North Carolina is home to over 10 million people, including a large senior community that makes up nearly 17% of the population. It has the ninth-largest senior community in the nation, and seniors are the fastest-growing demographic in the state. Many of North Carolina’s cities and counties are listed on the AARP Network of Age-Friendly States and Communities, but no matter where you live in the state, you can find access to community-based services that help you maintain your independence and quality of life throughout your retirement years. 

North Carolina is an affordable option for those seeking in-home care. Overall, the state’s cost of living comes in about 10% below the national median. Seniors don’t pay state taxes on their Social Security income, which may help those who rely primarily on this form of income to afford long-term care. In-home care is relatively affordable at $4,385 per month.  

This guide outlines what you can expect to pay for in-home care throughout that state and how rates compare to other senior care options. It also covers some ways that you may be able to pay for care, highlights local agencies that serve seniors and provides answers to frequently asked questions regarding in-home care.

The Cost of In-Home Care in North Carolina

The 2021 Genworth Cost of Care Survey reports that seniors in North Carolina pay competitive in-home care rates of $4,385 per month. This is nearly $600 lower than the national median rate of $4,957 and cost-effective compared to most of North Carolina’s bordering states. In Virginia, care costs are considerably higher at $4,767. In Tennessee, clients pay $4,576 for services, and in South Carolina, agencies charge $4,433. Only Georgia has more economically priced care, with rates averaging $4,290 per month.

$4385

North Carolina

$4957

The United States

$4767

Virginia

$4576

Tennessee

$4290

Georgia

$4433

South Carolina

In-home care costs vary throughout North Carolina, but rates in all cities are at or below the national median. Of the surveyed cities in the state, Raleigh is the costliest place to obtain care, with fees coming in at $4,957 per month. In Charlotte, care costs are considerably lower but still exceed the state median at $4,668, and in Wilmington, rates average $4,576. Seniors in Rocky Mount pay comparatively low monthly fees of $4,290, and seniors in Jacksonville pay $4,195. In Hickory, care is affordable at $4,099. Goldsboro has the lowest surveyed rates in the state of $3,813.  

$4290

Rocky Mount

$4957

Raleigh

$4668

Charlotte

$4099

Hickory

$3813

Goldsboro

$4195

Jacksonville

$4576

Wilmington

Seniors pay $4,385 for in-home care as well as home health care, which is similar but also includes skilled nursing services, making home-based care the second-most expensive long-term care option in North Carolina. Only nursing home care is costlier at $7,483 per month. Older adults may save money by moving into an assisted living facility, which provides personal care services along with housing, meals and recreational activities. For those who want to remain in their homes while obtaining affordable care, adult day care may be a viable option at $1,197 per month.

$4385

In-Home Care

$4385

Home Health Care

$1197

Adult Day Care

$4010

Assisted Living

$7483

Nursing Home Care

Does Medicaid Cover Home Care in North Carolina?

While North Carolina is a generally affordable state for in-home care, for some seniors, monthly expenses exceed what they can pay for with their retirement income. Fortunately, NC Medicaid provides coverage for in-home care for income-qualifying individuals in the state. It pays for services directly under its Personal Care Services program, which pays for an approved number of hours per month of attendant care. Because this program is part of regular Medicaid, it doesn’t have enrollment caps and those who qualify are guaranteed services.  

The Personal Care Services program features services provided by in-home aides who provide non-medical care to help you age in place. Services include: 

  • Bathing/showering  
  • Dressing 
  • Toileting 
  • Mobility  
  • Eating 
  • Housekeeping 
  • Grocery shopping 
  • Meal preparation 
  • Laundry 
  • Medication reminders 
  • Companionship  

To be eligible for services, you have to undergo an independent assessment that’s conducted by or on behalf of NC Medicaid. You must need partial help with at least three activities of daily living (ADLs) or partial help with one ADL and extensive or full help with a second ADL.  

NC Medicaid also covers in-home care through the Community Alternative Program for Disabled Adults program. This program provides home-based care as an alternative to nursing home care for those who need assistance due to age or disability.  

Home Care Waiver Programs in North Carolina 

Community Alternative Program for Disabled Adults 

The CAP/DA waiver program provides additional in-home services beyond the scope of the regular Medicaid program and is for those aged 18 and over with disabilities that qualify them for nursing home level care. Program participants may have the option to self-direct their care, meaning they choose who provides the services in their care plans. In some cases, family and friends are eligible for hire. Some services this program covers include: 

  • Adult day care 
  • In-home aide services 
  • Personal assistance  
  • Case management 
  • Money management 
  • Respite care 
  • Pest control 
  • Chore services 
  • Basic housekeeping and laundry services 
  • Transportation for errands 
  • Home-delivered meals 
  • Home and vehicle modifications 

To qualify for services, applicants must be at least 18 years old and they must need an institutional level of care. They must also meet Medicaid’s eligibility requirements and need at least one service the waiver pays for. While regular Medicaid is an entitlement, CAP/DA has enrollment caps, and eligible applicants may be placed on a wait list until slots are available. Each county has an allotted number of waiver slots, so even if the program is at capacity in one county, other counties may have open slots.  

To apply for CAP/DA, you must fax a referral request to North Carolina Medicaid at (919) 715-0052.  

How to Know If You’re Eligible for Medicaid in North Carolina 

The primary purpose of NC Medicaid is to provide comprehensive health insurance for low-income individuals. As such, the program has strict income and asset limits. If you are single, you may have an annual income of up to $13,596. All types of earned and unearned income count towards this limit, including veterans’ and public benefits, stock dividends, pensions, withdrawals from retirement accounts and wages. You may have up to $2,000 in countable assets, which include savings accounts, investments and rental or vacation properties you own. Your primary residence, vehicle and personal belongings are exempt. If you’re married, the respective income and asset limits are $18,312 and $3,000.  

2022 Medicaid Income Limits for Seniors in North Carolina  

Income Limits*
Asset Limits

Single Person

$13,596

$2,000

Two-Person Household

$18,312

$3,000

*Per year 

Along with meeting financial criteria, Medicaid applicants must meet additional requirements, including: 

  • They must be permanent North Carolina residents.
  • They must be legal U.S. citizens or residents.
  • They must need the coverage Medicaid provides.

How to Apply for Medicaid in North Carolina 

You can apply for Medicaid online through ePASS or HealthCare.gov. Alternately, you can fill out a paper application and submit it to your nearest Division of Social Services office in person, by fax, through email or through the postal service. You can also contact the DSS to check on the status of your application.   

What Information You Will Need 

To expedite the approval process, you should ensure that you have supporting documents on hand before submitting your Medicaid application. Some documents that you should have include: 

  • Driver’s license or state-issued ID card 
  • Policy numbers for primary health insurance, including TRICARE or Medicare 
  • Birth certificate 
  • Social Security card 
  • Proof of income 
  • Proof of assets 

How to Get Help Applying for Medicaid 

If you need help applying for Medicaid or understanding your benefits, several agencies and programs can assist you in navigating the system and making important decisions regarding your health insurance coverage. The following resources are open to all North Carolina residents and include specialists, legal advisors and informational services.  

Contact
Area Served
Services Provided

(877) 201-3750

Statewide

The NC Medicaid Ombudsman Program advocates for Medicaid beneficiaries in the state to help them access the information and services they need. If you need help with applying for in-home care coverage or appealing denied claims or canceled coverage, you can contact the ombudsman for free assistance.

Online Only

Statewide

The American Council on Aging provides comprehensive, easy-to-understand information on NC Medicaid, including income and asset limits, how income and assets are calculated and what you can do if your resources exceed eligibility requirements. It has a database of Medicaid planners and publishes an overview of strategies that help individuals qualify for coverage.

(866) 219-5262

Statewide

At Legal Aid of North Carolina, a free Medicaid Managed Care Clinic provides general information on the state’s Medicaid program and answers to questions about its coverage. The organization's licensed legal professionals offer one-on-one assistance with applying for Medicaid benefits and other programs that may help cover in-home care.

(888) 245-0179

Statewide

The NC Medicaid Contact Center is open on weekdays and fields calls from individuals with questions about the Medicaid application process, benefits and filing appeals for denied claims.

Does Medicare Cover In-Home Care in North Carolina?

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

  • Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
  • Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
  • Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
  • Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

Other Financial Assistance Options for In-Home Care in North Carolina

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost Resources for Seniors in North Carolina

The following table highlights resources in North Carolina that can help you obtain the services you need to age in place.

Contact
Area Served
 Services Provided

Statewide

Multiple senior centers throughout North Carolina provide residents with recreational activities and social services to help them maintain their physical and mental health and independence. These centers offer free and low-cost congregate meals, transportation services and information and referral services that may help you reduce in-home care costs. Centers also host special events throughout the year, such as tax preparation assistance, driving classes and technology courses. 

(855) 408-1212

Statewide

SHIIP provides free, unbiased health insurance options counseling for Medicare-eligible individuals in North Carolina. You can contact the program’s toll-free helpline for one-on-one assistance with understanding your Medicare benefits and assessing Medigap and Medicare Advantage Plans available in your zip code. SHIIP counselors can also help you read and understand medical bills and resolve issues such as double charges, charges for services not rendered and denied health insurance coverage. 

(800) 662-7030

Statewide

North Carolina has 16 Area Agencies on Aging, which are funded through the Older Americans Act and provide free and low-cost services to help those aged 60 and over maintain their independence. Through your local AAA, you can find home-delivered meals, volunteer-based transportation, friendly check-in services, durable medical equipment loans and prescription drug assistance. In some regions, AAAs provide low-cost in-home care services, which can reduce the amount you pay for services each month. 

(844) 624-8387

Statewide

The N.C. Department of Military and Veterans Affairs has offices in every county in the state, providing convenient access to in-person and over-the-phone benefits counseling and assistance. If you’re a veteran, you can contact the department for help obtaining state and federal benefits, including those that may help cover in-home care or offset care expenses. Your local office can also connect you to counseling, transportation, wellness and medical services in the community.

(800) 942-2677

Statewide

AmeriCorps Seniors RSVP is the largest nationwide program that provides exclusive volunteer opportunities to older adults. Through their local RSVP chapter, those aged 55 and over can serve their communities in ways that fit their schedules, interests and abilities. The program offers free placement services and on-the-job training as well as mileage reimbursement, invitations to recognition events and regular newsletters. 

(919) 855-3400

Statewide

The Division of Aging and Adult Services offers benefits, outreach and advocacy, opportunities and direct services to meet the needs of older North Carolina residents and help them age in place. It operates Adult Protective Services, which investigates reports of elder abuse or neglect. It also maintains a list of in-home aide agencies to help you begin the process of finding services in your area. 

2-1-1

Statewide

NC211 is an information and referral service that serves as a single point of entry to community-based services in the state. You can contact this free, confidential service for help obtaining home-delivered meals, securing home modification or weatherization services, emergency bill pay and volunteer-based transportation services.

COVID-19 Rules for In-Home Care Providers in North Carolina

Unless they have an exemption, home health care aides in North Carolina must be fully vaccinated against COVID-19 before working directly with seniors. This rule is current as of April 2022, but as new information on the virus is available or variants are introduced to the population, guidelines may continue to evolve. The local Area Agency on Aging or health department may have the latest guidelines that home health care agencies are required to follow.  

Currently, there are no vaccine mandates for in-home aides. However, agencies may have their own safety guidelines that exceed state and federal regulations. If you have questions or concerns about the precautions your home care agency takes against COVID, it may be a good idea to contact the agency directly.  

In-Home Care Laws and Regulations in North Carolina

The North Carolina Division of Health Service Regulation regulates home care providers throughout the state. This agency is also responsible for the licensing of home care agencies. The table below gives a basic overview of the rules and regulations that home care agencies in North Carolina must follow.

In-Home Care Laws and Regulations in North Carolina
Scope of Care
Licensed home care agencies in North Carolina may provide nutrition care services, personal care and housekeeping services, and health care services, including occupational therapy, physical therapy and nursing.
Care Plan Requirements
Home care agencies must provide detailed information to clients regarding the provided services, as well as the times and days of service provision.
Medication Management Requirements
Home health aides must complete state-mandated medication administration training prior to assisting with or administering medication.
Staff Screening Requirements
All home care workers must undergo a statewide criminal background check.
Staff Training Requirements
Home health aides are required to complete a training program approved by the Division of Health Service Regulation.
Medicaid Coverage
Medicaid's Community Alternatives and Personal Care Services Programs cover the cost of in-home care services for seniors.
Reporting Abuse
Abuse can be reported to North Carolina's Long-Term Care Ombudsman by emailing Victor.orija@dhhs.nc.gov

Frequently Asked Questions

How much does in-home care cost in North Carolina?

The cost of in-home care varies throughout North Carolina, depending on the agency and location. The average cost of in-home care in the state is $3,813 per month according to the Genworth Cost of Care Survey 2019.

Are there programs to cover home modifications in North Carolina?

North Carolina Medicaid covers the cost of some home modifications. Additionally, several local agencies can provide assistance with home repairs and home modifications. These services can be accessed via local Area Agencies on Aging.

Are there transportation assistance programs in North Carolina?

Individual counties throughout North Carolina offer transportation assistance services. Seniors can contact their local Area Agencies on Aging to discover the transportation services that are available in their county.

What are “Activities of Daily Living”?

Activities of daily living are self-care tasks that seniors must complete on a daily basis. This includes activities such as bathing, dressing, eating and basic mobility. It’s important to note that activities of daily living are not to be confused with instrumental activities of daily living, which include tasks such as grocery shopping and financial management.

What types of services does a home care aide provide?

An in-home care aide provides personal care and assistance with activities of daily living, as well as additional services such as cleaning, cooking and companionship.

How to Find an In-Home Care Provider in North Carolina

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. When you hire an in-home care aide you’re placing a lot of trust in the hands of the person by inviting them into your home, so you’ll want to be diligent in your search. At Caring.com, we’re here to help – we’ve created a helpful checklist below that can help guide you through the process of both determining your needs and finding a home care agency that will provide the best care possible.

Finding a Home Care Provider Checklist

Find Home Care Agencies Near You

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.

2020, 2021, 2022

Home Instead – Raleigh, NC

8360 Six Forks Rd, Raleigh, NC, 27615

We utilized Home Instead with my father and from the first call all the way to where the services were not needed any more, everyone was warm, welcoming and provided excellent care to everyone in our … (read more)
We utilized Home Instead with my father and from the first call all the way to where the services were not needed any more, everyone was warm, welcoming and provided excellent care to everyone in our … (read more)

2017, 2018, 2020

Right at Home of Wake County

2500 Blue Ridge Road, Suite 301, Raleigh, NC, 27607

I appreciate your staff making the switch in my Mother’s care. Shanquesha has been just wonderful for my Mother. She is very thoughtful, thinks ahead, and is a great help for my Mom. She also has a … (read more)
I appreciate your staff making the switch in my Mother’s care. Shanquesha has been just wonderful for my Mother. She is very thoughtful, thinks ahead, and is a great help for my Mom. She also has a … (read more)

Always Best Care of Raleigh-Durham

1151 South Main St., Ste. 327, Wake Forest, NC, 27587

Staff helped guide and navigate options for my mother. We found a new home for her and the extra attention she is now receiving has given both the family and her comfort and peace of mind. It is a c … (read more)
Staff helped guide and navigate options for my mother. We found a new home for her and the extra attention she is now receiving has given both the family and her comfort and peace of mind. It is a c … (read more)

Right at Home Durham-Chapel Hill

4905 Pine Cone Drive, Suite 2, Durham, NC, 27707

We have struggled for six months to have this service handle the most basic of services without any luck. They have a dedicated service provider at my mother-in-law’s independent living facility and … (read more)
We have struggled for six months to have this service handle the most basic of services without any luck. They have a dedicated service provider at my mother-in-law’s independent living facility and … (read more)

Wenev Home Care Services – Durham, NC

600 Park Offices Dr, Durham, NC, 27709

We are nurse own agency that provides the following: In-Home aides Companionship/sitter Respite Our staff are compassionate and caring and treats our clients with dignity and respect.
We are nurse own agency that provides the following: In-Home aides Companionship/sitter Respite Our staff are compassionate and caring and treats our clients with dignity and respect.

Home Instead – Smithfield, NC

1327 N Brightleaf , Suite F, Smithfield, NC, 27577

<p>Home Instead Senior Care is a non-medical provider of personal care, companionship, meal preparation, light housekeeping, medication reminders, errands, incidental transportation and even Alzheimer … (read more)
<p>Home Instead Senior Care is a non-medical provider of personal care, companionship, meal preparation, light housekeeping, medication reminders, errands, incidental transportation and even Alzheimer … (read more)

Acti-Kare – Raleigh, NC

2028 Thorpshire Dr , Raleigh, NC, 27615


AccordCare – Raleigh, NC

3739 National Dr suite 150 , Raleigh, NC, 27612

AccordCare company provides full-service private duty home care that is customized to your needs, allowing you to stay in your home where you feel most comfortable. We also offer specialized in-home n … (read more)
AccordCare company provides full-service private duty home care that is customized to your needs, allowing you to stay in your home where you feel most comfortable. We also offer specialized in-home n … (read more)

At Home Elder Care – East Wake

1100 Logger Ct , Ste H101, Raleigh, NC, 27609

At Home Eldercare of East Wake provides non-medical in-home care services. We provide home health aides and assistive personnel who systematically provide personal every daycare, including elder care, … (read more)
At Home Eldercare of East Wake provides non-medical in-home care services. We provide home health aides and assistive personnel who systematically provide personal every daycare, including elder care, … (read more)

At Home Eldercare of Western Wake County

187 Wind Chime Ct Suite 202 , Raleigh, NC, 27615

Our mission is to provide the best Senior Care and Companionship for those you love. We are committed to providing high quality care by Caregivers that strive for the client to achieve the highest lev … (read more)
Our mission is to provide the best Senior Care and Companionship for those you love. We are committed to providing high quality care by Caregivers that strive for the client to achieve the highest lev … (read more)

2019, 2020

Homewatch CareGivers of Cary

1210 SE Maynard Avenue, Suite 202, Cary, NC, 27511

My mom has been using Homewatch CareGivers of Cary since mid-May. It’s been working great. The people are always punctual. They always let me know if there’s a conflict of schedule. They do cleaning, … (read more)
My mom has been using Homewatch CareGivers of Cary since mid-May. It’s been working great. The people are always punctual. They always let me know if there’s a conflict of schedule. They do cleaning, … (read more)

2019, 2020, 2021

Always Best Care of East & South Wake

5421 Old Poole Rd, #105, Raleigh, NC, 27610

He can’t do without assistance so it has been great assistance. With that being said, there were some caregivers that were better than others. There are some caregivers that are fantastic and there … (read more)
He can’t do without assistance so it has been great assistance. With that being said, there were some caregivers that were better than others. There are some caregivers that are fantastic and there … (read more)

2018, 2019, 2020, 2022

Aware Senior Care, a division of Home Care Assistance

104-A Fountain Brook Circle, Cary, NC, 27511

They have been very helpful in making sure she has her meds, and helps her to the dining room, and helps her with the laundry and other things. I like that they have been accommodating but we have ha … (read more)
They have been very helpful in making sure she has her meds, and helps her to the dining room, and helps her with the laundry and other things. I like that they have been accommodating but we have ha … (read more)

2021, 2022

HomeChoice Home Care Solutions

312 W Millbrook Rd # 141, Raleigh, NC, 27609

It was pleasant for my mother to have someone in the house with her. I was very unfamiliar with the process and they were nice to me.
It was pleasant for my mother to have someone in the house with her. I was very unfamiliar with the process and they were nice to me.

HomeCare.com

7925 Jones Branch Drive, Suite LL 140, Mclean, VA, 22102

I’m using HomeCare.com. It’s fine. They’re very good and very responsive to any concerns I have, and they’ve provided me with a good health care aide, not great necessarily, but good. They also provid … (read more)
I’m using HomeCare.com. It’s fine. They’re very good and very responsive to any concerns I have, and they’ve provided me with a good health care aide, not great necessarily, but good. They also provid … (read more)

Caring Senior Service

5630 Six Forks Road , Suite 203, Raleigh, NC, 27609

I love this company, the difference they have made in the quality of our lives is incredible. Taking care of my parents had become very difficult for my sister and me. and Danny and his staff knew exa … (read more)
I love this company, the difference they have made in the quality of our lives is incredible. Taking care of my parents had become very difficult for my sister and me. and Danny and his staff knew exa … (read more)

Ideal Healthcare Services

4904 Waters Edge Dr, Ste. 160, Raleigh, NC, 27606

I have a person who comes at night from Ideal. She supervises my husband’s dinner and reminds me of his medication. She provides good care and patience to my husband. I’m very satisfied with the quali … (read more)
I have a person who comes at night from Ideal. She supervises my husband’s dinner and reminds me of his medication. She provides good care and patience to my husband. I’m very satisfied with the quali … (read more)

Golden Harmony

148 Wind Chime Court, Raleigh, NC, 27615

They help get me through my days and do the tasks that I need to get done. I like that they are competent and able to do their job. The people that work for them are nice.
They help get me through my days and do the tasks that I need to get done. I like that they are competent and able to do their job. The people that work for them are nice.

Affordable Family Care Services Inc

114 Wind Chime Ct., Suite 102E, Raleigh, NC, 27615

I have somebody from Affordable Family Care Services coming in for two hours a week, and so far so good. I have no real complaints. At first they said, they had a twelve hour a week minimum and I can’ … (read more)
I have somebody from Affordable Family Care Services coming in for two hours a week, and so far so good. I have no real complaints. At first they said, they had a twelve hour a week minimum and I can’ … (read more)

Glorious Life Home Care Services

212 N Corcoran St suite 208, Durham, NC, 27701

I’m perfectly and completely satisfied with the care I got from Glorious Life Home Care. At times it was above and beyond the call of duty. It was very good. The first person that came was a match and … (read more)
I’m perfectly and completely satisfied with the care I got from Glorious Life Home Care. At times it was above and beyond the call of duty. It was very good. The first person that came was a match and … (read more)

Home Care Services in North Carolina (552)