Your quote covers care hours. It rarely covers everything those hours touch. Groceries, cleaning supplies, paper goods, and the mileage on an errand run can all land on your side of the ledger. These are pass-through costs: someone spends money for you and expects it back. Treat them as a second bill, and set its rules before anyone reaches for a wallet.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Name every pass-through item

Write the list down. Ask the agency to name each category it expects to buy or drive for. The usual ones are food for the home, household supplies, gas for approved trips, and parking or entry fees on errands. If the answer is only as needed with no list, you have no rule yet.

What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).

Set a cap and an approval step

Decide the ceiling for each category. Decide who approves any purchase above it. Ask whether the aide can buy without asking first, or whether every item needs your yes beforehand. Put the answer in writing. A cap you never wrote down is only a hope.

Choose the payment route

Three routes come up again and again. The aide or agency pays and bills you. You pay directly. Or you fund a shared card or cash box that someone reconciles. Each route leaves different records. Ask which one applies, who keeps the receipts, how long they are kept, and how fast you see them. Ask whether the invoice lists pass-through items on their own lines. If they are folded into one total, you cannot check them.

Pin down the mileage rule

Mileage is the pass-through you are most likely to miss. Ask what counts as an errand, whether a trip starting at the office counts, how distance is logged, and what rate applies for each mile. Ask whether the aide's own car is ever used, and if so, who approves that. Those answers belong in the agreement.

Compare agencies on the same pass-through terms

When you compare agencies, do not stop at the care line. Send each one the same list of pass-through questions. An offer that looks lower can carry thin pass-through rules and a heavier total at the end of the billing cycle. Our guide to reading a quote shows where these lines tend to hide: How to read a home care quote.

What to check before you sign

Ask for a sample invoice with pass-through items shown. Ask how a disputed item is settled and how long you have to raise it. Ask whether the rules change when the aide changes. Write the answers into the agreement, not into a phone note.

For the full-year picture, the budgeting guide places these items next to the care hours so nothing sits outside the plan. Start with Budgeting a Year of Home Care.