Types of Home Care Services
Home care is a broad term that covers two distinct categories. Understanding the difference is essential for choosing the right agency and knowing what insurance will cover.
Non-medical home care (also called personal care or companion care) provides help with daily activities that do not require medical training. This includes meal preparation, light housekeeping, laundry, grocery shopping, medication reminders, companionship, and assistance with bathing, dressing, and grooming. Non-medical aides are not licensed nurses — they are trained caregivers.
Skilled home health care provides medical services at home. This includes nursing care (wound care, medication management, IV therapy), physical therapy, occupational therapy, and speech therapy. These services are provided by licensed professionals — registered nurses, licensed practical nurses, and licensed therapists.
Many seniors need a combination of both. A common arrangement is skilled nursing visits 2–3 times per week for medical needs, supplemented by non-medical aides several hours per day for daily living support.
How Much Does Home Care Cost in Manchester?
Non-medical home care in the Manchester area costs $25–$35 per hour. Rates vary by agency, time of day, and level of care needed.
Common service packages include companionship visits (4-hour minimum, $100–$140 per visit), part-time daily care (4–6 hours/day, $500–$1,050/week), and full-time live-in care ($250–$350/day). Overnight and weekend rates may carry a premium of $2–$5 per hour.
Skilled home health care costs $50–$100+ per hour depending on the type of clinician. However, skilled home health is often covered by Medicare, Medicaid, or private insurance when ordered by a doctor following a hospitalization or for a qualifying condition.
24-hour care is the most expensive option. Full-time round-the-clock care with non-medical aides costs $5,000–$8,000 per month in the Manchester area. Live-in care (one caregiver who sleeps at the home) is less expensive at $250–$350 per day.
What Medicare and Medicaid Cover
Medicare covers skilled home health care when three conditions are met: a doctor orders the care, you are homebound (leaving home is a major effort), and you need skilled nursing or therapy services. Medicare pays 100% of covered home health with no copay. However, Medicare does not cover non-medical home care, custodial care, or 24-hour care.
New Hampshire Medicaid covers home care services through the Choices for Independence (CFI) waiver program. This program provides both skilled and non-medical home care for qualifying seniors as an alternative to nursing home placement. Eligibility is based on both financial criteria and functional need. Contact ServiceLink to start the eligibility process.
Long-term care insurance may cover non-medical home care depending on your policy. Review your benefit triggers — most policies require that you need help with 2 or more activities of daily living (ADLs) before benefits activate.
Veterans may qualify for the VA Aid and Attendance benefit, which provides monthly payments to help cover home care costs. The Veterans Home in Tilton also provides resources for NH veterans.
How to Choose a Home Care Agency in Manchester
Licensing. New Hampshire requires home health agencies providing skilled care to be licensed by the Department of Health and Human Services. Non-medical companion care agencies are not required to be licensed in New Hampshire, which makes your own vetting more important.
Medicare certification. If you need skilled home health covered by Medicare, verify the agency is Medicare-certified. Check Medicare's Home Health Compare tool at medicare.gov for quality ratings.
Ask about caregiver screening. What background checks does the agency run? Do they verify certifications and references? Are caregivers bonded and insured? What training do new caregivers receive?
Ask about continuity. Will the same caregiver come regularly, or will you see different people each visit? Consistency matters enormously for seniors — building a relationship with a regular caregiver improves both care quality and the senior's comfort.
Ask about supervision. How does the agency monitor caregiver performance? Do supervisors conduct home visits? Is there a care plan that is reviewed and updated regularly?
Emergency protocols. What happens if a caregiver calls in sick? How quickly can the agency send a replacement? What is the after-hours contact process?
Ask for references. Talk to current or recent clients and their families. Ask specifically about reliability, caregiver quality, and the agency's responsiveness to problems.
Manchester-Area Considerations
Manchester is New Hampshire's largest city and has the most home care options in the state. This is an advantage — more competition generally means better service and pricing. However, there are local factors to consider:
Winter weather affects home care reliability. Ask agencies how they handle snow days and severe weather. Good agencies have backup plans and prioritize getting caregivers to clients even in bad weather. Seniors who depend on daily care visits cannot afford missed days in January.
Transportation is part of many home care arrangements. Manchester has limited public transit compared to Boston. If your care plan includes help with grocery shopping, medical appointments, or errands, confirm that the caregiver can drive and that the agency's insurance covers transportation.
Proximity to Boston means some Manchester-area agencies also serve southern New Hampshire. Agencies based in Nashua, Salem, or even northern Massachusetts may serve Manchester. Cast a wide net when shopping for agencies.
ServiceLink is your best first call. New Hampshire's ServiceLink aging and disability resource centers can help you understand your options, check program eligibility, and connect you with vetted agencies. The Greater Manchester ServiceLink office serves the city and surrounding towns.
Starting Home Care: What to Expect
Most agencies begin with a free in-home assessment. A care coordinator visits the senior's home to evaluate needs, discuss preferences, and create a care plan.
The care plan outlines specific tasks, schedule, and goals. It should be reviewed and updated regularly as needs change. You should receive a copy and have input on any changes.
Expect a trial period. It is common to try a caregiver for 2–4 weeks before deciding whether the fit is right. Good agencies will offer a replacement caregiver without penalty if the first match does not work out.
Communication is key. Establish how the agency will keep you informed — daily logs, weekly summaries, or a family portal. If you are managing care for a parent from a distance, ask about regular update calls or emails.
Frequently Asked Questions
Non-medical home care in Manchester costs $25–$35 per hour. Part-time daily care runs $500–$1,050 per week. Full-time live-in care costs $250–$350 per day. Skilled home health (nursing, therapy) costs $50–$100+ per hour but is often covered by Medicare.
Medicare covers skilled home health care (nursing, therapy) when ordered by a doctor and you are homebound. Medicare does not cover non-medical home care like companionship, meal prep, or housekeeping. There is no copay for Medicare-covered home health services.
Choices for Independence (CFI) is New Hampshire's Medicaid waiver program that provides home and community-based services as an alternative to nursing home placement. It covers both skilled and non-medical home care for qualifying seniors. Contact ServiceLink to check eligibility.
Skilled home health agencies must be licensed by NH DHHS. Non-medical companion care agencies are not required to be licensed in New Hampshire. This makes it especially important to ask about caregiver screening, insurance, bonding, and supervision when choosing a non-medical agency.
Start by contacting the Greater Manchester ServiceLink office — they can assess your needs and connect you with vetted agencies. You can also check Medicare's Home Health Compare tool for skilled care ratings, and ask your doctor or hospital discharge planner for referrals.
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