Budgeting for a year of in-home care: the numbers to plan around

A year is a stack of weeks. The only annual figure this desk prints is a wage, not a household total.

By the rate desk. Written September 11, 2026.

You cannot budget a year of in-home care from a national average, and you cannot budget it from the wage on this site. You can budget it from a week of hours you actually expect to buy, a written quote for that week, and an honest list of the weeks that will not look like the sample week. The federal numbers on this desk are there to keep the wage part of that plan from being a rumor.

The annual figure this site already prints is $29,700. That is the median annual wage for home health and personal care aides in the St. Louis metro, the same OEWS May 2024 row that prints $14.28 an hour, $13.08 at the 10th percentile, and $20.00 at the 90th. Source: BLS OEWS, area 41180, occupation 31-1120. It is what a typical aide in this survey earned across the year the survey is measuring. It is not what a household pays for a year of help in the house.

Plan around hours, not around a made-up annual rate

A year of care is not 12 copies of one month, and a month is not four copies of one week. People go to the hospital. Siblings visit. A winter illness adds nights. A trip out of town adds days. A paid caregiver quits. If you annualize a single quoted hour times a round number of hours, you will be wrong in both directions at different points in the year. This desk will not print that product, because the quoted hour is unpublished and the hour count is yours to bring.

Write the year as four questions instead:

• What does a normal week look like, in start and stop times, including overnight or not?
• How many weeks of the year will look like that week?
• What is the plan for holidays, a fifth week in a month, a hospital stay, and a week when family covers?
• Which pocket pays each of those weeks: household cash, a policy, a public program, or a relative who has agreed in writing?

Get two agencies to price the normal week in writing. Then ask each of them how the other weeks bill. The year is those answers, added by you, not a figure this page can invent.

The wage numbers that belong on the planning sheet

Keep these on the same sheet as the hour count. They are already published on this site. They will not total a household year. They will stop you from planning against the wrong labor market.

• Median hourly wage, this metro, this occupation: $14.28.
• Bottom tenth: $13.08. Top tenth: $20.00. Spread: $6.92.
• Median annual wage for the worker: $29,700.
• Aides counted in the metro: 42,390.
• St. Louis rank among the 25 largest U.S. metros on this wage: 20th. Seattle at the top of that list: $22.45. Houston at the bottom: $10.97.
• Among the 8 metros filed under Missouri: 7th of 8. Among the 19 Midwest metros with 5,000 or more aides: 18th of 19.
• St. Louis County industry payroll, private home health care services, 2024 Q4: average weekly wage $763, 5,023 jobs, 242 establishments, from BLS QCEW.
• Employer share of Social Security and Medicare: 6.2 percent plus 1.45 percent, combined 7.65 percent, Social Security wage base $184,500 in 2026, from IRS Tax Topic 751.

Put a blank on the sheet for the household rate. Leave it blank until a quote fills it. Do not fill it with the median wage. Do not fill it with the annual wage divided by anything. Do not fill it with a national cost-of-care figure this desk is not allowed to reprint.

The year has more than one labor cost

If the plan is only non-medical help in the house, you are buying occupation 31-1120, the largest care occupation in the metro and 14th of 16 in its own family by wage. If the plan also includes skilled visits, those visits are a different occupation, a different employer, and a different bill. Registered nurses in this metro have a median of $39.69 an hour. Licensed practical nurses have a median of $30.07. Nursing assistants have a median of $18.66. Those figures are wages, from the same OEWS file, and they are here so you do not budget a nurse year on an aide wage, or an aide year on a nurse wage. Clinical questions about which of those belongs in the house are not budget questions. They belong with the physician who treats the person receiving care.

Aides are 1st of 21 care occupations in this metro by headcount and 19th of 21 by wage. The household that is buying a year of hours is buying from the big cheap end of that table. A few cents of wage movement in this occupation touches 42,390 jobs. A few cents of household-rate movement touches your year. Those are not the same cents.

Build a reserve without inventing its size

This desk will not tell you to set aside a percentage of the year for call-offs, hospital weeks, or a rate change. It has no file for those events. It will tell you to name them. A year with no line for "the week the assigned person quits" is not a year. A year with no line for "holiday billing" is not a year. A year that assumes every week is the sample week is a hope.

Ask the company, in the same writing as the quote, how it bills a substitute, a hold during a hospital stay, a restart after a hold, and a change in hours with less than the notice period. Those answers are the reserve. They will be specific to the bid. They will not be a number you can copy from a federal table.

County payroll is a poor reserve signal. Jefferson County's $1,482 weekly wage sits on 3 establishments. St. Charles County printed $729 on 35 establishments. St. Louis city printed $699 on 77. The 15-county universe is the Census delineation for area 41180. Seven counties disclose a wage. Do not treat a disclosed county weekly wage as a monthly household budget for a house in that county. The unit is wrong and the industry is not the quote.

Payers change during a year

A year that starts as private pay can pick up a long-term-care claim, a VA decision, or a Medicaid waiver review. A year that starts with a program can lose it. The wage does not change when the payer does. The invoice might. Plan the hours first, then plan the pockets, and keep those as two columns. This desk owns the wage column. The pocket column lives on Paying for Care STL, which is built for the papers that decide who is billed.

Inside the family, a year is also a sequence of who covers which weeks with their own time. That unpaid time is not a line on the agency invoice and not a line in OEWS. It is still part of the year. If you pretend the hired hours are the whole plan, the first unpaid week will feel like a failure of the budget rather than a line you left off. Who Pays for Mom is the desk for that split. Put the unpaid weeks on the same calendar as the paid ones before you call the year planned.

What this desk will not do for your year

It will not multiply $14.28 by a full-time year. It will not multiply $763 by 52. It will not take the annual median of $29,700 and inflate it by a factor. It will not reprint a commercial cost-of-care annual total. Those moves would produce a number that looks like a budget and is not a measurement.

It will keep the floor visible while you collect quotes. The floor in this metro is low against peer markets and wide inside the occupation. A year of quotes that ignore both facts is a year of surprise. Collect the quotes against one sample week. Keep the wage table next to them. Revisit the hour count when the year changes shape. That is the whole method. It is slower than a single annual figure, and it is the only method this desk can stand behind.

---

Next
Hourly, live-in, or 24-hour care: how the monthly cost is built
When Medicaid, the VA, or long-term-care insurance offsets the cost
Sources and pull dates