In-home care (non-medical caregiver) costs in Texas
Here is the middle of the price range in Texas, and then — because it is the question that actually follows — who pays for it. The short answer on that second one surprises most people: Medicare does not.
The Texas median
$30.00 an hour
- Works out to, monthly
- $5,720
- Works out to, yearly
- $68,640
Our arithmetic, not the survey's. The survey reports this one by the hour, so the monthly and yearly figures assume a schedule: $30.00 an hour × 44 hours a week × 52 weeks ÷ 12 months. Fewer hours, smaller bill — the schedule is the biggest lever you have.
That is about 14% lower than the national median of $35.00 an hour. Within Texas the spread is usually wider still: a city costs more than a rural county, often by a great deal.
A caregiver who comes to the house to help with bathing, dressing, transferring and toileting, and who may also do light housekeeping and meal preparation.
What this number is, and what it is not.
It comes from an industry cost-of-care survey — providers reporting their prices — not from a government rate table. There is no federal agency that publishes what assisted living costs, which is why the survey is the source of record here and why we label it plainly rather than dressing it up as official.
A median means half charged more and half charged less. It is not a quote for any particular home, agency or facility, and no provider is bound by it. Prices collected for the 2025 survey.
Where Texas sits
$30.00 an hour ranks Texas 43rd of the 50 states priced for in-home care (non-medical caregiver): 42 charge more, 4 charge less. New Mexico, North Carolina and West Virginia report the same figure.
Tennessee is the next state up, at $31.00; Alabama the next down, at $27.00.
The national median is $35.00, so Texas runs $5.00 below it — 14% less, or $11,440 a year ($5.00 × 44 hours a week × 52 weeks).
The column runs $24.00 (Mississippi) to $46.00 (Wyoming). Texas sits 27% up it, 1.25× the lowest, with 11 other within a tenth of it.
Of the 6 kinds of care Texas was priced for, this is its 4th dearest standing: at best 25th of 46 for skilled nursing at home (private duty nurse), at worst 50th of 50 for nursing home, semi-private room.
What $5,720 a month becomes
Our multiplication, holding the Texas median flat — no real bill does — with the same span of the state's least costly priced care beside it:
Six months
$34,320
$11,700 of adult day health care
One year
$68,640
$23,400 of adult day health care
Two years
$137,280
$46,800 of adult day health care
Three years
$205,920
$70,200 of adult day health care
Five years
$343,200
$117,000 of adult day health care
Care is bought in years, not months, and $5,720 a month is $68,640 a year.
Five years at the national median would be $400,400: $57,200 more than five years in Texas.
Inside Texas, five years of adult day health care runs $117,000 and five of skilled nursing at home (private duty nurse) $1,029,600; this page's $343,200 sits 25% between them. Most families pay for more than one of these in sequence.
Against other care in Texas
Converted to a month on our schedule, set beside this page's $5,720:
Skilled nursing at home (private duty nurse)
$17,160 a month
$11,440 a month more, $137,280 a year, 3.00× this page. Texas places 25th of 46 for it, 18 above its 43rd here.
Nursing home, private room
$7,604 a month
$1,884 a month more, $22,608 a year, 1.33× this page. Texas places 48th of 49 for it, 5 below its 43rd here.
Assisted living community
$5,666 a month
$54 a month less, $648 a year, 0.99× this page. Texas places 34th of 50 for it, 9 above its 43rd here.
Nursing home, semi-private room
$5,627 a month
$93 a month less, $1,116 a year, 0.98× this page. Texas places 50th of 50 for it, 7 below its 43rd here.
Adult day health care
$1,950 a month
$3,770 a month less, $45,240 a year, 0.34× this page. Texas places 29th of 45 for it, 14 above its 43rd here.
On the same monthly footing, in-home care (non-medical caregiver) is the 3rd costliest of the 6 kinds of care priced in Texas, at $5,720. The conversions are ours; the medians are the survey's.
44 hours a week of in-home care in Texas is $5,720 a month against $5,666 for assisted living — 1% less. The first buys 44 hours and nothing else; the second includes the room, the meals, and someone awake overnight.
Who actually pays for this
This is the part most cost pages leave out, and it is the part that changes what a family does next.
Medicare does not pay for long-term care
Medicare pays for short stretches of skilled care — a limited stay in a skilled nursing facility after a qualifying hospital admission, or skilled home health under specific conditions. It does not pay for custodial care: help with bathing, dressing, meals, medication reminders and supervision. That is what most people need, and for years at a time.
Medicare's own page on long-term care ↗ says the same thing in its own words. It is worth reading once, because almost everyone assumes the opposite.
Medicaid may pay — after a spend-down
Medicaid is the largest payer of long-term care in the country, but it is needs-based: it begins once income and countable savings are inside the limits Texas sets. Getting there by spending savings on care is what people mean by a spend-down. There is also a look-back period, so gifts and transfers made in the years beforehand matter.
Veterans: Aid and Attendance may help
A wartime veteran, or a surviving spouse, who needs help with daily activities may qualify for an addition to the VA pension called Aid and Attendance. It is an income-and-net-worth benefit, it is paid monthly, and a great many families who qualify have never heard of it. Accredited veterans service organizations help with the claim for free.
Otherwise: savings, family, and long-term care insurance
Most families pay out of pocket first — from savings, a pension, the sale of a house, or several relatives contributing. A long-term care insurance policy bought years ago pays a daily or monthly amount if the policy's conditions are met; if there is a policy in the family, find it and read what triggers it before you need it.
Working out which of these applies to one particular family is exactly what a free Texas counselor does all day. They are paid by a federal grant, not by commission, and they have nothing to sell you. The Eldercare Locator (ACL): 1-800-677-1116 ↗ will connect you to the area agency on aging for your county.
Who to ask in Texas
Texas's free counseling program is Health Information, Counseling, and Advocacy Program (HICAP), on 1-800-252-9240. It is grant-funded and sells nothing.
Texas Health and Human Services Commission decides Medicaid long-term care here — not a facility, and not us. Texas runs it as Nursing facility (institutional) Medicaid, Home and community based services waiver (STAR+PLUS HCBS and related waivers) and Medicaid for the Aged and People with Disabilities (SSI-related), with a 60-month look-back on gifts and transfers.
Beside $5,720 a month — our comparison, its limits — that is what "spend-down" means: a single applicant's monthly income may not top $2,982, which this bill clears 1.9 times over and countable assets may not top $2,000, or about 11 days of in-home care (non-medical caregiver) at this rate.
Verified 2026-08-02 against CareScout (formerly Genworth) Cost of Care Survey 2025, fielded July-November 2025 (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against SHIP National Technical Assistance Center (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against Texas Health and Human Services, STAR+PLUS Handbook Appendix VIII, Monthly Income/Resource Limits — 2026 Income and Resource Reference Chart (effective 2026-01-01)
Common questions
- Does Medicare pay for in-home care (non-medical caregiver) in Texas?
- No. Medicare pays for short stretches of skilled care after a qualifying hospital stay, and for skilled home health in limited circumstances. It does not pay for long-term custodial care — help with bathing, dressing, meals and supervision — which is what most families are actually paying for.
- Is in-home care (non-medical caregiver) dearer in Texas than in other states?
- $30.00 an hour places Texas 43rd of the 50 states the survey priced for it: 42 charge more and 4 charge less. The national median is $35.00. That ranking is our arithmetic on the survey's published medians, not a ranking the survey itself publishes.
- Is this the price I will be quoted in Texas?
- No. It is the middle of a range from an industry cost-of-care survey: half of the providers surveyed charged more, half charged less. Prices vary a great deal between a city and a rural county in the same state, and no facility is bound by this figure.
- Who can help me work out how to pay for it?
- Texas runs its free counseling program as Health Information, Counseling, and Advocacy Program (HICAP), on 1-800-252-9240. It is paid for by a federal grant, sells nothing, and the Eldercare Locator (1-800-677-1116) will connect you to the area agency on aging that covers your county.