In-home care (non-medical caregiver) costs in Maryland
Here is the middle of the price range in Maryland, and then — because it is the question that actually follows — who pays for it. The short answer on that second one surprises most people: Medicare does not.
The Maryland median
$35.00 an hour
- Works out to, monthly
- $6,673
- Works out to, yearly
- $80,080
Our arithmetic, not the survey's. The survey reports this one by the hour, so the monthly and yearly figures assume a schedule: $35.00 an hour × 44 hours a week × 52 weeks ÷ 12 months. Fewer hours, smaller bill — the schedule is the biggest lever you have.
That is almost exactly the national median of $35.00 an hour. Within Maryland the spread is usually wider still: a city costs more than a rural county, often by a great deal.
A caregiver who comes to the house to help with bathing, dressing, transferring and toileting, and who may also do light housekeeping and meal preparation.
What this number is, and what it is not.
It comes from an industry cost-of-care survey — providers reporting their prices — not from a government rate table. There is no federal agency that publishes what assisted living costs, which is why the survey is the source of record here and why we label it plainly rather than dressing it up as official.
A median means half charged more and half charged less. It is not a quote for any particular home, agency or facility, and no provider is bound by it. Prices collected for the 2025 survey.
Where Maryland sits
$35.00 an hour ranks Maryland 26th of the 50 states priced for in-home care (non-medical caregiver): 25 charge more, 19 charge less. Delaware, Indiana, Michigan, New York and Virginia report the same figure.
Wisconsin is the next state up, at $36.00; Kansas the next down, at $34.00.
Maryland lands on the national median of $35.00 exactly.
The column runs $24.00 (Mississippi) to $46.00 (Wyoming). Maryland sits 50% up it, 1.46× the lowest, with 23 other within a tenth of it.
Of the 6 kinds of care Maryland was priced for, this is its 5th dearest standing: at best 11th of 50 for nursing home, semi-private room, at worst 29th of 46 for skilled nursing at home (private duty nurse).
What $6,673 a month becomes
Our multiplication, holding the Maryland median flat — no real bill does — with the same span of the state's least costly priced care beside it:
Six months
$40,040
$15,210 of adult day health care
One year
$80,080
$30,420 of adult day health care
Two years
$160,160
$60,840 of adult day health care
Three years
$240,240
$91,260 of adult day health care
Five years
$400,400
$152,100 of adult day health care
Care is bought in years, not months, and $6,673 a month is $80,080 a year.
Inside Maryland, five years of adult day health care runs $152,100 and five of skilled nursing at home (private duty nurse) $972,400; this page's $400,400 sits 30% between them. Most families pay for more than one of these in sequence.
Against other care in Maryland
Converted to a month on our schedule, set beside this page's $6,673:
Skilled nursing at home (private duty nurse)
$16,207 a month
$9,533 a month more, $114,400 a year, 2.43× this page. Maryland places 29th of 46 for it, 3 below its 26th here.
Nursing home, private room
$14,448 a month
$7,775 a month more, $93,296 a year, 2.17× this page. Maryland places 12th of 49 for it, 14 above its 26th here.
Nursing home, semi-private room
$12,927 a month
$6,254 a month more, $75,044 a year, 1.94× this page. Maryland places 11th of 50 for it, 15 above its 26th here.
Assisted living community
$7,173 a month
$500 a month more, $5,996 a year, 1.07× this page. Maryland places 12th of 50 for it, 14 above its 26th here.
Adult day health care
$2,535 a month
$4,138 a month less, $49,660 a year, 0.38× this page. Maryland places 16th of 45 for it, 10 above its 26th here.
On the same monthly footing, in-home care (non-medical caregiver) is the 5th costliest of the 6 kinds of care priced in Maryland, at $6,673. The conversions are ours; the medians are the survey's.
44 hours a week of in-home care in Maryland is $6,673 a month against $7,173 for assisted living — 7% more. The first buys 44 hours and nothing else; the second includes the room, the meals, and someone awake overnight.
Who actually pays for this
This is the part most cost pages leave out, and it is the part that changes what a family does next.
Medicare does not pay for long-term care
Medicare pays for short stretches of skilled care — a limited stay in a skilled nursing facility after a qualifying hospital admission, or skilled home health under specific conditions. It does not pay for custodial care: help with bathing, dressing, meals, medication reminders and supervision. That is what most people need, and for years at a time.
Medicare's own page on long-term care ↗ says the same thing in its own words. It is worth reading once, because almost everyone assumes the opposite.
Medicaid may pay — after a spend-down
Medicaid is the largest payer of long-term care in the country, but it is needs-based: it begins once income and countable savings are inside the limits Maryland sets. Getting there by spending savings on care is what people mean by a spend-down. There is also a look-back period, so gifts and transfers made in the years beforehand matter.
Veterans: Aid and Attendance may help
A wartime veteran, or a surviving spouse, who needs help with daily activities may qualify for an addition to the VA pension called Aid and Attendance. It is an income-and-net-worth benefit, it is paid monthly, and a great many families who qualify have never heard of it. Accredited veterans service organizations help with the claim for free.
Otherwise: savings, family, and long-term care insurance
Most families pay out of pocket first — from savings, a pension, the sale of a house, or several relatives contributing. A long-term care insurance policy bought years ago pays a daily or monthly amount if the policy's conditions are met; if there is a policy in the family, find it and read what triggers it before you need it.
Working out which of these applies to one particular family is exactly what a free Maryland counselor does all day. They are paid by a federal grant, not by commission, and they have nothing to sell you. The Eldercare Locator (ACL): 1-800-677-1116 ↗ will connect you to the area agency on aging for your county.
Who to ask in Maryland
Maryland's free counseling program is State Health Insurance Assistance Program (SHIP), on 1-800-243-3425. It is grant-funded and sells nothing.
the Maryland Department of Health decides Medicaid long-term care here — not a facility, and not us. Maryland runs it as Nursing facility (institutional) Medical Assistance, Home and community based services waiver and Medically needy Medical Assistance for the aged, blind and disabled, with a 60-month look-back on gifts and transfers.
Beside $6,673 a month — our comparison, its limits — that is what "spend-down" means: countable assets may not top $2,500, or about 11 days of in-home care (non-medical caregiver) at this rate and an at-home spouse may keep up to $162,660, or about 2.0 years of it.
Verified 2026-08-02 against CareScout (formerly Genworth) Cost of Care Survey 2025, fielded July-November 2025 (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against SHIP National Technical Assistance Center (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against Maryland Department of Health, Medical Assistance Manual Appendix Schedules — 2026 Updates effective 1/1/2026 (Schedules MA-1, MA-2, MA-2A, MA-6, MA-8, MA-10), with Manual Section 1000 Eligibility for Institutionalized Persons (effective 2026-01-01)
Common questions
- Does Medicare pay for in-home care (non-medical caregiver) in Maryland?
- No. Medicare pays for short stretches of skilled care after a qualifying hospital stay, and for skilled home health in limited circumstances. It does not pay for long-term custodial care — help with bathing, dressing, meals and supervision — which is what most families are actually paying for.
- Is in-home care (non-medical caregiver) dearer in Maryland than in other states?
- $35.00 an hour places Maryland 26th of the 50 states the survey priced for it: 25 charge more and 19 charge less. The national median is $35.00. That ranking is our arithmetic on the survey's published medians, not a ranking the survey itself publishes.
- Is this the price I will be quoted in Maryland?
- No. It is the middle of a range from an industry cost-of-care survey: half of the providers surveyed charged more, half charged less. Prices vary a great deal between a city and a rural county in the same state, and no facility is bound by this figure.
- Who can help me work out how to pay for it?
- Maryland runs its free counseling program as State Health Insurance Assistance Program (SHIP), on 1-800-243-3425. It is paid for by a federal grant, sells nothing, and the Eldercare Locator (1-800-677-1116) will connect you to the area agency on aging that covers your county.