Increasing numbers of Tennessee’s 1.1 million seniors citizens are opting to remain in their own homes as they age. The Tennessee Commission on Aging and Disability helps make aging in place easier by funding and administering many senior-centric programs and resources. The state also provides seniors with extra peace of mind about in-home care, thanks to its strict regulation of personal support service providers. Along with enjoying life in a state known for its friendliness and natural beauty, Tennesseans also pay only $3,813 per month for in-home care, a savings of almost $500 compared to the national average.

The following guide contains detailed information about home care costs in Tennessee and ways to help pay for this care, along with free and low-cost resources available to seniors who prefer to age in place at home.

The Cost of In-Home Care in Tennessee

In-Home Care Costs in Nearby States

As shown by the Genworth Cost of Care Survey 2019, home care in Tennessee costs a moderate $3,813 per month. Not only is this substantially lower than the median rate paid nationally, but it is also almost $400 less than the average monthly price in neighboring Virginia. The cost of in-home care is on par in Kentucky, while seniors in Mississippi and Alabama pay significantly less on a monthly basis, with average rates of $3,432 and $3,394, respectively.

$3813

Tennessee

$4290

United States Average

$4195

Virginia

$3813

Kentucky

$3432

Mississippi

$3394

Alabama

Cost of Other Types of Care in Tennessee

Senior care costs vary in Tennessee, but the price differences are often related to the type of care needed and the setting where it’s provided. Home health services that include nursing and other medical care average $3,892 per month, which is just $79 more than nonmedical home care. Assisted living facilities charge slightly more, at an average of $3,900 per month. Nursing homes that offer 24/7 specialized care have the highest monthly average at $6,836, while adult day care costs the least at only $1,495 per month.

$3813

In-Home Care

$3892

Home Health Care

$1495

Adult Day Care

$3900

Assisted Living Facility

$6836

Nursing Home Care

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

Comparing Costs Across Tennessee

The cost of in-home care in Tennessee differs across the state. This is demonstrated by variances in the average monthly prices paid in Tennessee’s five largest cities. In the largest metropolitan area, Nashville, the average cost is $4,195 per month, while the price drops by $427 to $3,768 in the second-largest city, Memphis. Average monthly rates in Knoxville and Chattanooga fall in between and are almost identical at $3,935 and $3,916, respectively. The cost of in-home care is $3,861 per month in Clarksville, which is more than $300 higher than the rate paid in Nashville, but fairly consistent with the other major Tennessee cities mentioned. It is worth noting that these prices are all below the national average of $4,290 per month.

$4195

Nashville

$3768

Memphis

$3935

Knoxville

$3916

Chattanooga

$3861

Clarksville

Financial Assistance for In-Home Care in Tennessee

TennCare CHOICES in Long-Term Services and Supports

Tennessee residents who need help with activities of daily living and meet the eligibility guidelines may qualify for in-home assistance through the TennCare CHOICES in Long-Term Services and Supports program. This Medicaid waiver program provides a wide range of supportive services, including homemaker assistance, personal care, meal delivery, respite care and personal emergency response systems. Transportation services and home modifications to improve accessibility and safety are other available program benefits.

Who Is Eligible?
Applicants aged 65 or older must be eligible for Medicaid coverage and meet the TennCare program’s current income and asset limitations. They must also need the level of care usually offered in a nursing facility or be at risk of placement in a nursing home if in-home assistance is not provided. Due to participation limits, eligible applicants may be placed on a waiting list before receiving services.

How to Apply
Interested seniors may contact the Area Agency on Aging and Disability serving their area by calling 866-836-6678.

OPTIONS for Community Living

The Tennessee Commission on Aging and Disability administers the OPTIONS for Community Living program to help qualified seniors access needed in-home care and support services. This state-funded program covers personal care, assistance with household tasks, prepared meals and home maintenance and modifications. It also allows for self-direction, which gives participants the ability to hire a relative as a caregiver.

Who Is Eligible?
To be eligible, seniors must be aged 60 or older and certified by a doctor or other medical professional as needing help performing regular activities of daily living. Eligibility and the cost of services are based on applicants’ income. Individuals with an income below 200% of the Federal benefit rate receive services free of charge. Those with 200% to 600% of the FBR qualify but pay a sliding-scale fee for provided services.

How to Apply
Seniors in need of in-home assistance may call 866-836-6678 to apply through their local Area Agency on Aging and Disability.

Program of All-Inclusive Care for the Elderly

Medicare’s Program of All-Inclusive Care for the Elderly (PACE) offers eligible individuals complete care that encompasses medical, social and supportive services, with the goal of preventing nursing home admission. Care is coordinated by an assigned case manager and delivered by an interdisciplinary team at the PACE center and in the participant’s home.

The program provides a wide range of benefits that include full medical, dental, vision and prescription drug coverage, in-home care, home health and nursing services. Nutritional counseling, prepared meals, social and recreational programming and transportation services are also covered. Participants enrolled in Medicare pay a monthly sliding-scale fee based on their income, whereas PACE services may be provided at no cost for those who dually qualify for Medicaid.

Who Is Eligible?
Currently, PACE is only available to residents of Hamilton County. Applicants must be aged 55 or older and assessed as needing a nursing facility level of care to qualify for the program. The individual also must be able to live at home with no risk to their health or safety.

How to Apply
Interested residents of Hamilton County may complete an online contact form or call Ascension Living Alexian PACE at 423-698-0802 to apply.

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 Tennessee

There are a number of free and reduced-cost resources available that may help seniors who want to retain their independence and continue living in their own homes. These include nutrition programs, in-home assistance and companionship, caregiver and respite support and transportation services. There may be financial and functional criteria to meet, depending on the program.

ContactArea ServedServices Provided
Aging Nutrition ProgramContact the nearest Area Agency on Aging and Disability or call 866-836-6678Entire stateThe senior nutrition program provides healthy, home-delivered meals to eligible adults aged 60 and older.
Senior Farmers Market Nutrition ProgramContact your county Department of HealthDavidson, Dyer, Hamblen, Shelby and Warren CountiesThrough this program, seniors aged 60 and older receive vouchers to use to purchase fresh produce from local participating farmers’ markets. To be eligible, seniors must meet the Commodity Supplemental Food Program income guidelines.
Senior CompanionsFind program services in your areaVarious areasThis Senior Corps program matches volunteers aged 55 and over with elderly individuals who live on their own. Seniors benefit from companionship and assistance with daily activities, such as paying bills and shopping.
Living Well with Chronic Conditions ProgramContact Dr. Bobbi Clarke at 865-974-8197, or Jessica Taylor at 865-974-7393Various counties and areasCoordinated through the University of Tennessee Extension, this six-week program provides seniors with information and tools to manage their chronic conditions more effectively. The program is offered through a network of organizations across the state.
Family Caregiver Support ProgramCall 866-836-6678 to be directed to your local Area Agency on Aging and DisabilityEntire stateAvailable through AAADs in Tennessee, the FCSP offers support, resources and assistance for family caregivers of seniors. Support groups, counseling, caregiver training and short-term respite services may be available, based on location.
Transportation AssistanceFind transportation resources in your area on the interactive mapEntire stateThe Tennessee Commission on Aging and Disability maintains a searchable list of senior transportation programs and resources throughout the state.
Senior Trust/Elder TrustContact the specific grant program you wish to apply forEntire stateThe Senior Trust/Elder Trust initiative provides funding for grants to low-income seniors for housing improvements, dental care, legal assistance and transportation.

In-Home Care Laws and Regulations in Tennessee

In Tennessee, nonmedical home care is provided by personal support services agencies, which are regulated and licensed by the Tennessee Department of Mental Health. The department’s Licensing Division oversees the licensing application process, conducts compliance inspections of licensed agencies and investigates complaints. The following table provides an overview of the rules and regulations governing personal support services agencies in Tennessee.

Scope of CarePersonal support services agencies may provide clients with a wide range of in-home care services. These may include assistance with self-care to maintain the client’s health and wellness, such as bathing, dressing, eating, mobility and toileting. Household assistance may also be provided, such as housekeeping, meal planning and preparation, laundry and bill paying. Workers may also provide personal assistance, such as transportation to appointments and activities within the community.
Care Plan RequirementsPersonal support services agencies must prepare a written service plan for each client, based on an assessment of their needs. The plan must detail the types of services agency workers will provide, as well as their frequency and duration.
Medication Management RequirementsPersonal support services workers may provide medication assistance to clients, but may not administer prescription medication or injections. Assistance may include opening packaging, putting medication within the client’s reach, steadying their hand while they take medications and applying nonprescription creams or lotions externally.
Staff Screening RequirementsPersonal support services workers who will have direct contact with clients must submit to a criminal background check within 10 days of being hired and every two years going forward. Their employer must also verify that a worker is not listed on the state’s abuse and sexual offender registries.
Staff Training RequirementsDirect-care workers must have documented training that relates to the services they provide to clients, as well as continual training on an annual basis. Those who provide medication assistance must complete relevant training under the supervision of a registered nurse.
Medicaid CoverageTennessee Medicaid may help cover the cost of in-home care for eligible seniors through two programs: The CHOICES in Long-Term Care program, which is available statewide, and the PACE program, which is only available in Hamilton County.
Reporting AbuseSuspected abuse, neglect or exploitation of a senior may be reported to the Tennessee Department of Human Services’ Adult Protective Services unit by calling 888-277-8366.

Frequently Asked Questions

Does Tennessee Medicaid Pay for In-Home Care?

TennCare offers a waiver program to eligible state residents called CHOICES in Long-Term Care, which helps pay for in-home care. The state Medicaid plan may also contribute to the cost of services provided through the PACE program for seniors who reside in Hamilton County.

How Much Does In-Home Care Cost in Tennessee?

In Tennessee, nonmedical in-home care costs an average of $3,813 per month, based on data from the Genworth Cost of Care Survey 2019. This is almost $500 below the national median, and about $80 less than the monthly state average for home health care services.

Are There Programs to Cover Home Modifications in Tennessee?

Medicaid-eligible seniors who qualify for the CHOICES in Long-Term Care program may receive help paying for safety- and accessibility-related home modifications. Funding may also be available in specific counties through the Senior Trust/Elder Trust grant project, administered by the Tennessee Commission on Aging and Disability.

Does Medicare Pay for In-Home Care?

The Medicare program only covers specific kinds of in-home care for beneficiaries recovering from illnesses, injuries, surgeries and in-patient hospital stays and under a doctor’s care. These typically include home health aide and skilled nursing visits and a certain number of occupational or physical therapy treatments.

What Does It Mean to Age in Place?

Aging in place refers to a person’s choice to live independently in their own home as they age. To accomplish this, seniors may need to make safety- and accessibility-wise home modifications, begin using assistive technologies and arrange for outside assistance with activities of daily living.

Home Care Services in Tennessee (348)