Private Duty Home Care
Also called: private pay home care, agency home care, pdhc
Family-paid (or insurance-paid) home care delivered by an agency-employed caregiver under a private agreement — the standard non-medical home care model.
Private duty home care is the formal industry term for non-medical home care that is paid for privately — by the family out of pocket, by long-term care insurance, by VA Aid & Attendance, or by Medicaid waiver programs like Michigan's MI Choice — as opposed to short-term Medicare home health, which is doctor-ordered, intermittent, and tied to a recovery episode rather than ongoing daily support.
The "private duty" name has historical roots in nursing, where private-duty nurses were dedicated to a single patient for the shift rather than being assigned a unit. The term carried over to non-medical home care to emphasize the same idea: the caregiver is dedicated to one client during the shift, working from a family-directed care plan, on a schedule the family controls. That stands in contrast to facility-based care where staff rotate among many residents on each shift.
In a private duty agency model, the agency is the caregiver's employer of record. The agency handles recruiting, vetting (background checks, driving record, reference verification, drug screening, professional license verification where applicable), orientation, ongoing training, supervision by a care coordinator and credentialed oversight team, scheduling, payroll, federal and state tax withholding, workers' compensation insurance, professional and general liability insurance, and backup coverage when the assigned caregiver is sick. None of that work falls on the family.
The alternative is private hire, where the family directly employs a caregiver they find on their own (through a registry, online platform, or word of mouth). Private hire rates run $18–$28/hr in Southeast Michigan — these are NOT our rates and we cite them only in educational comparison contexts to show the costs that show up later. Private hire shifts payroll, taxes (the IRS treats household employees as W-2 employees with employer tax obligations), workers' comp, vetting, training, supervision, and coverage onto the family. The hourly rate looks lower until those obligations are added back in. Most families choose an agency once they understand the full picture.
Affordable Home Care is a private duty home care agency. Our rate ranges in Southeast Michigan, with mandatory pricing attribution: companion care $27–$32/hr, personal care $29–$37/hr, specialized care $35–$42/hr, live-in $400–$500/day. Visit /guides/private-hire-vs-agency for the full side-by-side and use /cost-calculator to model your situation.
Frequently Asked
What does "private duty" actually mean?
It means the caregiver is dedicated to one client during the shift, working from a family-directed care plan on a schedule the family controls — as opposed to facility staff who rotate among many residents. The term came from nursing where private-duty nurses were dedicated to a single patient.
Why do agency rates look higher than private hire?
Because the agency rate includes everything that disappears in private hire: background checks, training, supervision, payroll taxes, workers\' compensation, liability insurance, and backup coverage when the caregiver is sick. Private hire rates of $18–$28/hr in Southeast Michigan look lower until those costs are added back in. We cite private hire rates only for educational comparison; our rates are companion $27–$32/hr, personal $29–$37/hr, specialized $35–$42/hr, and live-in $400–$500/day in Southeast Michigan, with mandatory pricing attribution.
Does Medicare pay for private duty home care?
No. Private duty home care is paid privately — out of pocket, by long-term care insurance, by VA Aid & Attendance, or by Medicaid waivers like Michigan's MI Choice. Medicare covers short-term home health (skilled nursing and therapy under a doctor's order) but not the ongoing daily support that private duty provides.
Related
Glossary terms
Home Care
Care Types
Non-medical support delivered in a person's residence — companionship, personal care, meal prep, transportation, and household help.
Caregiver
Roles & People
A trained, vetted professional (or unpaid family member) who provides hands-on support for an older adult's daily living needs.
Care Plan
Process & Planning
A written document that defines what care is provided, when, by whom, and how it adjusts as the client's needs change.
See also
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