Linda Keilman is a practicing gerontological nurse since 1989 and a member of the Michigan State University College of Nursing faculty since 1992.
Linda J. Keilman, DNP, MSN, GNP-BC, FAANP Gerontology Updated: Oct 11, 2023, 9:04amCommissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.
From navigating recovery and rehabilitation after a hospitalization to managing a lifelong disability, there are myriad reasons why a person might benefit from assistance offered by home care service agencies. In fact, for those who are able to live independently but perhaps need a bit more support with activities of daily living (ADLs), home care can be a vital—even lifesaving—service.
However, finding the right home care support can be a daunting task, as different agencies offer a variety of specific services, certify the credentials of their aides in distinct ways and have unique availability based on location and current client load.
To determine the best home care services, the Forbes Health editorial team analyzed data on national home care service providers, ranking them based on factors including whether they accept Medicare, Medicaid, veterans benefits and/or long-term care insurance, the number of locations they maintain throughout the U.S., whether all caregivers undergo background checks and more. Read on to learn more about top-rated home care service providers, along with helpful guidance on finding the best care for yourself or a loved one.
Note: Not all services provided by each home care service agency are available at each location. For more information, contact each agency’s local affiliate.
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Amedisys provides care for over 465,000 clients nationwide each year, according to the company. It offers an array of home care, home health and therapy services, including (but not limited to):
Amedisys employs home health aides with at least 75 hours of training who can help clients with ADLs. The company also staffs medical social workers who help coordinate care and help families ensure the best care for their loved ones.
Amedisys accepts Medicare, Medicaid, veterans benefits and long-term care insurance. All Amedisys caregivers are fully insured, and its home health aides are overseen by nursing professionals who the company says help conduct assessments and assist with case management and care planning, as well as verifying attendance and hours worked.
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Visiting Angels offers a comprehensive suite of care options, including (but not limited to):
The company, which consists of independently-owned franchises, operates in every state nationwide. It accepts Medicare, Medicaid, veterans benefits and long-term care insurance.
Care services are provided by home health aides, all of whom must pass background checks prior to hiring. Visiting Angels services are available 24/7, including night care services for clients who need it. Initial consultations are free and are used to create custom care plans for each client.
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Home Instead operates over 620 locations throughout the U.S. and nearly 50 in Canada. The company’s background-checked caregivers offer personal care services including (but not limited to):
While Home Instead doesn’t provide virtual care services, it does offer night care services and 24/7 care. In terms of payment assistance, the company accepts Medicare, Medicaid and long-term care insurance.
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Senior Helpers provides home care services via over 320 locations across the U.S.. Its caregivers offer a range of personal care services, including (but not limited to):
Senior Helpers touts its LIFE Profile assessment tool, which the company says was developed after analyzing data on the most common causes of hospitalization for 75,000 older adults. The results of each assessment are used as a guide to reveal key areas of concern for a client, action items an aide could help address and tangible wellness benchmarks the client and aide can work toward together.
The company accepts Medicaid, Medicare and long-term insurance, and it offers assistance for veterans, helping them qualify for benefits like the VA’s Aid and Attendance program. Depending on the location, aide and schedule, care is also available 24 hours a day.
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AccentCare provides care and support for people in over 260 locations nationwide. The company offers a multitude of home care, home health and personal services, including (but not limited to):
The company also partners with Medical Guardian to provide its clients with medical alert systems that can help detect falls and offer them and their loved ones additional peace of mind.
AccentCare offers 24/7 care, and all of its caregivers must pass background checks and thorough vetting prior to hiring, per the company. In terms of payment assistance, it accepts Medicaid, Medicare and long-term care insurance, though it’s advised to connect with one’s local AccentCare provider to confirm the specific types of coverage it accepts.
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To identify the best home care services, the Forbes Health editorial team analyzed data on national home care service providers and ranked them based on factors including:
Home care services are a range of personal care services that can help people live independently for as long as possible, says Jim Palazzo, CEO and founder of Transitions Care, which offers end-of-life care services in Indiana. Home care services can empower people and enable them to manage chronic illnesses at home rather than moving to a nursing facility, he says.
“It’s important people know the difference between home health care and home care services,” says Jung-Ah Lee, Ph.D., a nurse scientist specializing in gerontology and associate professor at the University of California, Irvine.
Home health care is provided by people with medical training, such as licensed nurses, certified nursing assistants and licensed practical nurses, who help monitor health conditions, perform certain medical tests, administer medications, offer wound treatment and help with physical, speech or occupational therapy.
Meanwhile, home care services are meant to help people with non-medical care, says Dr. Lee. Before committing to a provider, it’s important to pinpoint an individual’s needs to determine exactly which types of home care services they need.
A wide range of home care services are available depending on a person’s specific needs and can include:
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Both Dr. Lee and Palazzo reiterate that it’s important to consider an individual’s level of need when determining whether they’d find home care services helpful. For example, if a person is safe living alone but needs help with certain tasks, such as cooking, cleaning or bathing, they could likely benefit from home care services, says Dr. Lee. However, someone with dementia may present fine physically, but as their dementia progresses, it may not be safe for them to continue living alone. In such instances, the person’s level of care needs extend beyond what home care services can offer.
It’s also important to consider one’s physical health. Both experts reiterate that if someone has specific medical problems, home care services are likely not enough to meet those needs.
Dr. Lee says it may take working with several private companies to meet specific needs. For example, a home care agency may have aides who help with personal care but don’t offer transportation assistance, so a transportation service would also be required to meet those separate needs. If a person has many daily needs, a move to an assisted living community may be more beneficial than trying to work with home care services.
Start by asking your (or your loved one’s) primary care provider for recommendations, says Dr. Lee. “[Older adults] often have been going to the same primary care provider for a long time, and they can assess the person’s level of care and tell them what they truly need,” she says. Primary care providers also frequently know exactly what type of home care service companies and aides to recommend because they make these types of referrals often, adds Dr. Lee.
Individuals can also ask for recommendations at local Area Agencies on Aging and senior support groups. “Virtually every area has a senior center, and they can align you with the types of services you need,” says Palazzo.
Working with a geriatric care manager or certified senior advisor (CSA) can be helpful as well. CSAs can help older adults pinpoint exactly what services they need and connect them with the companies or organizations that can help meet these needs. Find a CSA near you through the Society of Certified Senior Advisors’ locator tool.
After assessing individual needs and asking for recommendations, it’s important to vet any aides or caregivers before hiring them. If a home care service agency accepts Medicaid, they’re required to meet very specific standards, and if they fall short, it’s required these shortcomings be reported, says Dr. Lee. Any violations must be made available to the public and should be listed on each state’s department of health website. Otherwise, when vetting an agency, ask if they perform background checks on their employees, and when considering hiring an individual, consider performing your own background check, recommends Dr. Lee. Also ask about their specific training credentials to ensure they are properly qualified.
While Medicare typically covers most home health services required or recommended by an individual’s health care provider, home care services aren’t as widely covered. However, if an older adult qualifies for Medicaid, certain home care services may be covered. Review your local Medicaid eligibility and coverage details for more information.
The average cost of home care services in 2023 is $28.64 per hour or $179 daily, according to the Genworth Cost of Care survey [1] Cost of Care Survey. Genworth. Accessed 5/30/2023. . Senior centers and certified financial advisors can recommend resources like nonprofit organizations or government services that may help individuals manage these costs, such as American Veterans Aid, or provide some services for free, such as Meals on Wheels.
The federal government’s Program for All-Inclusive Care for the Elderly (PACE) is another initiative that helps cover in-home care costs for those who qualify. An individual must be at least 55 years old, in need of in-home care as determined by the state, a resident of an area with a PACE organization and able to live alone safely with help from PACE.
