Home Care Fees in Massachusetts Beyond the $45 Hourly Rate

Care Remedy home health aide care is $45 an hour, one to eight hours a day, with no minimum contract and no assessment fee. Four things sit outside that hourly rate rather than inside it: transportation, stair assistance, overnight coverage and skilled nursing. Everything an aide does during a normal shift is in the $45.

What does the $45 an hour actually include?

The aide's time, and the work an aide is trained to do. Bathing, dressing, grooming and toileting. Transfers and walking. Meals cooked and dishes done. Laundry, bed changes and light housekeeping. Reminders, company, and being in the room so that somebody is there if a fall happens. If the aide spends the shift doing those things, the bill is the hours times $45.

There is no assessment fee, so nobody charges you to come out and decide what is needed. There is no minimum contract, so you are not signing for six months. There is no four hour minimum per visit either, which matters more than families expect. A two hour morning visit is a real option here.

Meals, laundry and light housekeeping are part of the hourly rate, not a separate homemaker charge.

Which services are billed separately from the hourly rate?

Four, and each has its own published price:

• Wheelchair accessible transportation. $115 each way, $230 round trip, within five miles. Beyond five miles it is $2 a mile. This is a van with a ramp and a four point tie down, not an aide driving a sedan.
• Stair assistance. $200 a visit. That brings two trained staff and an electric stair chair, which is what a flight of stairs with no ramp requires. One aide on an hourly visit is not a safe way to get somebody down steps.
• Overnight coverage. $540 for a twelve hour night.
• Skilled nursing. A separate service with separate pricing, because an aide is not a nurse.

The reason those four are separate is that each one costs us something different to deliver. A van, a second staff member, a piece of equipment, a licensed clinician. Folding them into one blended hourly rate would mean charging every family for capacity most of them never use.

What does a month of care cost at each schedule?

On a thirty day month, with no separately billed services added:

• Three hours twice weekly, about $1,170
• Two hours a day, about $2,730
• Three hours a day, about $4,095
• Four hours a day, about $5,460
• Six hours a day, about $8,200
• Eight hours a day, about $10,900
• Every night, about $16,200
• Around the clock at $1,080 a day, about $32,800

Build your own number off the schedule you actually need rather than the one an agency quotes you. The breakdown by hour and by month is in home care cost in Massachusetts per hour and per month, and the full picture on continuous coverage is in what 24 hour home care costs in Massachusetts.

Why is my quote from another agency higher than the hours I asked for?

Usually a minimum. Many agencies will not staff a visit shorter than four hours and some require a minimum number of hours a week before they will take the case at all. If you asked for two hours three mornings a week and the quote came back as twelve hours a week, you were quoted the minimum, not your schedule.

That is a staffing decision, not a care decision, and it is worth naming out loud when you compare quotes. We go into how the minimums work and why they exist in home care agency minimum hours in Massachusetts.

What should I ask any agency so there are no surprises on the bill?

Ask these nine, and ask for the answers in writing before anyone starts:

• What is the minimum number of hours per visit, and per week?
• Is there an assessment, intake or registration fee?
• Is the rate different on holidays, weekends or overnight?
• If the aide drives my mother to an appointment or the pharmacy, who pays for mileage and parking, and in whose car?
• Does the clock start when the aide leaves their home or when they arrive at mine?
• How much notice do I have to give to cancel a shift, and am I charged if I miss that window?
• Does the rate change if two people are needed for a transfer?
• What happens when the regular aide is sick, and is the replacement billed the same?
• Is there a contract term, and what does it take to end it?

For our own answers to any of those, call 781 957 8076 and we will give them to you on the phone rather than after the first invoice. If you are still interviewing agencies, the longer list is in questions to ask a home care agency in Massachusetts.

How do I know the aide actually showed up for the hours I am billed?

Visits are logged in MyCase, our own coordination platform, which means a missed shift is visible to our office rather than something you find out about from your mother three days later. Ask any agency the same question and listen for whether the answer is a system or a promise. An agency that cannot tell you how arrival is recorded cannot tell you what you are paying for.

Will a home health aide do medical tasks if I pay more?

No. Our aides are trained, background checked and insured, and they are not nurses. An aide does not administer medication, including insulin, does not change dressings and does not make clinical judgments. An aide can be present while a client manages their own medication, can help if something goes wrong, and can call for help. That boundary is not a pricing tier you can buy your way past. If the task is clinical, it needs skilled nursing, which is priced separately.

Is private pay the right route at all?

Not always, and it is worth ruling out the free and lower cost routes first. Your local Aging Services Access Point can tell you what state funded home care your parent qualifies for. The town Council on Aging runs programs that cost nothing. If your parent has MassHealth and needs hands on help with daily activities, the Personal Care Attendant program pays a caregiver of their choosing, and that is a different and much cheaper path than paying an agency hourly. A long term care insurance policy, if there is one, may reimburse hourly care once its conditions are met.

Private pay makes sense when you need a specific schedule now, when nobody qualifies for a program, or when the program hours do not cover the hours that are actually hard. Those are real situations and they are most of our work. They are just not every situation.

Who do I call?

781 957 8076, or info@careremedyinc.com. We serve eastern and central Massachusetts from offices in Woburn, Springfield and Brockton. Tell us the schedule you want and we will quote that schedule, including whatever separately billed services it needs, before you commit to anything.

Program eligibility and insurance terms vary by household. Confirm benefit questions with the program itself, and anything involving taxes or a policy's conditions with your own accountant or attorney.