What is private pay home care?
Private pay home care simply means your family pays for care at home out of pocket, instead of Medicaid, Medicare or insurance paying. Private home care services are usually non-medical: bathing, dressing, meals, housekeeping, errands, company and supervision. Some families also pay privately for nursing at home or home health aides.
Private in home care is the most flexible option. You choose the hours, the caregiver and the tasks, with no assessment and no waiting list. That flexibility is why many families use private care for elderly at home relatives while they apply for programs that might pay later. Private home care for seniors can be as little as a few hours a week — see part-time and short-term home care — or as much as 24-hour care.
Some people call it private care in your own home, private in home care services, private care services, or private home help. It all means the same: you pay, and you choose.
Private home care agencies vs. private caregivers
The biggest decision is who employs the caregiver.
| Private home care agency | Independent caregiver | |
|---|---|---|
| Who employs the caregiver | The agency | Usually you, as a household employer |
| Hourly cost | Higher — includes overhead | Usually lower |
| Screening and background checks | Agency does it | You do it |
| Payroll taxes | Agency handles | You handle (IRS Publication 926) |
| Backup if the caregiver is sick | Agency sends someone | You find someone |
| Insurance | Agency carries liability and workers' comp | You arrange it |
| Choice of caregiver | Agency assigns; you can ask for changes | You pick |
Private home care agencies — also called private home care providers, private care agencies, private care companies or private care providers — sell you a service. A private caregiver agency does the hiring, training and scheduling, and sells private caregiver services by the hour. Private pay home care agencies often have minimum shift lengths, so ask. Our checklist for choosing a home care agency covers the questions, and local home care agencies compares agency types. For national brands, see our independent comparisons of Home Instead, Right at Home and Home Helpers.
A third option sits between the two: caregiver registries and online platforms that introduce you to independent caregivers for a fee. They may run background checks, but in most cases you're still the employer. Read the terms carefully.
How much private pay caregivers cost
CareScout's 2025 Cost of Care Survey put the national median for non-medical caregiver services — homemakers and home health aides, now reported together — at $35 an hour, or $80,080 a year at 44 hours a week. That median reflects agency rates. Independent caregivers usually charge less per hour, but you add the employer's taxes and insurance.
| Schedule | Hours per week | Approximate weekly cost |
|---|---|---|
| Mornings, three days | 9 | $315 |
| Four hours, weekdays | 20 | $700 |
| Full-time weekdays | 44 | $1,540 |
| Around the clock, hourly | 168 | $5,880 |
Rates vary a lot by region, so ask several agencies and caregivers. For all the ways families pay — savings, long-term care insurance, VA benefits and Medicaid — see the cost of in-home care. A live-in caregiver is priced differently again.
Hiring a private caregiver on your own
An independent caregiver works directly for your family. Many are experienced aides who left agencies for better pay and steadier schedules with one client. When families hire private caregivers for hire, or independent caregivers for hire, they're usually looking for three things: someone reliable, someone their parent likes, and a lower hourly rate.
Private caretakers — sometimes advertised as caretakers for hire or senior caregivers for hire — vary widely. A private caregiver for elderly parents can be a certified aide, a CNA, a former nurse or someone with years of family experience and no certificate. Private caregivers for seniors don't need a license for non-medical care in most places, so you decide what training you require; a private home care aide with a certificate may charge more. Private in home caregivers who give hands-on care should, at minimum, have experience with transfers, bathing and whatever conditions your parent has.
Independent in home caregivers sometimes offer independent home care services as a small business. If a caregiver says they're self-employed, that doesn't settle it: under IRS rules, if you control what work is done and how it's done, they are usually your household employee.
How to find a caregiver: where families look
When families first try to find a caregiver, the caregiver search usually runs through these places:
- Word of mouth — friends, neighbours, your parent's place of worship, and aides who've cared for people you know.
- Your Area Agency on Aging, which often keeps lists of local home care providers and caregivers.
- Caregiver registries and online platforms that list private caregivers.
- Home care agencies — including ones with private-duty divisions.
- Hospital social workers and discharge planners, who know local options.
- Family. If a relative is already helping, Medicaid may pay them — see below.
Families looking for private caregivers do best when they write down the job first: tasks, hours, days, and must-haves like driving, lifting or a second language. Whether you want to find home care, find a caretaker, find senior caregivers, find an in home caregiver or find local caregivers, a clear job description gets you better candidates faster. Our home care near me guide walks through local searches.
How to vet a private caregiver
Before you hire a caregiver, check:
- Identity and work eligibility. As an employer you complete Form I-9.
- Background check. Use a reputable screening service, with the caregiver's written consent. Include your state's abuse and neglect registry where one exists.
- Driving record, if they'll drive your parent.
- Two or three references from families they've worked for — and actually call them.
- Training and certificates, if they say they're a CNA or home health aide. States have online lookups for certified aides.
- A paid trial shift with you present.
Then write a short agreement: duties, schedule, pay rate, overtime, how to request time off, and what happens if either side wants to end it. If you hire in home caregiver help for a parent with dementia, add how to handle wandering and emergencies.
Find out in 2 minutes
Answer 5 easy questions. See your programs and pay before you share any contact info.
Household employer taxes when you hire privately
If the caregiver is your household employee, IRS Publication 926 sets out what you owe. For 2026:
- Social Security and Medicare tax applies if you pay one household employee $3,000 or more in cash wages in the year. You withhold the employee's share and pay your share.
- Federal unemployment tax (FUTA) applies if you pay $1,000 or more in any calendar quarter to household employees.
- Federal income tax withholding isn't required — only if the employee asks and you agree.
- You'll need an employer identification number (EIN), file Schedule H with your tax return, and give the employee a Form W-2.
Many families use a household payroll service to handle all of this. A tax preparer can also tell you whether the dependent care credit or other breaks apply.
Insurance for private caregivers
When you hire privately, think about three kinds of risk:
- Injury to the caregiver in your home. Ask your homeowner's or renter's insurer what's covered. Some states require workers' compensation for household employees; check your state's rules.
- Injury to your parent or damage to property. Some independent caregivers carry their own liability insurance; ask for proof.
- Driving. If the caregiver drives your parent, check your auto policy covers them.
Agencies should carry liability insurance, workers' comp and a bond. Ask for certificates, not just assurances.
"I need a caregiver": where to start
Most people don't search for "private pay home care." They type what's happening: "I need a caregiver," "need a caregiver," "I need a caregiver for my mother," "looking for a caregiver for my mom," "need help at home" or "I need home care." If that's you, start here:
- Name the need. Is it help with bathing and dressing, supervision, medical care, or a break for you? That tells you whether you need an aide, a nurse or respite care.
- Check what could pay. Our two-minute check shows whether Medicaid may cover care. Medicare covers short-term skilled care only — see home health vs. home care.
- Line up private help for now. Call an agency or two and ask around for an independent caregiver.
- Apply for programs at the same time, so private pay is a bridge, not a permanent cost.
If you're finding a caregiver for an elderly parent from another city, lean on the Area Agency on Aging where your parent lives. Finding help for elderly parents is easier when someone local can check in.
When the caregiver is for you
If you're thinking "I need a caregiver for myself" or "I need a caretaker," the same steps apply. Many Medicaid programs let you hire and direct your own caregiver — including a relative or friend — through consumer-directed care.
Finding home care for elderly parents
Finding home care for elderly parents usually starts in a rush — after a fall, a hospital stay or a worried phone call. When you're finding in home care for elderly relatives, it helps to plan for the next year, not just the next week. An ad that reads "caregiver needed for elderly person, mornings" today may need to cover more hours in six months.
If you need a caregiver for elderly parents or are looking for a caregiver for elderly relatives, ask candidates about experience with the specific conditions — dementia, Parkinson's, diabetes, recovery after stroke. Whether you're looking for home care, looking for in home caregiver help or looking for a private caregiver, you're hiring a person. When you find caregiver for elderly parents who fits, try to keep them: consistency matters more than almost anything for older adults. Private care for seniors works best with the same one or two people.
Our guides to caring for aging parents and senior home care cover the wider decisions, including when assisted living might fit better.
Private duty home care
"Private duty" means care paid privately and delivered in longer shifts for one client, rather than short visits. A private duty home care agency supplies aides or nurses for those shifts. Caregivers sometimes call a long-term private-pay client a "private case," so a private case caregiver is someone working for one family on an ongoing basis.
Private duty is common for overnight care, post-hospital recovery that Medicare's visits don't cover, and families who want the same caregiver every day. For skilled private duty, see in-home nursing care.
Private caregivers near me: searching locally
Local searches are the most common way families start. The phrases vary — private caregivers near me, private caregivers for hire near me, independent caregivers near me, private home care near me, private pay home care near me — but the method is the same:
- Search for two or three private home care agencies near me and ask for private-pay rates and minimum shifts.
- Ask your Area Agency on Aging for private home care services near me and any local caregiver registry.
- Post a clear "private caregiver needed" ad with the job description, and interview at least three independent caregivers.
- Compare the true cost: agency rate vs. caregiver rate plus taxes and insurance.
If you're looking for caregiver near me help today — whether you searched find a caregiver near me, find caregivers near me, hire a caregiver near me, need caregiver near me, caregivers for hire near me, private duty caregivers near me or private duty home care near me — agencies can usually start fastest. Families looking for private caregivers near me for the long run often end up with an independent caregiver or a paid family member.
Private caregivers for elderly near me, private home care for elderly near me, private care providers near me, private care services near me, private caregiver agencies near me, private duty agencies near me, private duty aides near me, private duty near me, private in home caregivers near me, private pay caregivers near me, private care company near me and private home help near me searches all land on the same local agencies and caregivers. Use the questions in how to choose a home care agency to sort them, and see home care near me and home care by city.
Private carers: the same search in other words
"Carer" is the British and Australian word for caregiver, and plenty of Americans use it too. If you're looking for a carer, want to hire a carer, or need to find a carer near me, everything on this page applies. Searches like "find carer," "hire carer," "independent carer," "independent carers near me," "private carers," "private carer near me," "private carers near me," "private carers in my area," "private carers at home," "private home carers near me," "looking for private carers" and "find a private carer" all mean the same thing as a private caregiver.
Finding a carer for the elderly works the same way as finding a caregiver. And if you've thought "I need a carer" or "I need a carer for myself," see the steps in the "I need a caregiver" section above.
Before you pay privately for years: check Medicaid
Private pay makes sense for short stretches or light schedules. For long-term care, the costs add up fast — and many families pay privately without knowing their relative qualifies for Medicaid home care, which has higher income limits than most people expect.
Medicaid can pay an agency, and in every state it can also pay a family member through self-directed programs. If you're already the caregiver, see how to get paid to care for a family member, Medicaid home care and agency care vs. a paid family caregiver. Sunroom Care helps families enroll at no cost to the family.
Private home care by state
Private pay rates and the Medicaid programs that can replace them vary by state:
- Georgia: if you're comparing a private home care provider Georgia families recommend with Medicaid, note that Georgia's Structured Family Caregiving reports $1,987–$2,400 a month. See Georgia caregiver programs, Fulton County and Gwinnett County.
- New York: CDPAP reports $18.65–$20.65 an hour. See New York and Nassau County.
- Texas: Consumer Directed Services reports $15 an hour. See Texas and Dallas County.
- California: IHSS reports $16.90–$22 an hour. See IHSS and San Diego County.
Find your state on the state list.
Where to go next
Frequently asked questions
What does private pay home care mean?
It means your family pays for care at home directly, rather than Medicaid, Medicare or insurance. You can pay an agency or hire an independent caregiver.
How much does a private caregiver cost?
CareScout's 2025 survey put the national median for non-medical caregiver services at $35 an hour. Independent caregivers often charge less per hour, but you pay employer taxes and arrange insurance.
Is it cheaper to hire a caregiver privately than through an agency?
Usually per hour, yes. But you take on screening, backup care, payroll taxes and insurance, which the agency's rate includes.
Do I have to pay taxes for a private caregiver?
If the caregiver is your household employee and you pay them $3,000 or more in cash wages in 2026, you owe Social Security and Medicare taxes. FUTA applies if you pay $1,000 or more in any quarter. See IRS Publication 926.
Is a caregiver from an agency my employee?
No. IRS Publication 926 says a worker is not your household employee if an agency controls how the work is done. The agency handles payroll taxes.
How do I find a trustworthy private caregiver?
Use referrals, your Area Agency on Aging and caregiver registries, then check identity, run a background check, call references, verify any certification and do a paid trial shift.
Can Medicaid pay instead of private pay?
Often, yes. Medicaid home care programs pay for care at home in every state, and many let your relative hire a family member as the paid caregiver.
Does Medicare pay for a private caregiver?
No. Medicare covers short-term skilled home health from certified agencies, not ongoing non-medical care or private caregivers.
Sources: IRS Publication 926 (2026): Household Employer's Tax Guide · CareScout 2025 Cost of Care Survey results · Medicare.gov: Home health services coverage · Medicaid.gov: Self-directed services. Program rules and rates change — always confirm with the program. Reviewed September 30, 2026.