Costs and paperwork

Caregiver cost per hour in Houston, Los Angeles and Miami (2026)

Updated October 15, 2026 · Reviewed against official sources

When a family starts looking for help for Mom or Dad, the first question is almost always the same: how much is this going to cost? The answer depends mostly on two things: how you hire (through an agency or directly) and what state you live in. In this article, we explain the latest official figures and how to use them to work out your own estimate at your own pace.

Two different numbers: agency rate and wage

It's very common to mix them up, and the difference is big:

• Agency rate: what the family pays a home care agency for each hour. It includes the caregiver's pay, payroll taxes, insurance, supervision, finding a replacement when the caregiver can't come, and the agency's operating costs.
• Caregiver's wage: what the worker earns per hour. If you hire a caregiver directly, that's your starting point, but on top of it come your obligations as an employer.

That's why it's normal for an agency's rate to be about double the caregiver's wage. It's not that anyone is overcharging: the agency takes on tasks and costs that, if you hire on your own, become your family's responsibility.

The numbers by state

Where these numbers come from: the agency rate comes from the Cost of Care 2025 survey by CareScout (Genworth), which in 2025 combined help around the house and personal care aides into a single "non-medical caregiver" category. The wage comes from the Bureau of Labor Statistics (BLS), for the occupation Home Health and Personal Care Aides, with data from May 2025.

Important: these medians are for the whole state. There are no comparable official figures just for Houston, Los Angeles, or Miami. In large metro areas, prices can be above or below the state average. Use them as a starting point and ask two or three agencies in your area for quotes.

A note about California

California's median wage ($16.50) is lower than the 2026 state minimum wage ($16.90). That's not a mistake: the data is from May 2025, before the increase, and it includes many providers in the IHSS program (the Medi-Cal program that pays caregivers who work in the home). If you hire directly, you can never pay less than the minimum wage that applies in your city. In the City of Los Angeles, that minimum is $18.42 an hour as of July 1, 2026.

How much is it per month?

Here's a simple example using the agency rate, for 40 hours a week (8 hours, 5 days):

Here's how to figure it: rate × hours per week × 52 weeks ÷ 12 months. For example, in Florida: $32 × 40 × 52 ÷ 12 = about $5,547.

Many families don't need 40 hours right away. If your loved one only needs help in the mornings to bathe, get dressed, and eat breakfast, 4 hours a day Monday through Friday (20 hours a week) would cost half as much: about $2,600 a month in Texas at the median rate.

Before you decide, ask each agency:

• whether the rate changes on weekends, at night, or on holidays;
• whether there's a minimum number of hours per visit (many require 3 or 4 hours);
• how much they charge for a 24-hour shift or for a live-in caregiver.

You'll find the full list in our article on questions to ask a home care agency.

If you hire directly: what you should know

Hiring a caregiver on your own is usually cheaper per hour, but you become a household employer. According to IRS Publication 926, if you pay a caregiver $3,000 or more during 2026, you must pay Social Security and Medicare taxes (known as FICA taxes) and file Schedule H with your tax return. Federal and state unemployment taxes may also apply, and in some states, workers' comp.

Overtime counts too. Federal and state overtime rules for household workers have exceptions (for example, for some companionship services or for workers who live in the home), and they have been under review. California also has its own rules for domestic workers. Before you agree on pay, especially if the caregiver will live in the home or work more than 40 hours, check with your state's labor office or an accountant.

To see the full cost with taxes included, use our home care cost calculator, which uses your state's data.

Is there help to pay for it?

Yes, though it depends on your loved one's situation:

• Medicaid can pay for personal care at home in many states: for example, through IHSS in California (see our guide to Medi-Cal and IHSS), STAR+PLUS in Texas, or the long-term care program of Florida Medicaid. Some programs have waiting lists.
• Medicare doesn't pay for a caregiver to help with daily activities when that's the only need. See what it covers in our guide on Medicare and long-term care.
• Veterans and their surviving spouses may have VA benefits, like the extra payment explained in our guide to Aid and Attendance.
• There's also support for caregivers, like respite care. See help for family caregivers and free programs for older adults.

💬Frequently asked questions

Why does the agency charge twice what the caregiver earns?

Because the rate covers much more than pay: payroll taxes, insurance, training, supervision, and arranging replacements. If you hire on your own, those tasks and costs become yours.

Are prices in Houston, Los Angeles, and Miami the same as the state's?

Not necessarily. The official figures that exist are statewide medians. To find out the real price in your city, ask several agencies for written quotes.

Can I pay the caregiver in cash?

You can pay however you both agree, but your tax obligations don't change based on how you pay. If you go over the yearly threshold ($3,000 in 2026), you're responsible for household employer taxes. Keep a record of every payment.

When does it make sense to compare with other options?

If your loved one already needs help most of the day, compare the cost with an adult day center combined with a few hours at home, or with what a nursing home costs or an assisted living community in your state. You can look for agencies in our care at home section.

Sources

• CareScout (Genworth), Cost of Care Survey 2025, median cost tables: https://assets.carescout.com/x/8fcb50422f/282102.pdf (accessed October 15, 2026)
• U.S. Bureau of Labor Statistics, Occupational Employment and Wages, May 2025: https://www.bls.gov/news.release/ocwage.nr0.htm (accessed October 15, 2026)
• U.S. Bureau of Labor Statistics, OEWS tables: https://www.bls.gov/oes/tables.htm (accessed October 15, 2026)
• U.S. Department of Labor, minimum wage by state: https://www.dol.gov/agencies/whd/minimum-wage/state (accessed October 15, 2026)
• City of Los Angeles, Office of Wage Standards, 2026 increase: https://wagesla.lacity.gov/sites/g/files/wph1941/files/2026-04/2026%20MWR%20Increase%20Memo%2001-30-26%20ADA%20Final.pdf (accessed October 15, 2026)
• IRS, Publication 926 (2026), Household Employer's Tax Guide: https://www.irs.gov/publications/p926 (accessed October 15, 2026)

This is general information, not medical, legal or financial advice. Rules vary by state and by year: confirm with the official agency that applies to you.

👉Keep reading

Home care

A caregiver from an agency or hired by your family, Medicare home health and Medicaid (IHSS, STAR+PLUS): typical costs and your duties as an employer.

10 questions to ask a home care agency before you hire

Ten useful questions to ask before you hire a home care agency: license, staff, Spanish-speaking caregivers, prices, fill-ins and handling problems.

Help for family caregivers

What the National Family Caregiver Support Program is, who qualifies, its five services and how to apply. Plus FMLA and Medicaid for family caregivers.

How much care costs

Nursing home, assisted living, adult day care, and home care prices by state (CareScout 2025). What the rate includes, what's extra, and how to pay.