Home Care, Assisted Living or Nursing Home: Cost and Care Compared

Is home care cheaper than assisted living or a nursing home?

Home care is cheaper when your parent needs a few hours of help a day. It stops being cheaper at around 6 hours a day, based on national medians. A nursing home costs the most per month. The right choice depends on how much help your parent needs and what kind.

Here are CareScout’s 2025 national medians. CareScout surveyed about 16,000 providers from July through November 2025.

CareScout’s own calculator assumes 44 hours a week of home care. At that schedule, the national figure is about $6,673 a month (estimate: $35 x 44 x 52 / 12). That is close to the $6,200 assisted living price.

What do these three options give your parent?

Each option answers a different need. Home care brings help to the house. Assisted living moves your parent to a residence with staff. A nursing home adds nursing care around the clock.

The National Institute on Aging describes assisted living as for people who need help with daily care but not as much as a nursing home provides. It lists meals, personal care, help with medications and housekeeping, and 24-hour supervision. It says nursing homes offer nursing care, 24-hour supervision, meals and help with everyday activities, plus rehabilitation services.

HomeCare.com care is non-medical. Its caregivers can help with companionship, meals, mobility, personal care and medication reminders. They do not give medication, treat wounds or provide skilled nursing.

At how many hours a day does home care cost more than assisted living?

At national medians, home care costs more than assisted living once your parent needs about 5.8 hours of paid help a day. The math is an estimate: $6,200 / ($35 x 365 / 12) = 5.8 hours a day, or about 41 hours a week.

Use this table to see how home care grows with hours. All home care figures are estimates at $35 an hour.

This is a rough guide. It leaves out three things:

• Assisted living rates are base rates. NIA says residents pay more if they need extra services or special care.
• Home care does not include rent, food or home upkeep. Assisted living covers housing and meals in its price. If your parent owns the home, those costs continue.
• Home care can change by the week. Facility moves are harder to reverse.

Our guide to 24-hour and live-in care costs explains the high end of the home care scale.

How do the costs compare in each of our states?

In most of our states, the break-even sits between 5 and 7 hours a day. The table uses each state’s 2025 CareScout medians. Monthly nursing home figures are our estimate: the daily rate x 365 / 12. The break-even column is our estimate: assisted living monthly rate / (hourly rate x 365 / 12).

Texas stands out. CareScout’s median semi-private nursing home rate there is $185 a day, which is lower than its median assisted living rate of $5,666 a month by our math. Check local prices, because medians hide wide gaps between cities. Our cost of home care page lists market medians by location.

When does a nursing home make sense?

A nursing home makes sense when your parent needs skilled nursing or medical care that cannot be given at home or in assisted living. Examples are daily skilled treatment, complex wound care or ongoing therapy after a hospital stay. A doctor or discharge planner can tell you if your parent needs that level.

Medicare covers some short stays. Medicare.gov says Part A covers skilled nursing facility care only if you meet conditions, including a qualifying inpatient hospital stay and a provider’s finding that you need daily skilled care. For 2026, Medicare lists $0 a day for days 1 to 20 after the deductible, $217 a day for days 21 to 100 and all costs from day 101. Medicare also says it does not pay for long-term care, including a long stay in a nursing home. Plans and rules can change, so confirm with Medicare.

Can someone with dementia stay home?

Many people with dementia stay home safely with the right support. Safety needs a plan, though. The National Institute on Aging says not to leave a person with Alzheimer’s who has a history of wandering unattended. It suggests locks, door alarms and ID bracelets as safeguards.

Night is often the hardest time. Home care can add overnight or live-in help as needs grow. Some assisted living communities and nursing homes have special units for memory care. They may suit a person who needs a secure setting. Talk with your parent’s doctor about what is safe.

Aging in place works best when the plan can change. Start with a few hours, add nights if needed and review often. Our 24-hour care service page explains how round-the-clock coverage works at HomeCare.com.

What costs does each option leave out?

No monthly figure tells the whole story. Check what each price includes before you compare.

• Home care: The hourly rate covers the caregiver’s time. It does not cover rent or a mortgage, food, utilities, home repairs or safety changes such as grab bars. Your parent keeps paying those.
• Assisted living: The monthly rate usually covers housing, meals and a base level of help. Ask what each added service costs, and how the price changes if needs grow. Ask about one-time community or move-in fees too.
• Nursing home: The daily rate covers the room and nursing care. Ask what is billed separately, such as therapy, supplies or a private room.

Add these extras to each side before you decide. A fair comparison counts your parent’s full monthly spending in each setting. If your parent would keep the house, a facility adds a second bill. If your parent would sell it, that changes the math. An elder law attorney or a financial planner can help with that choice. For a hybrid plan, live-in care may sit between part-time home care and a facility.

Who pays for each option?

Most families pay out of pocket for all three. Medicare does not pay for assisted living, according to the National Institute on Aging. Medicare.gov says it does not pay for long-term care, including non-medical care at home. Medicaid may cover part of some options depending on state rules and eligibility. Some long-term care insurance policies pay for home care, assisted living or nursing homes. Read your policy.

See our guide on what Medicare does not cover. An elder law attorney can explain Medicaid rules in your state. Ask a care advisor which payment options apply to your situation.

How do I decide?

Decide by matching needs to setting, then check the budget. Walk through these steps with your family and your parent’s doctor:

1. List what your parent needs help with each day, and at what times.
2. Ask the doctor whether any needs are skilled or medical.
3. Count the hours of help needed on a normal day, including nights.
4. Use the table above to see where those hours land against assisted living.
5. Ask your parent what matters most. Many people strongly prefer to stay in their own home.
6. Choose a plan you can change. Review it every month or after any hospital stay.

Next step

If you are weighing home care against a move, a care advisor can help you size the hours and see what home care would involve. Call 800-974-3458 or request a call from a care advisor to talk it through.