Quick answer: Companion care is non-medical help with company, meals, errands and light housekeeping. It does not include bathing or dressing. Agencies price it inside the non-medical caregiver band. That band had a 2025 national median of $35 an hour, with state medians from $24 to $46.
Most families do not need a nurse. They need someone in the house a few afternoons a week.
That is companion care. It is the cheapest form of paid help, and it is usually the first thing families should buy.
What companion care includes
Companion care is about presence and daily life, not medicine.
A companion typically does these things.
- Conversation, company and activities
- Meal planning and cooking
- Light housekeeping, laundry and dishes
- Grocery shopping and errands
- Rides and company at appointments
- Reminders for medication, meals and appointments
- Watching for changes and calling family
CareScout’s definition of homemaker services matches this. It describes ancillary assistance with light house cleaning and meal planning and preparation.
The safety value is real. Someone in the house notices a new limp, a missed meal or a stack of unopened mail.
What it does not include
A companion is not a nurse and usually not a certified aide.
Companion care does not include hands-on help with bathing, dressing, transferring or toileting. It does not include wound care, injections or medication administration.
Many agencies allow reminders but not handing over pills. Ask where your agency draws that line before you sign.
Companion care vs personal care vs home health
These three tiers get confused constantly, and the confusion costs money.
| Type Of Care | Typical Tasks | Who Pays |
|---|---|---|
| Companion care | Company, meals, errands, housekeeping, reminders | Private pay, Medicaid HCBS, VA benefits |
| Personal care | Bathing, dressing, transferring, toileting | Private pay, Medicaid HCBS, some Advantage plans |
| Home health | Skilled nursing, physical or occupational therapy | Medicare, if homebound and doctor-ordered |
Buy the cheapest tier that meets the actual need. Families often pay personal care rates for what is really companionship.
The reverse mistake is worse. If someone needs help getting out of the tub, a companion cannot legally or safely provide it.
What it costs in 2026
CareScout now reports homemaker services and home health aide services together as one “non-medical caregiver” category. Companion care is priced within that band.
The 2025 national median was $35 an hour, up 3% from $34 in 2024. State medians ran from $24 an hour in Mississippi to $46 in Wyoming.
At 44 hours a week that equals $80,080 a year nationally. Most companion-care families buy far fewer hours than that.
| Schedule | Weekly Cost At $35/hr | Annual Cost |
|---|---|---|
| 4 hours, twice a week | $280 | About $14,600 |
| 4 hours, five days a week | $700 | About $36,400 |
| 8 hours, five days a week | $1,400 | About $72,800 |
Rates as of September 2026, based on the 2025 CareScout national median.
Companion-only visits often price at or below the local median, because the work needs less training. Ask each agency for its companion rate and its personal care rate separately.
Watch for minimum shifts. Many agencies will not book less than three or four hours. That changes the real cost of a “quick visit.”
Our in-home care cost guide has the full state-by-state table.
Agency or independent hire
This is the decision that shapes everything else.
Hiring through an agency
You pay more per hour and get a lot for it. The agency handles payroll taxes, workers’ compensation, liability insurance, background checks, supervision and replacement staff.
If the companion quits, the agency sends someone else. That reliability is the product.
Ask these five questions on the first call.
- Are caregivers your employees or independent contractors?
- What background checks do you run, and how often?
- What is your minimum shift, and is there a service start fee?
- Who supervises the caregiver, and how often do they visit?
- What happens when our regular person is sick?
Hiring independently
You will pay a lower hourly rate. You will also become a household employer.
IRS Topic 756 says you generally withhold Social Security and Medicare tax once cash wages reach $3,000 in 2026. Employer and employee each pay 7.65% of wages.
Federal unemployment tax applies if you pay household employees more than $1,000 in any calendar quarter. It is 6% on the first $7,000 of wages. A credit of up to 5.4% applies for state unemployment contributions.
You file Schedule H with your Form 1040. A payroll service handles all of this for a monthly fee, and it is worth it.
There is one family exception worth knowing. You do not withhold those taxes on wages paid to your spouse, your child under 21 or your parent. A few exceptions apply. See our guide on paying a family member for caregiving.
Screening an independent hire
Do this yourself, because no agency is doing it for you.
Run a criminal background check and verify the driver’s license and auto insurance if driving is part of the job. Call at least two references and ask about reliability, not personality.
Write a simple job description. List tasks, hours, pay rate, mileage reimbursement and what to do in an emergency.
Do a paid trial shift with a family member present. Most bad matches show up in the first three hours.
How to pay for it
Companion care is long-term care, and Medicare does not cover long-term care.
The home health rules exclude homemaker services unrelated to your care plan. They also exclude custodial care when that is the only care you need. Do not waste a month appealing that.
Four real sources remain.
Medicaid HCBS. Medicaid.gov lists homemaker services, personal care and respite care among standard 1915(c) waiver services. Many states also allow self-direction, so your relative can hire their own worker.
VA benefits. Aid and Attendance raises a veteran’s pension, and families often use that income for companion care. The Program of Comprehensive Assistance for Family Caregivers may help if a family member is the caregiver.
Older Americans Act respite. Your Area Agency on Aging can sometimes fund hours through the National Family Caregiver Support Program. Call the Eldercare Locator at 1-800-677-1116.
Long-term care insurance. Check whether the policy covers non-medical care and what the elimination period is.
One tax note. IRS Publication 502 lets you count wages for nursing-type services as a medical expense. Pure household and personal services do not qualify. If the same person does both, the payment must be split.
Make the hours count
A few hours of company go further when the house supports independence.
Pair companion care with a monitored alert device for the hours nobody is there. Compare options in our best medical alert systems for seniors guide.
Fix the obvious hazards too, using our aging in place checklist. A companion should not be the only thing standing between your parent and a fall.
Bottom line
If your parent is safe but lonely, isolated or skipping meals, companion care is the right first purchase. Budget around the local non-medical caregiver median, which was $35 an hour nationally in 2025.
Use an agency if reliability matters more than price, and hire independently only if you are ready to run payroll. Either way, screen for dependability and start with two short visits a week.
Escalate to personal care the moment bathing or transferring becomes unsafe. If money is tight, call your Area Agency on Aging before you call an agency. Respite hours are free.
Frequently asked questions
What is the difference between companion care and personal care?
Companion care is non-medical company and household help: conversation, meals, errands, appointments, reminders and light housekeeping. Personal care adds hands-on help with activities of daily living such as bathing, dressing, transferring and toileting. Many agencies charge more for personal care because it requires trained aides and more supervision.
How much does companion care cost per hour?
Agencies price it within the non-medical caregiver band. The 2025 CareScout Cost of Care Survey put the national median for a non-medical caregiver at $35 an hour, with state medians from $24 in Mississippi to $46 in Wyoming. Companion-only visits usually sit at or below the local median.
Does Medicare pay for companion care?
No. Medicare does not pay for homemaker services unrelated to your care plan, and it does not pay for custodial care when that is the only care you need. Medicare covers skilled nursing and therapy at home for homebound patients. Companion care is long-term care, which Medicare does not cover.
Is companion care covered by Medicaid?
Often, through home and community based services. Medicaid.gov lists homemaker services, personal care and respite care among standard services states may offer under a 1915(c) waiver. Many states also let the person self-direct, meaning they hire and supervise their own worker. Rules and waiting lists vary by state.
Do I owe taxes if I hire a companion directly?
Usually yes. IRS Topic 756 says a household employer generally withholds Social Security and Medicare tax once cash wages reach $3,000 in 2026, with employer and employee each paying 7.65%. Federal unemployment tax applies if you pay more than $1,000 in any calendar quarter. You file Schedule H with your return.
Sources
- CareScout Cost of Care Survey 2025 — accessed 2026-09-02
- CareScout 2025 Cost of Care Survey median cost data tables — accessed 2026-09-02
- Medicare.gov — Home health services — accessed 2026-09-02
- Medicare.gov — Long-term care — accessed 2026-09-02
- Medicaid.gov — Home & Community Based Services 1915(c) — accessed 2026-09-02
- IRS Topic no. 756, Employment taxes for household employees — accessed 2026-09-02
- IRS Publication 502 (2025), Medical and Dental Expenses — accessed 2026-09-02
- Eldercare Locator (Administration for Community Living) — accessed 2026-09-02