How the estimate is calculated
The planning formula is hourly rate × 24 hours × 365 days ÷ 12 months. At $35 per hour, that is approximately $25,550 per average month and $306,600 per year.
Round-the-clock care usually requires multiple workers and shifts. Overtime, weekends, holidays, minimum shift lengths, overnight expectations, and agency pricing can materially change the total.
Important
Live-in, sleep-in, continuous, and 24-hour arrangements are not interchangeable. Ask for the staffing structure and price in writing.
What changes the price?
- Local wage levels and caregiver availability.
- Agency care versus direct hiring.
- Number and length of shifts and overtime.
- Hands-on personal care, transfers, dementia support, awake overnight care, or two-person assistance.
- Weekends, holidays, transportation, language needs, minimum hours, and cancellation rules.
- Screening, insurance, payroll, supervision, and backup coverage.
Does Medicare pay for 24/7 home care?
Medicare states that its home health benefit does not pay for 24-hour-a-day care at home. It also generally does not cover custodial or personal care when that is the only care needed.
Medicaid, veterans’ benefits, long-term-care insurance, and state programs may help some people. Confirm eligibility and coverage directly with the program or payer.
Agency versus direct hiring
An agency rate may include recruiting, screening, payroll, scheduling, supervision, insurance, and replacement coverage. Direct hiring may offer more control but can make the household responsible for employment classification, taxes, overtime, insurance, backup coverage, and supervision. Compare total responsibility—not only the hourly rate.
If you are interviewing candidates directly, the caregiver interview questions guide covers job-related questions and consistent scoring.
Questions to ask providers
- Is the quote hourly, daily, live-in, or continuous-care pricing?
- How many caregivers and shifts are included?
- What happens when someone calls out?
- Are overtime, holidays, weekends, transportation, and minimum hours included?
- Which tasks are included or require a nurse?
- How often can rates change?
- What are the cancellation, deposit, and termination terms?