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Private home care explained

Private home care: what it is and how it works

You pay for it directly and you choose the hours. Here is what it covers, what it costs in our states, how families pay for it and how it begins.

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What is private home care?

Private home care is help at home that a family pays for directly, without a Medicare or insurance referral, on a schedule the family chooses. It covers company, meals, errands and, where the state allows, hands-on personal care, from a few hours a week to around the clock. Endurance arranges it in Connecticut, New Jersey and New York.

How it is paidPrivatelyEndurance does not accept insurance directly. Families with a long-term care policy can use it, and we help with the paperwork.
Market median, Connecticut$36 an hourCareScout Cost of Care Survey 2025, in-home caregiver category. A market figure and not an Endurance price.
Medicare and 24-hour careNot coveredMedicare.gov: it does not pay for 24-hour-a-day care at your home.
Connecticut registrationHCA.0002450Homemaker-Companion Agency, Connecticut Department of Consumer Protection. New Jersey: Health Care Service Firm HP0435100.

The short version

What is private home care?

Private home care means you arrange and pay for the help yourself. For companion care with an agency like ours, there's no insurer deciding how many visits you get. You decide what help is needed, on which days, and for how many hours, and the agency builds the schedule around that.

People also call it private pay home care, because the family pays out of pocket or from a long-term care insurance policy or other savings. The word private describes who pays. It doesn't describe the quality of the care or the kind of help, and it doesn't tell you what a caregiver is trained to do. For that, see our guide to the different caregiver roles.

  • Paid privately

    The family pays the agency directly. Endurance doesn't accept insurance directly.

  • A schedule you choose

    A few hours a week, every night, a caregiver who lives in, or caregivers working shifts around the clock. It can change as needs change.

  • No homebound rule

    Medicare home health has eligibility conditions your parent has to meet. Private home care doesn't, because Medicare isn't the payer.

How is private home care different from Medicare home health?

They answer different needs. Medicare's own page says that to get home health you must "need part-time or intermittent skilled services" and be "homebound." Federal rules add that a doctor or allowed practitioner certifies the need and that a Medicare-certified home health agency provides the care.

Medicare also lists what it doesn't pay for: "24-hour-a-day care at your home," homemaker services such as shopping and cleaning unrelated to your care plan, and "custodial or personal care that helps you with daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need." A home health aide is covered only alongside skilled care such as nursing or therapy.

That leaves a gap for the help most families actually ask us about: someone to be there for meals, bathing, company and nights. Medicare says that since most long-term care is custodial, it and most health insurance don't pay for it, and that you pay all costs for services that aren't covered. Private home care fills that gap. Many families use both, with a Medicare home health agency for the nursing or therapy and a private caregiver for the days around it.

What help does private home care cover?

Two things decide what you get: the kind of help and the schedule. They're separate choices, and you can change either one later.

Companion care is company, meals, light housekeeping, errands, rides and reminders, with no hands-on help. Personal care adds hands-on help with bathing, toileting, dressing and moving safely. Medication help from an Endurance caregiver is reminders only.

  • Hourly

    Help during agreed visits or blocks of time, such as mornings or an afternoon and dinner.

  • Overnight

    A caregiver who stays awake through the agreed night hours.

  • Live-in

    A caregiver lives in the home with agreed working time and a proper night's rest. Being in the house isn't the same as being awake all night.

  • 24-hour

    Caregivers work awake shifts, usually two 12-hour or three 8-hour shifts, so someone is up day and night.

  • Where each kind is offered

    Companion care runs in Connecticut, New Jersey and New York. Personal care runs in Connecticut and New Jersey. In New York, Endurance provides companion care only.

  • Connecticut schedules by county

    In Connecticut, hourly care, and with it overnight and awake 24-hour care, is offered in Fairfield and New Haven counties. In the other Connecticut counties, care is live-in.

What does private duty home care mean?

"Private duty" is a phrase families, insurers and agencies use in different ways. We didn't find a statutory definition of it in Connecticut, New Jersey, New York or federal law, so we won't tell you it has one legal meaning. When you hear it, ask the person using it what they include: hours of company and daily help, or nursing.

In cost surveys, "private duty nurse" means skilled nursing at home from a licensed practical nurse or registered nurse. That comes from licensed nursing providers, and a homemaker-companion agency isn't one. In Connecticut, Endurance Home Health, a separate company from Endurance Home Care, provides skilled nursing, home health aides and physical therapy.

If someone offers you "private duty" care, ask whether the person coming is a nurse, a home health aide, a certified nursing assistant or a companion, and who they work for.

How much does private home care cost?

Endurance doesn't publish rates. What it costs depends on the schedule, the kind of help and where you live, and we explain it on the first call once we've heard what the days and nights are like. For a market reference, here are the CareScout (Genworth) Cost of Care Survey 2025 state medians for its in-home caregiver category. The survey ran July through November 2025.

These are market figures from a national survey, not Endurance prices. CareScout cautions that the cost for any particular provider may differ significantly from the median in your area. The annual figures assume 44 hours a week for 52 weeks, which is far fewer hours than 24-hour care.

  • Connecticut

    $36 an hour, $82,368 a year at 44 hours a week. CareScout 2025 state median.

  • New Jersey

    $38 an hour, $86,944 a year at 44 hours a week. CareScout 2025 state median.

  • New York

    $35 an hour, $80,080 a year at 44 hours a week. CareScout 2025 state median, state level only.

  • United States

    $35 an hour, $80,080 a year at 44 hours a week. CareScout 2025 national median.

  • Private duty nurse, for comparison

    CareScout lists a national median of $90 an hour, $105 in New Jersey and $120 in New York. It lists no Connecticut figure.

  • What changes the cost

    The number of hours, the kind of schedule (hourly, overnight, live-in or 24-hour), and the kind of help (companion or personal care).

How do families pay for private home care?

Most families pay privately from savings, income or help from relatives. A few other sources can offset part of the cost.

  • Private pay

    You pay the agency directly for the hours you use. Under Connecticut law the agency must give you a written contract or service plan within seven days of starting, and at least 60 days' written notice before changing its rate for the same level or type of services.

  • Long-term care insurance

    LongTermCare.gov says these policies cover personal and custodial care at home, usually reimburse a daily amount up to a set limit, and vary by policy. Whether a policy pays a particular agency depends on the policy. We help families with the policy paperwork.

  • VA Aid and Attendance

    It's a monthly payment added to a VA pension for eligible Veterans and survivors who need another person's help with daily activities, such as bathing, feeding and dressing. It's needs-based. The VA publishes its maximum annual pension rates, with Aid and Attendance, and a net worth limit; check the current table on VA.gov.

  • What Medicare does

    Medicare doesn't pay for 24-hour care at home, or for custodial or personal care when it's the only care you need.

How do you start private home care?

You call, and we talk about what's hard at home right now. The first conversation is free, and nothing starts until you say so.

  • 1. A nurse visits

    A registered nurse visits at home and writes the care plan with you and your family.

  • 2. You meet the caregiver

    We choose a caregiver for your parent or spouse and introduce them before the first visit. If it isn't working, we find someone else.

  • 3. Care begins

    A Care Manager looks after the plan and keeps the family posted. A Care Coordinator looks after the schedule and the caregiver match.

  • 4. The plan is reviewed

    Plans are reviewed as needs change, and the schedule can change with them.

Questions families ask

What is private home care?

Private home care is help at home that a family pays for directly instead of relying on Medicare or an insurance referral. The family chooses the kind of help and the hours. It can be companionship and meals, hands-on personal care where the state allows it, or a caregiver who lives in or works around the clock.

What is private pay home care?

Private pay home care is the same thing named by who pays: the family covers the cost out of pocket or from a long-term care insurance policy or other savings. Endurance is private pay and doesn't accept insurance directly. Families with a long-term care policy can use it, and we help with the policy paperwork.

What is private duty home care?

The term private duty is used in different ways, and no statute we found defines it, so ask what a provider includes. Cost surveys use "private duty nurse" for skilled nursing from a licensed nurse. In Connecticut, skilled nursing comes through Endurance Home Health, a separate company from Endurance Home Care.

How much does private home care cost?

Endurance publishes no rates, because the cost depends on hours, schedule and the kind of help. As a market reference, CareScout's 2025 survey puts the state median for its in-home caregiver category at $36 an hour in Connecticut, $38 in New Jersey and $35 in New York. Your provider's price may differ significantly.

What changes the cost of private home care?

Three things: how many hours you need, the kind of schedule, and the kind of help. Hourly visits, overnight care, a live-in caregiver and 24-hour shifts are priced differently, and personal care differs from companion care. We go through the options on the first call, once we know what the days and nights are like.

Does Medicare pay for private home care?

No. Medicare doesn't cover the ongoing daily help most families want. Medicare says it doesn't pay for 24-hour-a-day care at home, or for custodial or personal care when that's the only care you need. Medicare home health covers part-time skilled care for people who are homebound, and an aide only alongside skilled care.

Can long-term care insurance pay for private home care?

Often it can. LongTermCare.gov says these policies are designed to cover personal and custodial care at home, usually by reimbursing a daily amount up to a limit. What a policy pays, and whether it pays a given agency, depends on the policy. Endurance helps families with the policy paperwork.

Does the VA help pay for home care?

It can. VA Aid and Attendance is a monthly payment added to a VA pension for eligible Veterans and survivors who need help with daily activities. It's needs-based, and the payment is the maximum rate minus countable income. VA also has a separate Homemaker and Home Health Aide program through VA-contracted organizations.

Is there a homebound requirement for private home care?

No. Being homebound is a Medicare home health condition, and private home care isn't paid by Medicare. A person who gets out regularly, drives, or lives in a community can still have a caregiver for company, meals, rides and the help they want.

Can I get hourly care anywhere in Connecticut?

Hourly care, and with it overnight and awake 24-hour care, is offered in Fairfield and New Haven counties. In the other Connecticut counties, care is live-in. In New Jersey, every schedule is available, and in New York, Endurance provides companion care only.

How do I start private home care with Endurance?

Call or request a call. A registered nurse visits at home and writes the care plan with your family, we introduce the caregiver before the first visit, and a Care Manager keeps the family posted. The first conversation is free, and nothing starts until you say so.

Where we arrange care

Endurance Home Care service area across Connecticut, New York and New JerseyCompanion care and personal care in every county of Connecticut and New Jersey (29 counties). In Connecticut, hourly, overnight and 24-hour care are available in Fairfield and New Haven counties, and live-in care is available in every county. Companion care only in every county of New York (62 counties). In New York, companion care by the hour, overnight or around the clock is available in Westchester County and Manhattan, and live-in companion care is available in every county. The same counties are listed as links beside this map.
  • Companion and personal care
  • Companion care, any schedule
  • Not served

Companion and personal care

In Connecticut, hourly, overnight and 24-hour care are available in Fairfield and New Haven counties, and live-in care is available in every county.

Companion care, any schedule

In New York we provide companion care only: company, meals, errands, appointments and someone watching out for your parent. In New York, companion care by the hour, overnight or around the clock is available in Westchester County and Manhattan, and live-in companion care is available in every county.

We serve every town in every county shown. Find your town or tell us the address when you call.

Talk with our care team

Let's talk about the help you need

Tell us a little about what's happening, and we'll call to talk it through. The first conversation is free, and nothing starts until you say so.

Tell us a little about the help you need.

Share your contact details and where care is needed. You can tell us more when we speak.

Town or ZIP code, for example Greenwich or 06830

Or call our care team at (203) 936-6847
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