These are two fundamentally different arrangements, and the cost gap is the biggest reason families look into Home Help in the first place. Private-pay home care means the family pays an agency directly, hour by hour, with no insurance or Medicaid involved. Home Help means Medicaid pays a caregiver — including, often, a family member — with no bill going to the family at all.
What private-pay home care actually costs in Metro Detroit
Non-medical private home care agencies in Wayne, Oakland, and Macomb County generally charge families somewhere in the $28-$35/hr range as of 2026, often with a minimum shift length of three to four hours. At 20 hours a week, that's roughly $2,400-$3,000 a month, entirely out of pocket, indefinitely.
What Home Help costs your family
If your loved one is Medicaid-eligible — 2026 asset limits are $9,950 for a single applicant, $14,910 for a married couple, with the primary home generally exempt up to $752,000 in equity — Home Help costs the family nothing. Medicaid pays the caregiver: $17.13/hr direct if self-directed, or up to $23/hr through one of our licensed agency partners, with no bill to the recipient or their family.
The trade-offs that matter
Private pay means you can start immediately without an assessment or approval process, and you're not limited to Medicaid-eligible individuals. Home Help requires Medicaid eligibility and an approval process that typically takes several weeks — but for families who qualify, the cost difference over months and years is substantial, and self-direction means a trusted family member can be the one getting paid instead of a stranger.
Which one actually fits your family
If your loved one isn't yet on Medicaid but might be close to the asset limits, it's worth checking eligibility before assuming private pay is the only option — our full eligibility checklist walks through both tests. Families who don't qualify for Medicaid, or who need care to start before an assessment can happen, often use private pay as a bridge.
