North Carolina, located along the Atlantic shore, boasts coastal views, lush, rolling landscapes and plenty of charming cities and towns that make great places for seniors to call home. One in six of the state’s residents are seniors aged 65 and older, and in North Carolina, there’s no shortage of things to keep seniors happy and entertained as they settle into their retirement years. Those who require help at home with daily tasks or chores can consider in-home care, which costs just $3,813 per month, $477 less than the U.S. average.

This guide includes comprehensive information about in-home care in North Carolina, as well as how much seniors can expect to pay for it and the financial assistance programs that are available.

The Cost of In-Home Care in North Carolina

In-Home Care Costs in Nearby States

According to Genworth Financial’s 2019 Cost of Care Survey, in North Carolina and throughout its surrounding states, the average cost of in-home care is below the national average of $4,290. In North Carolina, as well as in South Carolina, Tennessee and Georgia, the average monthly cost of in-home care is $3,813 per month. In Virginia, the average cost is slightly higher, at $4,195 per month.

$3813

North Carolina

$4290

United States Average

$3813

South Carolina

$3813

Tennessee

$4195

Virginia

$3813

Georgia

Cost of Other Types of Care in North Carolina

The cost of senior care varies, depending on the type of care required. While in-home care and home health care cost an average of $3,813 per month in North Carolina, assisted living costs are a bit higher at an average of $4,000 per month. Seniors who require care in a nursing home can expect to pay an average of $7,057 per month, while those who are enrolled in adult day care pay an average of $1,170 per month.

$3813

In-Home Care

$3813

Home Health Care

$1170

Adult Day Care

$4000

Assisted Living Facility

$7057

Nursing Home Care

The Cost of In-Home Care in North Carolina’s Top Cities

The average cost of in-home care varies quite a bit throughout the state. The costs in Fayetteville, Wilmington and Greenville, which are $3,432, $3,804 and $3,718 per month respectively, are below the state’s average cost. Cities such as Raleigh and Charlotte have costs that are slightly above the state average at $4,004 and $3,890, respectively.

$3804

Wilmington

$3890

Charlotte

$4004

Raleigh

$3432

Fayetteville

$3718

Greenville

Financial Assistance for In-Home Care in North Carolina

Community Alternatives Program

The Community Alternative Program is the state’s home and community-based services waiver program. It helps low-income seniors to access services in their own homes, including home care aides and home health aides who can provide personal care, assistance with activities of daily living, housekeeping services and nursing care. The program also helps seniors to pay for costs such as home medical equipment, minor home modifications, meal delivery services and case management. This is a non-entitlement program, which means that there are waiting lists for enrollment in some cases.

Under the Community Alternatives Program, seniors can direct their own care. This allows them to hire and train their own caregivers, including friends, family or relatives. They may also choose the services and supports that best suit their needs.

Who Is Eligible?
Applicants can automatically qualify for this program if their income is $1,041 or less per month for individuals and $1,409 for married couples. As of April 2020, these income limits will increase to $1,063 for individuals and $1,437 for married couples. Applicants are also subject to an asset limit of $2,000 for individuals and $3,000 for married couples. Additionally, applicants must be at least 18 years of age and require a nursing level of care.

How to Apply
Seniors can apply for this program by contacting the lead agency nearest their city or county.

North Carolina Personal Care Services Program

The North Carolina Personal Care Services Program helps residents who require assistance with activities of daily living. It allows these individuals to access care services within their home from an agency of their choice. This program covers the cost of services that help seniors to live independently, such as assistance with daily tasks, including bathing, toileting, eating and dressing. This program does allow some seniors to receive light house cleaning services as well.

Upon enrollment in this program, seniors are assessed to determine their level of need. They receive up to 130 hours of care per month based on this assessment.

Who Is Eligible?
To qualify for the Personal Care Services Program, seniors must have a functional need for in-home care and meet the state’s financial Medicaid criteria, meaning that their income may not exceed $1,041 per month if they are single or $1,409 if they are married. As of April 2020, the monthly income will increase to $1,063 for individuals and $1,437 for married couples. Additionally, seniors may not have more than $2,000 in countable assets, or $3,000 for married couples.

How to Apply
Seniors can learn more about this program or request a personal needs assessment by calling Liberty Healthcare at 855-740-1400.

Program for All-Inclusive Care for the Elderly (PACE)

The North Carolina PACE Association provides coordinated care services to elderly persons throughout the state. Those enrolled in PACE programs receive access to care services, including in-home personal and health care, primary care, occupational and physical therapy, and dental care, depending on their needs. PACE participants meet with a case manager regularly to determine the services they will receive.

PACE programs are free of charge for those with modest or no incomes, while those with higher incomes can enroll provided they pay for their own services. Costs are determined on a sliding scale based on the participant’s income.

Who Is Eligible?
To qualify for PACE, applicants should be at least 55 years old. They must require a nursing level of care but be able to reside safely within the community.

How to Apply
Seniors can learn more about PACE programs in their area by calling the North Carolina PACE Association at 919-234-1707.

More Ways to Pay for In-Home Care

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 In-Home Care Resources in North Carolina

Many resources are available to residents of North Carolina to help them find safe, reliable in-home care services such as meal deliveries, housekeeping services, transportation assistance and prescription assistance.

ContactArea ServedServices Provided
Money Follows the Person855-761-9030Entire StateThis program helps Medicaid-eligible residents in nursing homes and assisted living facilities access supports and home modifications that allow them to transition back into the community.
Resources for Seniors Transportation Programs919-713-1556Wake CountyResources for Seniors Transportation Programs provides several transportation assistance programs that seniors can use to attend medical appointments.
Home-Delivered Meals211Entire StateSeniors in North Carolina can dial 211 to connect with meal delivery services, such as Meals on Wheels, within their county or city.
Medication Assistance Program919-527-6457Entire StateThe Medication Assistance Program works with health centers around the state to provide low-income seniors and families with access to free prescription medications.
Long-Term Care OmbudsmanVictor.orija@dhhs.nc.govEntire STateThe Long-Term Care Ombudsman manages and investigates complaints against home care providers and long-term care facilities.

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.

Scope of CareLicensed 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 RequirementsHome care agencies must provide detailed information to clients regarding the provided services, as well as the times and days of service provision.
Medication Management RequirementsHome health aides must complete state-mandated medication administration training prior to assisting with or administering medication.
Staff Screening RequirementsAll home care workers must undergo a statewide criminal background check.
Staff Training RequirementsHome health aides are required to complete a training program approved by the Division of Health Service Regulation.
Medicaid CoverageMedicaid’s Community Alternatives and Personal Care Services Programs cover the cost of in-home care services for seniors.
Reporting AbuseAbuse 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.


Home Care Services in North Carolina (552)