You just found out a parent or spouse needs help at home, and before you can even think about schedules or which agency to call, one question crowds out everything else: what is this going to cost?
Here’s the short answer. If a doctor has ordered skilled care such as nursing visits, physical therapy, or wound care, and your loved one is homebound, Medicare typically covers home health care at $0 out of pocket. If what’s needed is a companion or aide to help with bathing, meals, and daily tasks without a medical order behind it, that’s a different category, usually paid for privately, and in the Chicago area it runs roughly $30 to $40 an hour.
Most articles on this topic blur those two categories together, which is exactly why so many families end up either overpaying for help they didn’t need to pay for, or assuming nothing is covered when part of it actually is. This guide keeps the two separate, gives you real numbers for each, and shows you how to find out in one phone call which category your family falls into. As a Medicare-certified, ACHC accreditation home health agency serving Chicago, Orland Park, Palos Hills, Palos Heights, Tinley Park, Oak Lawn, and the rest of Will County, this is a conversation we have with families every week.
“Home Health Care” vs. “Home Care”: Why the Words Matter for Your Bill
These two phrases get used interchangeably in everyday conversation, but they mean very different things to Medicare, to your insurance company, and to your wallet.
Home health care is skilled, medical care ordered by a physician: intermittent care from a nurse, physical therapy, occupational therapy, speech-language pathology, and medical social work, delivered under a specific plan of care. This is what Medicare Part A and Medicare Part B are built to cover, when your loved one qualifies.
Home care, also called personal care, companion care, or custodial care, is non-medical support: bathing, dressing, meal prep, light housekeeping, and supervision. It doesn’t require physician certification, and outside of a few specific programs, Medicare does not pay for it.
The reason this distinction matters for cost is simple. One of these is very often free to the patient, and the other almost never is. Knowing which one your family actually needs is the single biggest factor in what you’ll end up paying.
| Term | What It Means | Who Typically Pays |
| Home health care | Skilled, physician-ordered medical care | Medicare, in most qualifying cases |
| Home care | Non-medical personal support | The family, out of pocket |
Does Medicare Cover Home Health Care Costs?
For most families with Original Medicare, yes. When the situation meets Medicare’s criteria, covered home health services are paid in full, with no deductible and no coinsurance for the visits themselves.
To qualify for Medicare home health care, a physician has to certify that your loved one is homebound, meaning leaving home requires considerable effort or is medically inadvisable, and needs skilled nursing care, physical therapy, or speech-language pathology on an ongoing basis. Once that certification is in place, Medicare-covered home health can include:
- Skilled nursing visits
- Physical, occupational, and speech-language therapy
- Medical social services
- Home health aide services, but only when they are part of the same plan of care for skilled needs
- Medical supplies used during a covered visit
There is no per-visit co-payment and no annual deductible for these services under Original Medicare, based on Medicare’s official home health coverage guidelines. If your loved one has a Medicare Advantage plan instead, coverage rules are similar but plan specific, so it’s worth a quick call to confirm details directly with that plan.
Not sure where your situation falls? Call (708) 489-0123 and we will walk through your loved one’s situation with you, no obligation, just a straight answer.
What Medicare Does NOT Cover
Being upfront about the limits matters as much as explaining what’s covered. Here is what Medicare home health does not pay for:
- Twenty-four hour a day care at home
- Meal delivery
- Homemaker services such as cleaning or laundry, when they aren’t part of your care plan
- Custodial or personal care, when that is the only kind of help needed, with no skilled care involved
- Durable medical equipment, which is covered but typically carries a 20% DME coinsurance under Part B, unlike the home health visits themselves
If your family’s need falls into one of these categories, that isn’t necessarily bad news. It just means you’re likely looking at the private-pay or alternative-payment side of this guide, not a coverage gap or a mistake anyone made.
What Private-Pay Home Care Costs in the Chicago Area
When care isn’t Medicare-eligible, most often because it’s custodial rather than skilled, or because more hours are needed than a skilled care plan covers, families typically pay privately for a home care aide. In Illinois, that generally runs $30 to $40 per hour, with the Chicago metro area often landing at or slightly above the state average.
To make that concrete, here’s roughly what different care levels look like per month at a $35 per hour rate.
| Care Level | Hours per Week | Approximate Monthly Cost |
| A few check-in visits | 7 hrs/week | About $1,050/month |
| Part-time daily support | 15 hrs/week | About $2,275/month |
| Substantial daily care | 30 hrs/week | About $4,550/month |
| Around-the-clock care | 24/7 | Significantly higher, usually priced per shift |
These are planning estimates, not a quote. Actual pricing depends on the level of care, whether overnight or live-in support is involved, and the specific agency you choose.
Comparing Your Payment Options at a Glance
Because the biggest source of confusion is which payment path applies to your situation, here’s a direct comparison.
| Service Type | Who Typically Pays | Typical Out-of-Pocket Cost |
| Medicare-covered skilled home health | Original Medicare or Medicare Advantage | $0 for covered visits, once eligibility is certified |
| Private-pay non-medical home care | The family | $30 to $40 per hour in the Chicago area |
| Medicaid waiver home care | Illinois Medicaid, for those who qualify | Little to no cost, based on financial and medical eligibility |
Other Ways to Pay for Home Health Care
Medicare and full private pay aren’t the only two options. Depending on your loved one’s situation, one of these may reduce or eliminate the out-of-pocket cost.
- Medicaid waiver programs: Illinois’ Persons Who Are Elderly Home and Community-Based Services waiver can cover in-home care for those who qualify financially and medically, including custodial care that Medicare wouldn’t cover.
- Medicare Advantage plans: Some plans offer limited in-home support benefits beyond what Original Medicare covers. Check directly with the specific plan.
- VA benefits: Veterans may qualify for skilled home health or Homemaker and Home Health Aide Care through the VA.
- Long-term care insurance: If your loved one has an existing policy, it may cover custodial home care that Medicare will not.
Working through which of these applies to your family is exactly what a short call with us is for. We’ll walk through your loved one’s situation and tell you plainly which of these options, if any, fits.
How to Find Out What You’ll Actually Pay
The fastest way to get a real answer, rather than a generic range, is a short conversation.
- Call us and describe your loved one’s situation: diagnosis, current living arrangement, and what kind of help is needed.
- We’ll tell you honestly whether it sounds like a Medicare-covered skilled care situation, a private-pay situation, or a mix of both.
- If it looks Medicare-eligible, we handle the physician certification and paperwork with you, so you’re not navigating it alone.
Not sure if you qualify for $0 out-of-pocket home health care? Call (708) 489-0123 for a free eligibility check. There’s no cost and no obligation to find out.
Frequently Asked Questions
Does Medicare cover the full cost of home health care?
Yes, for services that meet Medicare’s criteria: skilled nursing, therapy, and related services ordered by a physician for a homebound patient. Original Medicare covers 100% of the cost, with no deductible or coinsurance for the visits themselves.
How much does home health care cost per hour in Illinois?
When it’s Medicare-covered skilled care, there is no hourly cost to the patient. When it’s private-pay non-medical home care, expect roughly $30 to $40 per hour in the Chicago area.
Is home health care free with Medicare?
It can be, if your loved one meets Medicare’s homebound and skilled-care requirements. It isn’t automatically free for every type of in-home help. Custodial-only care generally isn’t covered.
What is the average cost of home care in Illinois?
Non-medical home care in Illinois averages around $30 to $40 per hour, which translates to roughly $1,000 to $4,500 or more per month depending on how many hours per week are needed.
How much does a home health aide cost per day?
If the aide is part of a Medicare-covered skilled care plan, there is typically no cost. If it’s a private-pay arrangement for a full day of care, cost scales with hours. An eight-hour day at $35 per hour runs around $280, though many agencies price extended shifts differently.
Does Medicaid cover home health care in Illinois?
Illinois Medicaid’s HCBS waiver programs, including the Persons Who Are Elderly waiver, can cover home health and, in some cases, custodial care for those who meet financial and medical eligibility requirements.
Does secondary insurance cover home health care costs?
For Medicare-covered services, there is usually nothing left for secondary insurance to pay, since Original Medicare already covers the full cost. Secondary insurance matters more for related costs like DME coinsurance.
How many hours of home health does Medicare cover?
Medicare covers intermittent care, generally meaning fewer than eight hours a day and fewer than 28 to 35 hours a week, rather than full-time or around-the-clock coverage.
The Bottom Line
Most families searching for this answer are really asking one of two questions: can we get help without going broke, or how much should we budget. The honest answer depends entirely on whether your loved one’s situation qualifies as Medicare-covered skilled care or private-pay custodial care, and that’s not something a generic cost calculator can tell you, because it depends on their specific medical situation.
If you’d rather just ask than guess, call Choice Care Home Health at (708) 489-0123. We’re a Medicare-certified, ACHC accreditation agency serving Chicago, Orland Park, Palos Hills, Palos Heights, Tinley Park, Oak Lawn, and Will County, and we’ll give you a straight answer about your family’s situation in one conversation.
