Affording Care: Understanding Your Payment Options for Home Care Services
When planning for home care services, understanding your financial options is crucial. Home care costs have continued to rise in 2025, but numerous funding sources can help make quality care more affordable. Here’s your comprehensive guide to paying for home care across Connecticut, Rhode Island, and South Carolina.
Current Home Care Costs (2025)
National Average Rates
- Non-medical home care: $33 per hour nationally
- Personal care assistance: $25–$35 per hour
- Skilled nursing care: $50–$130 per hour
- 24-hour care: Up to $21,823 per month
State-Specific Rates
Connecticut: $30–$38 per hour
Rhode Island: Similar to regional New England rates
South Carolina: $21–$28 per hour (more affordable than national average)
Rates vary based on location, services needed, caregiver qualifications, and agency vs. independent providers.
Primary Payment Options
1. Private Pay (Out-of-Pocket)
Advantages
- Complete choice and control over care services
- No eligibility requirements or waiting periods
- Flexible scheduling and service modifications
Financial Planning Strategies
- Many agencies offer package discounts for regular weekly hours
- Consider cost differences between urban and rural areas
- Independent caregivers may cost 20–30% less than agencies
2. Medicare Coverage (Limited but Important)
What Medicare Covers
- Part-time skilled nursing care following hospitalization
- Physical, occupational, and speech therapy
- Medical social services and home health aide services
- Medical equipment and supplies
Eligibility Requirements
- Must be homebound (difficulty leaving home requires considerable effort)
- Need for skilled care certified by a physician
- Services must be medically necessary
- Care from a Medicare-approved agency
- Physician face-to-face evaluation required
What Medicare Does NOT Cover
- 24-hour or custodial care
- Homemaker services (unless part of a skilled plan)
- Meal delivery or companionship-only services
- Personal care if no skilled services are needed
2025 Update: Some Medicare Advantage plans now include additional home care benefits for daily living activities.
3. Medicaid & Waiver Programs
Connecticut
- CHCPE: Medicaid waiver for seniors 65+ at risk of nursing home placement
- Covers personal care, homemaker services, adult day health
- Asset limits: $47,376 (single), $63,168 (couples)
- 2025 Update: Added CAPABLE and COPE
Community First Choice: Enhanced personal care services through the state plan.
Rhode Island
- @Home Cost Share Program (formerly DEA Co-Pay)
- For seniors 65+ with income below 250% FPL
- Participants pay $4.50–$7.50/hour for CNA services
- Adult day services: $7.00–$15.00/day
South Carolina
- Community Choices Waiver for at-risk seniors
- 2025 income limits: $2,901/month (single), $5,802/month (couples)
- Covers personal care, companion care, home mods, respite
- ~29,383 slots available statewide
- Healthy Connections Prime: Medicare-Medicaid dual-eligibles, with gym memberships and more
4. Long-Term Care Insurance
- Covers medical & non-medical in-home care
- Benefits range from daily/monthly maximums; elimination periods 30–180 days
- 2025 Tax Deduction: Age 70+ up to $6,020; couples up to $12,040
- Typically covers ADL assistance, meal prep, companionship, home mods
5. Veterans Benefits
VA Aid & Attendance
- 2025 Rates: Married $2,795; Single $2,358; Spouse $1,515; Veteran w/ill spouse $1,851
- Requires wartime service, ADL assistance need, basic pension eligibility, physician certification
- Apply via VA Form 21-2680
Other VA Programs
- Veterans Transportation Service: Free rides to VA facilities
- Beneficiary Travel: Mileage reimbursement
6. Additional Financial Assistance
Tax Deductions & Credits
- Medical Expense Deduction: Expenses over 7.5% AGI
- Adult Dependent Care Credit: Up to 35% of care expenses
- HSA/FSA: Covers qualified medical/home care expenses
State-Specific Programs
- CT: Home mod grants & transportation funds via AAAs
- SC: Ramp reimbursement up to $500 & caregiver support grants
Grants & Scholarships
- OATS technology grants
- Local community foundation emergency funds
- Religious organization support
Smart Financial Planning
Cost-Reduction Tips
- Compare agency vs. independent caregiver rates
- Consider shared-care arrangements
- Use family caregivers when allowed
- Start with minimal hours, then adjust
- Leverage adult day programs
Documentation for Tax Benefits
- Keep detailed expense records
- Obtain physician prescriptions for services
- Save receipts for equipment & mods
- Track mileage for care-related travel
Long-Term Planning
- Apply early for Medicaid waivers
- Purchase LTC insurance while healthy
- Explore VA benefits if eligible
- Plan for escalating care needs
Getting Started
- Assess care needs with your provider
- Research state program eligibility
- Get cost estimates from agencies
- Review insurance for home care benefits
- Consult an elder-law attorney
Professional Guidance Available
Helping Hands and Healing Hearts can help you:
- Navigate state-funded program applications
- Coordinate with insurers
- Develop cost-effective care plans
- Connect with local financial resources
Contact us at 800-381-6478 for personalized guidance in Connecticut, Rhode Island, or South Carolina.
This information is educational only. Consult qualified professionals for advice specific to your situation; program details may change.