Non-medical caregivers in 5 North Carolina locations, from a few hours a week to live-in care. No minimums, no contracts.
Sources: CareScout Cost of Care Survey 2025; U.S. Census Bureau, American Community Survey 2020-2024.
Hourly: area median home care rate (CareScout 2025). 65+: Census share of residents (metro area for "Metro" locations).
North Carolina licenses home care agencies through the NC Division of Health Service Regulation (DHSR).
A home care agency license covers hands-on in-home aide (personal care) services. Since a 2023 law change (S.L. 2023-150), the statute also requires a license for a "home assistance services provider", which is an organization that mainly provides companion, sitter, respite or homemaker services without hands-on care. A Medicare-certified home health agency is a separate category that needs a Certificate of Need, and licensed-only home care agencies cannot bill Medicare. Nurse registries are exempt only if they tell clients in advance that they are not a licensed agency and do not guarantee the training or competence of the workers.
Tip: Ask the agency for its current NC home care license number, then check that it appears on the DHSR Home Care facility listing (updated monthly). Check a license
Sources: NC General Assembly: G.S. 131E-136 Definitions; NC General Assembly: G.S. 131E-138 Licensure requirements; NC DHSR: Home Care Frequently Asked Questions (revised 5/30/25); NC DHSR: Consumer's Guide to Home Care; NC DHSR: Facility Listings (licensed home care agencies); NC DHSR: Home Care Licensure Information
Most families pay privately, with long-term care insurance or with veterans benefits. These programs can pay for help at home for people who qualify.
Who: A person who has NC Medicaid, has a medical condition, disability or memory problem, and needs help with daily tasks. An assessment must show needs in 3 of 5 daily tasks, or 2 tasks with one needing a lot of help or full help.
Help with eating, dressing, bathing, using the bathroom and moving around, given by aides who work for licensed home care agencies or adult care homes.
Who: Disabled adults age 18 and older who need the level of institutional care covered by the Medicaid state plan and who need at least one CAP/DA service. The person must be an approved Medicaid beneficiary and be assessed by a CAP/DA case manager.
In-home aide levels 1 and 2, adult day health, respite, personal emergency response, equipment and modifications, meal delivery, and other waiver services.
Family caregivers: Yes. Consumer Directed Services let the participant or a representative act as employer and hire, supervise and set pay for a personal assistant.
Who: People age 55 or older who live in a PACE service area, are determined to need a nursing facility level of care, and can live safely in the community. Enrollees can have Medicaid, Medicare, both, or pay privately.
Medical care, adult day health center services, in-home services, therapies and prescriptions, coordinated by a care team and paid through combined Medicare and Medicaid payments.
Who: Adults age 60 or older who live at home, need personal care or home management help, and can direct their own care or have someone who does. Not offered in every county.
A consumer-directed in-home care program with a care advisor and payroll help from a financial management service.
Family caregivers: Yes. The older adult may hire family, friends or others. The person who directs the care cannot be the paid caregiver.
Who: Adults age 60 or older who live at home and need home management or personal care help, where no responsible person is available or the caregiver needs relief.
Home management, personal care and respite at several levels of need, offered by local providers funded through the block grant.
Rules change; confirm with NC Department of Health and Human Services, Division of Health Benefits (NC Medicaid). A care advisor can talk through payment options.
At the North Carolina median of $30 an hour, home care for part of the day usually costs less than a facility.
Costs in every locationNorth Carolina medians, CareScout Cost of Care Survey 2025. Home care months are estimates: hourly rate x hours x 52 / 12. Not HomeCare.com prices.
Home care in North Carolina helps seniors who need assistance with “activities of daily living (ADL’s)” and their family. In-Home Care can be provided in North Carolina by either a home care agency or private duty caregivers. Agencies have physical locations and are more strictly regulated by the state, but many more experienced caregivers decide to work directly for the family as private duty home health aides so they can avoid the agency overhead that cuts into their wages.
HomeCare.com specializes in connecting families with caregivers who meet their unique needs. Our care advisors have years of experience dedicated to assisting families through this process. We'd be happy to offer you a free consultation to discuss your specific requirements and help you find the best possible caregiver.
NC Medicaid reports 11 PACE organizations operating in 14 locations in the state. PACE programs serve Buncombe (CarePartners), Mecklenburg (Senior TLC), Durham (Senior CommUnity Care of North Carolina), Guilford (PACE of the Triad) and New Hanover (Elderhaus) counties, which cover all five locations here.
CareScout's 2025 Cost of Care Survey puts the North Carolina median for a non-medical caregiver at $30 an hour. The national median is $35. The same survey lists assisted living at $6,496 a month and adult day care at $85 a day. Costs vary by metro, so check your local page. A care advisor can talk through payment options.
It can, for people who qualify. NC Medicaid covers Personal Care Services (PCS) after an in-person assessment. The Community Alternatives Program for Disabled Adults (CAP/DA) is a waiver for adults 18 and older who need an institutional level of care. The NC Medicaid Ombudsman, at 1-877-201-3750, helps members with problems.
Yes. The NC Division of Health Service Regulation licenses home care agencies. Since a 2023 law change, an organization that mainly gives companion, sitter, respite or homemaker help also needs a home assistance services provider license. Nurse registries are exempt only if they tell clients in advance they are not licensed agencies. A care advisor can explain how HomeCare.com works.
In some programs, yes. In CAP/DA, a participant can direct their own care and hire a personal assistant. Home Care Independence lets an older adult hire family or friends, but the person who directs the care cannot be the paid caregiver. The Family Caregiver Support Program does not pay caregivers. Ask your Area Agency on Aging.
Start with your Area Agency on Aging. Each one is housed in a regional Council of Government and covers several counties. The NC Division of Aging can be reached at 919-855-3400. The federal Eldercare Locator, at 1-800-677-1116, can route any caller. The NC Lifespan Respite Program can reimburse eligible family caregivers up to $750 a year.
You call a care advisor at 800-974-3458, describe the help you need, and HomeCare.com refers credentialed, non-medical caregivers. Choose the schedule, including live-in or 24-hour care. There are no minimums and no contracts. Short-notice and backup care are available, the app verifies each visit, and support is open 7 days a week.
