Care at home around Winston-Salem: aides, home health and how to pay

What is in-home care in North Carolina?

In-home care covers two different services: home care agencies, licensed by DHSR, that send aides for bathing, dressing, meals, companionship and respite, and home health, which sends nurses and therapists for skilled care under a doctor's orders.

North Carolina licenses both under its home care license, with home health marked separately; the state's files show 20 home care agencies licensed for home health, 10 hospice licenses and 149 other home care agencies with offices in the five counties.

What does home care cost around Winston-Salem?

CareScout's 2025 North Carolina median for a non-medical home care worker is $30 an hour, about $5,720 a month at 44 hours a week; agencies set their own rates and minimum shift lengths.

Home health visits ordered by a doctor for a homebound patient usually cost nothing under Medicare.

Who pays for home care?

Families usually pay for aide hours privately or through long-term care insurance; Medicare pays only for skilled home health; NC Medicaid pays through CAP/DA for members who meet nursing facility level of care; and in Davidson and Davie counties PACE covers home care for enrollees.

VA pension with Aid and Attendance can also help veterans and surviving spouses pay for aides.

How do we choose a home care agency?

Confirm the license, then ask whether aides are employees, how they are trained and supervised, the minimum shift, how call-outs are covered, and whether the agency accepts CAP/DA or long-term care insurance.

Ask for references from families in your parent's part of town.

When is in-home care not enough?

When help is needed around the clock, when a parent is unsafe alone at night, or when the hours needed cost more than a licensed adult care home, which happens around 48 hours a week at North Carolina's medians.

At that point, assisted living or a nursing home may be safer and cheaper.

How many home care agencies serve the Winston-Salem area?

149 home care agencies without home health have offices in the five counties, 125 of them in Forsyth County. They are listed with their licensed services in our directory.

Most agencies serve clients across several counties from one office.

How is in-home care spread across the five counties?

This is how the state's files distribute in-home care across Forsyth, Davidson, Davie, Stokes and Yadkin counties; agencies have no beds to count.