Home care vs assisted living in Massachusetts: the real monthly cost
Side-by-side monthly numbers at 20, 40 and 84 hours a week, using our published rates and the Massachusetts median for assisted living — including the point where assisted living becomes the cheaper choice.
Below about 55 hours of care a week, home care in Massachusetts costs less than the median assisted living bill; above that, assisted living is usually cheaper. At our personal care rate of $38 an hour, 40 hours a week works out at roughly $6,582 a month, against a Massachusetts assisted living median of about $9,058 a month — but assisted living includes rent, meals and utilities, and home care does not.
The monthly numbers
Care hours below are costed at Westmark's published weekday rates and 4.33 weeks a month. Assisted living and nursing home figures are the Massachusetts medians from the Genworth/CareScout Cost of Care Survey.
| Option | Cost per month |
|---|---|
| Home care, 20 hrs/week — companion at $34/hr | $2,944 |
| Home care, 20 hrs/week — personal care at $38/hr | $3,291 |
| Home care, 40 hrs/week — companion at $34/hr | $5,889 |
| Home care, 40 hrs/week — personal care at $38/hr | $6,582 |
| Assisted living — Massachusetts median | $9,058 |
| Home care, 84 hrs/week (12 hrs a day) — companion at $34/hr | $12,366 |
| Home care, 84 hrs/week (12 hrs a day) — personal care at $38/hr | $13,821 |
| Nursing home, semi-private room — Massachusetts median | $14,448 |
| 24-hour live-in care at $816/day | $24,806 |
| Our hourly rates assume the 6-hour standard minimum per visit. Weekends and holidays add $3/hour, and care booked with under 24 hours' notice adds $4/hour. Live-in is charged per day, not per hour. | |
Where the line falls
Divide the assisted living median by your hourly rate and you get the crossover point:
- At $38 an hour (personal care), assisted living and home care cost about the same at 55 hours a week.
- At $34 an hour (companion care), the crossover is about 61 hours a week.
Below those hours, home care costs less. Above them, a community usually costs less — and at genuine 24-hour need, considerably less. That is the arithmetic, and it does not change because we would rather sell you care hours.
What each price actually includes
This is where a straight cost comparison misleads people. The two prices do not buy the same things.
Assisted living includes a private apartment, meals, utilities, housekeeping, activities, and staff in the building around the clock. The monthly figure is close to all-in, though most communities charge more as care needs rise.
Home care includes a caregiver, and nothing else. Rent or mortgage, food, heat and upkeep continue as they are. If the family would keep the home regardless, those costs are not caused by the care decision — but they belong in the comparison if the alternative is selling the house.
When assisted living is the better call
- Care is needed for most of the day and night. Past roughly 55 hours a week, you are paying more for less supervision.
- Someone is unsafe alone overnight. Awake overnight care at home is $38 an hour; a community has staff on site anyway.
- The house is the problem. Stairs, isolation, a bathroom that cannot be adapted.
- Loneliness is the main issue. A few hours of company a day is not the same as living among people.
When home care is the better call
- Help is needed for part of the day — mornings, evenings, or a few days a week.
- Staying home matters more than anything else, and the home is workable.
- The need is temporary, such as recovery after a hospital or rehab stay.
- One person needs care and a spouse does not. A move uproots both.
- Consistency matters — dementia especially, where the same caregiver in a familiar room does more than any building.
Work out your own number
Hours a week × 4.33 × hourly rate = monthly cost. Twenty-five hours a week of personal care is 25 × 4.33 × $38, or about $4,114 a month. Our published rates are on the site, and a written quote is free and takes a few minutes.
Common questions
Is home care cheaper than assisted living in Massachusetts?
Up to about 55 hours a week, yes. At our $38/hour personal care rate, 40 hours a week costs about $6,582 a month against a state assisted living median near $9,058. Past roughly 55 hours a week, assisted living usually costs less.
At how many hours does assisted living become the cheaper option?
At $38 an hour the two meet at about 55 hours a week; at the $34 companion rate, about 61 hours. Those are cost crossovers only — they assume the person is safe at home during the hours nobody is there.
Does the assisted living price include everything?
The median covers rent, meals, utilities, housekeeping and on-site staff. Many communities charge extra as care needs rise, and for medication management or incontinence care, so the real bill often lands above the median. Ask for the full fee schedule in writing.
Is staying home really cheaper if we still pay the mortgage?
Compare like with like. Assisted living bundles housing and food; home care does not. If the home is owned outright and the family would keep it anyway, the care hours are the added cost. If the alternative is selling, add the home's running costs first.
Does Medicare or MassHealth pay for either one?
Medicare does not pay for non-medical home care, nor for assisted living room and board. Families more often use long-term care insurance, VA benefits, or MassHealth programmes. We cover the usual routes in how families actually pay for home care in Massachusetts.
Can a family combine home care with assisted living?
Yes, and many do. Some begin with a few hours a day at home and move later; others keep a private caregiver for companionship or appointment escorts after a move. The two are not mutually exclusive.
Talk it through with someone who will say "not us"
If the hours you need put you past the crossover, we will tell you, and point you toward communities worth touring. If home care fits, you will get a written quote with no deposit, no contract and no obligation.
Sources
Massachusetts medians for assisted living ($108,696/year) and nursing home care ($173,375/year semi-private) are from the Genworth/CareScout Cost of Care Survey, 2024 data, published 4 March 2025, converted to monthly figures. Westmark rates are our published weekday rates as of September 2026. Medians are statewide; Greater Boston and MetroWest communities often price above them.