As a person ages, even if they are still physically capable of living independently, they may find themselves needing emotional companionship. After all, as spouses, friends or family pass, a senior’s social interactions might decrease, causing daily loneliness to skyrocket. At the same time, family members who work or live out of state may not be able to provide that much-needed, in-person interaction with aging loved ones.
“Consequently, families may choose to hire an independent companion caregiver, or they may choose to hire an in-home care agency that provides in-home care companions,” explains Ryan Miner, director of business development at Nest & Care.
Here, the basics on companion care services and how much they cost.
“Companion care is administered primarily as an emotional support system for aging adults, senior citizens and individuals with disabilities who wish to remain in their homes.”
Ryan Miner of Nest and Care
What is companion care?
Companion care is a non-medical, in-home care service offering companionship to aging adults, senior citizens and individuals with disabilities, explains Miner. Companion care can be administered by a certified nurse assistant (CNA), but certification is not required to administer this non-medical care.
“Companion care is administered primarily as an emotional support system for aging adults, senior citizens and individuals with disabilities who wish to remain in their homes,” he says.
This type of care only helps individuals with non-medical activities of daily living and does not include hands-on or medical assistance. “It can be administered by a family member, a loved one or a friend,” says Miner who adds that companion care can take place at home, in a senior living community, independent living or wherever an older adult resides.
Some aging adults may require assistance with their hygiene practices or other personal care services to ensure they remain healthy, comfortable and confident at all times. However, Miner explains that companionship care is different, and it’s certified home health aides who typically perform more hands-on care.
Personal care services that companion caregivers do not provide include:
- Toileting.
- Incontinence care.
- Perineal care.
- Catheter care.
- Bathing.
- Oral hygiene.
- Hand washing.
- Dressing.
- Skin, hair and nail care.
How to find a companion care services
How you go about searching for and hiring a companion caregiver can impact the hourly rate that you pay. Here are various ways to hire companion care:
Through an agency
Home health or nursing agencies are the most common source of finding companion care, according to Gail Weatherill, a registered nurse who works to support dementia caregivers and provided companionship care to a family friend. According to Weatherill, hourly rates vary drastically between regions, but whatever the rate, she adds, “the companion generally is paid about half of the fee.”
Another thing to consider, according to Stephan Baldwin, founder of Assisted Living Center, is that agencies usually require a certain number of hours a day, “so you cannot book them for specific hours of the day.”
Miner adds that in his experience, it’s a daily four-hour care minimum with the cost of companion care rising if you opt for less than four hours a day.
Directly
Families may also opt to directly hire a companion to avoid the heavy overhead costs of using an agency, explains Weatherill. You can look at caregiver listings on Care as well as on Craigslist, social media or in local print media, or reach out to trusted loved ones and search by word of mouth.
Through a volunteer or social worker
Some volunteers don’t charge at all, explains Baldwin, and they can be found through local churches, colleges and community centers. “Some local agencies on aging provide counseling on the best ways to find local care,” adds Weatherill, and families can find their local agency through the National Association of Area Boards on Aging.
“Some local agencies on aging provide counseling on the best ways to find local care.”
—Gail Weatherill, registered nurse
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What you can expect to pay for companion care
Typically, companion caregivers charge an hourly rate. However, the set amount will vary based on a range of factors, including:
- Your location.
- The senior’s needs.
- Whether you are going through any agency.
According to Brittany Ferri, an occupational therapist specializing in geriatric care, a caregiver’s prior experience and whether or not they carry other certifications will impact their rate. However, she notes that some organizations may also offer package deals if you book, say, five or more hours per week.
According to the most recent Genworth’s recent Cost of Care survey, conducted in 2022, the median national hourly cost for homemaker services, or companion care, is $26.78, but this drastically changes depending on location, ranging from $19.00 to $35 per hour.
States with the most expensive median hourly rate for a homemaker or companion caregiver in 2021, according to Genworth:
- Minnesota: $35.00
- Washington: $34.34
- Colorado: $33.50
- California: $32.00
- New Hampshire: $31.50
- Oregon: $31.50
- Massachusetts: $31.00
- South Dakota: $31.00
- Alaska: $30.00
- Hawaii: $30.00
States with the lowest median hourly rate for a homemaker or companion caregiver in 2021, according to Genworth:
- Tennessee: $24.00
- Texas: $24.00
- South Carolina: $23.25
- North Carolina: $23.00
- Georgia: $22.50
- Arkansas: $21.95
- Alabama: $20.00
- Mississippi: $20.00
- Louisiana: $19.00
- West Virginia: $18.50
“Private insurances are far less likely to cover in-home services that are not medical in nature.”
—Brittany Ferri, occupational therapist
Does insurance cover companion care?
No matter where you live, companion care can quickly add up depending on how often you hire someone to help. Unfortunately, insurance coverage varies largely depending on the type that someone has, explains Ferri.
“Some insurances offer a certain level of reimbursement, but private insurances are far less likely to cover in-home services that are not medical in nature,” she says. “There are also grants that may be available to older adults who have limited assets and want this type of care, but these vary based on location and region.”
Below is a general breakdown of potential coverage:
Medicare
Usually, Medicare only covers an individual’s medical care for a short period of time to recover from things like surgeries, but not companion care services, according to Baldwin. Since Medicare is unlikely to cover costs for this non-skilled, in-home companion care, Miner suggests families consider hiring “a geriatric care manager or a social worker to navigate the complexities of Medicare and Medicaid when determining coverage and benefits for in-home companion care coverage.”
Medicaid
Medicaid may help with companion care costs in some states, according to Weatherill, as they may not require that a caregiver be a trained nurse’s aid. “These requirements are set by the state legislature,” she says and you can find more information about each state’s Medicaid companion care eligibility requirements here.
Private insurance
Some insurance plans may offer to cover companion care but many do not, according to Miner. “However, don’t hesitate to get in touch with your insurance company to learn if your plan covers the costs of in-home companion care,” he says.
Long-term care insurance
Some LTC policies may help pay for a home health aide, however less are likely to cover companion care. In Weatherill’s experience, “almost all policies require that the client need hands-on care before the policy will activate.” However, Miner urges policy holders to contact your LTC insurance company directly as he’s found that many plans do offer some type of coverage for non-medical, in-home companion care.
Veteran aid
If your senior is a military veteran, Miner says that Aid & Attendance may cover companion care if you meet certain eligibility requirements.
Hospice
Lastly, if an individual is placed into hospice care, the hospice provider may offer an in-home companion care provider for the hospice patient.
Ultimately, companion care is a fantastic option for older adults who don’t need daily medical care but do need hands-off activity and social interaction to combat isolation. If it feels like this type of care is best for your loved one, it could pay to investigate your options.
