursing home semi-private room ~$9,277/month — private room ~$10,646/month. See what your specific care need actually costs, and for how long.
Four very different price tags for the same need
We ran the four standard care types through the 2024 Genworth/CareScout survey side by side: a full-time (44 hr/week) in-home aide costs $77,792/year, assisted living $70,800/year, a nursing home semi-private room $111,325/year, and a nursing home private room $127,750/year. The gap between the cheapest and most expensive option is over $56,000 a year — enough to make the "which care type" decision worth more analysis than most families give it before a crisis forces the choice.
| Care type | Monthly | Annual |
|---|---|---|
| In-home aide (44 hrs/wk) | $6,483 | $77,792 |
| Assisted living | $5,900 | $70,800 |
| Nursing home (semi-private) | $9,277 | $111,325 |
| Nursing home (private room) | $10,646 | $127,750 |
Notice that in-home care isn't automatically the cheap option — it only undercuts assisted living if the hours needed stay well below full-time. Someone needing round-the-clock supervision (more than 44 hrs/week of paid coverage) can blow past nursing-home pricing on the "cheaper" home-care path once you account for all the hours actually needed.
How the math works
- In-home aide hourly rate = $77,792 ÷ 52 weeks ÷ 44 hours = $33.96/hour (Genworth's assumed standard week).
- In-home monthly cost = hourly rate × your hours/week × 52 ÷ 12.
- Assisted living / nursing home monthly cost = the 2024 national annual median ÷ 12 (flat rate, not hours-based).
- Total cost = monthly cost × 12 × years of care needed.
Source: Genworth/CareScout Cost of Care Survey 2024 — the industry-standard annual reference, published since 2004.
Math runs locally. Inputs never leave your browser.Source on github.
Where this comparison doesn't apply
- Your metro area may be far from the national median.Genworth's survey shows huge regional spread — assisted living in some high-cost metros runs 40-60% above the national figure, while some rural areas run well below it. Check your state-level figure if you're planning a real budget.
- Memory care and specialized dementia units cost more.These figures are for standard assisted living / nursing care — a dedicated memory-care unit typically adds 20-30% to the assisted-living baseline.
- Not inflation-adjusted.Long-term care costs have historically risen faster than general CPI. If you're planning years ahead, add a few percentage points of annual increase on top of this year's figure.
- Medicaid and VA benefits aren't modeled.These are private-pay national medians. Medicaid (after spend-down) and VA Aid & Attendance benefits can cover some or all of these costs for qualifying individuals.
What to actually do
- Get real quotes for 2-3 facilities or agencies in your actual area — national medians are a planning starting point, not a budget.
- Estimate the hours of care actually needed per week before assuming home care is cheaper — run the numbers at your real hour count, not a guess.
- If the total looks large relative to savings, check whether long-term care insurance changes the picture (see the LTC break-even tool below).
- If you or a sibling might reduce work hours to provide care instead of paying for it, run the opportunity-cost tool before deciding — unpaid care isn't free.
- Ask about Medicaid spend-down rules and VA Aid & Attendance eligibility if private-pay costs would exhaust savings within a few years.