Home care questions, answered plainly
The questions families actually ask us on the phone — about cost, caregivers, how fast care can start, transportation, and how people pay for it. Every answer links to the page that goes deeper.
Jump to: Cost · Caregivers · Getting started & scheduling · Transportation · Paying for care
Cost
How much does home care cost in Massachusetts?
Westmark publishes its rates: companion care $34/hour, personal care $38/hour, dementia care $40/hour, awake overnight care $38/hour, and 24-hour live-in care $816/day. Weekends and holidays add $3/hour. There are no membership fees, deposits or contracts. See the full rate card.
Is there a minimum number of hours per visit?
Six hours is the standard minimum for ongoing home care and staffing visits. A 4-hour post-discharge block is available for people coming home from hospital or rehab. Transportation has no minimum and is quoted per trip.
Why does Westmark ask for six-hour visits?
A six-hour visit lets one caregiver do personal care, cook, tidy, run errands and actually sit with someone. Short drop-ins spend a large share of the time arriving and leaving. Why a six-hour visit beats three two-hour drop-ins.
What does a month of home care cost?
At 4.33 weeks a month: 20 hours a week of personal care is about $3,291, and 40 hours is about $6,582. At the $34 companion rate the same hours are about $2,944 and $5,889. Live-in care is about $24,806 a month.
Do rates change at weekends or for short-notice bookings?
Yes. Weekends and holidays add $3 an hour, and care booked with less than 24 hours' notice adds $4 an hour. Both are on the published rate card, so nothing appears on an invoice that you have not already seen.
How much does 24-hour or live-in care cost?
Live-in care is $816 a day, about $24,806 a month. If hourly cover fits better, awake overnight care is $38 an hour. Live-in and 24-hour care are different services, and the difference matters.
Is home care cheaper than assisted living?
Up to about 55 hours a week at our $38 rate, yes. Massachusetts assisted living runs near $9,058 a month; 40 hours a week at home is about $6,582. See the full cost comparison.
Is home care cheaper than a nursing home?
On price alone, up to about 88 hours a week. But a nursing home provides 24-hour skilled nursing and we are non-medical, so the comparison only holds where the need is daily living rather than treatment. Compare the two.
Does home care cost more in some towns than others?
No. The same rate card applies across our whole service area — Billerica, Burlington, Woburn, Winchester, Reading, Framingham, Hopkinton, Holliston, Hudson, Bellingham, Quincy and Boston. Regional transportation trips are the one thing priced by distance.
What is the difference between companion care and personal care?
Companion care at $34 covers company, meals, housekeeping, laundry, errands, reminders and supervision. Personal care at $38 adds hands-on help: bathing, dressing, grooming, toileting and transfers. What the extra $4 buys.
Caregivers
How are Westmark caregivers vetted?
Every caregiver passes a criminal background check (CORI), reference verification and an in-person interview before being placed with a family. What background checks actually catch — and what they don't.
Does Westmark employ the caregivers, or do we?
We do. Screening, scheduling, insurance, payroll and supervision are ours. You are a customer, not an employer — which is the main practical difference from hiring privately through a marketplace.
What does a caregiver actually do during a visit?
Bathing, grooming and dressing, toileting, mobility and safe transfers, meals, light housekeeping and laundry, medication reminders, errands, and genuine company. Here is a visit, hour by hour.
What can a caregiver not do?
Westmark is non-medical. Caregivers do not provide nursing, wound care or medical treatment, and do not administer medication — they remind, and can hand over a prepared dose. Anything clinical needs a nurse or a home health agency.
Can a caregiver give my parent their medication?
They can remind, prompt and hand over a prepared dose, and tell you if pills are being missed. Filling an organiser, injections and dose decisions are medication management, which requires a nurse.
Can home care help someone with Alzheimer's or dementia?
Yes. Dementia care is $40 an hour, with caregivers trained in consistent routines, patient redirection and safety at home. Why consistency matters more than almost anything else.
What happens if our caregiver calls out sick?
We send someone else. Cover is part of what an agency rate buys, and it is the most common failure point for families who hire privately. What actually happens when a shift is at risk.
Is Westmark insured and bonded?
Yes — insured, bonded and background-checked. Caregivers are covered by our workers' compensation rather than a family's household policy, so a caregiver injured in your home is our responsibility, not yours.
Getting started & scheduling
How quickly can home care start?
Most families start within days of the first call. After a free in-home assessment we match a caregiver and agree a schedule. Urgent hospital discharges are common for us — say so when you call and we will work to the discharge date.
Do I need a doctor's referral?
No. Non-medical home care does not require a physician's order. Anyone can request a free assessment — an adult child, a spouse, a discharge planner, or the person needing care themselves.
Is the quote free, and does it commit me to anything?
The quote is free and carries no obligation. There are no deposits and no long-term contracts. Most families receive a written quote the same day they ask. Request one here.
What happens at the free in-home assessment?
A coordinator visits, looks at the home, and talks through the day: what is hard, what is still easy, what worries the family. You get a written plan and a price. What actually happens, step by step.
Do you provide overnight care?
Yes. Awake overnight care is $38 an hour, with a caregiver who stays awake through the night. When overnight care makes sense — and when it doesn't.
Can you help right after a hospital or rehab discharge?
Yes, and it is one of the most common reasons families call. The 4-hour post-discharge block at $44 an hour exists for those first weeks. What the first two weeks actually look like.
Which towns does Westmark serve?
Billerica, Burlington, Woburn, Winchester, Reading, Framingham, Hopkinton, Holliston, Hudson, Bellingham, Quincy and Boston, plus surrounding communities across Greater Boston and MetroWest. If you are just outside, call and ask.
Can you arrange care for a parent when I live out of state?
Yes, and we do it often. Everything can be arranged by phone and email, and we report back to whoever the family nominates. The adult child's guide to coordinating care from out of state.
Transportation
What is door-through-door transportation?
The driver comes inside. They help your loved one get ready, out of the house and into the vehicle, stay with them at the appointment, and see them safely back indoors — not a kerbside drop-off. More on transportation.
Is there a minimum for transportation?
No. Trips are quoted individually with no hourly minimum: $45 flat for a local trip in the same or a neighbouring town, or $35 plus $2.50 a mile for regional trips across Greater Boston and MetroWest.
Can the driver wait during a medical appointment?
Yes. The escort stays at the appointment, and the first hour of wait time is included in the trip price. Beyond that, wait time is $30 an hour.
Is this wheelchair van or medical transport?
No. We provide non-medical transportation for people who can transfer into a standard vehicle with help from the driver. What non-medical transportation includes, and what it doesn't.
Paying for care
Does Medicare pay for home care?
Medicare does not cover ongoing non-medical home care. It can cover short-term skilled home health after a qualifying event — a nurse or therapist, not a caregiver. The difference explained.
Does MassHealth pay for home care?
MassHealth may cover some in-home support through specific programmes, each with its own eligibility rules and waiting lists. It is worth asking about, and worth applying early, because approval is rarely quick.
Will long-term care insurance reimburse home care?
Many policies do, usually after an elimination period and against itemised invoices. Check the daily benefit limit and what triggers the policy — we can supply the documentation insurers ask for.
What is VA Aid and Attendance?
A benefit that can help wartime veterans and surviving spouses pay for help with daily living at home, paid monthly on top of a pension. What it actually covers, and our page for veteran families.
How do most families actually pay for home care?
Usually private pay from income or savings, often combined with long-term care insurance, VA benefits, or contributions split between adult children. How families actually pay in Massachusetts.
Is there a deposit or a contract?
No deposits and no long-term contracts. You can change or stop care as circumstances change. The written quote and service agreement set out the services and charges before anything begins.
Still have a question?
Call (508) 233-8062 — the line is answered 24/7 — or ask for a free written quote and we will answer it as part of the conversation.