In New York City, 24-hour home care costs about $35 to $42 per hour for split-shift (continuous, awake) care, or $450 to $550 per day for live-in care. Monthly, that is roughly $25,000 to $30,000 for split-shift and $13,500 to $16,700 for live-in. The big difference comes down to one thing: whether a caregiver is paid to stay awake all night or is given sleep and break time as a live-in.
If your loved one needs round-the-clock support, choosing between live-in and split-shift care is the decision that most affects your cost. This 2026 guide breaks down both options, shows real monthly costs, explains what drives the price, and includes a free calculator so you can estimate your cost in seconds.
Key Takeaways
- 24-hour home care in NYC comes in two forms: live-in (about $450 to $550 per day) and split-shift or continuous care (about $35 to $42 per hour).
- Monthly cost differs a lot: live-in runs roughly $13,500 to $16,700, while split-shift runs roughly $25,000 to $30,000.
- Live-in is cheaper because the aide gets sleep and break time; split-shift pays for awake caregivers around the clock.
- Split-shift suits high overnight needs; live-in suits people who are stable through the night.
- Skilled nursing at home costs more, about $50 to $90+ per hour for complex medical care.
- Medicare does not cover 24-hour care. Medicaid (MLTC), long-term care insurance, and VA benefits may help those who qualify.
How Much Does 24-Hour Home Care Cost in NYC?
There is no single 24-hour price, because “24-hour care” actually describes two different services at two very different costs:
- Live-in care: about $450 to $550 per day, or roughly $13,500 to $16,700 per month; and
- Split-shift (continuous) care: about $35 to $42 per hour, or roughly $25,000 to $30,000 per month.
For skilled medical needs, nursing care runs higher. See current figures in our Home Care Costs in 2026: NYC Pricing Guide and private pay home care rates.
Live-in vs Split-Shift Care: What Is the Difference?
This is the heart of the decision, so it is worth getting right:
- Live-in care: one caregiver lives in the home and provides support throughout the day, but is given sleep and break time at night. It is designed for people who are generally stable overnight and do not need frequent active help after hours.
- Split-shift (continuous 24-hour) care: two or more caregivers rotate in shifts so someone is always awake and available, 24 hours a day. It is designed for people who need help or supervision at any hour, including overnight.
For a deeper explanation of the care types, see our guide to the difference between 24-hour, live-in, overnight, and hourly care.
Cost Comparison: Live-in vs Split-Shift
Here is how the two compare at a typical 7-day-per-week schedule:
| Care type | Rate | Estimated monthly (7 days) |
| Live-in | $450 to $550 / day | ~$13,500 to $16,700 |
| Split-shift / continuous | $35 to $42 / hour | ~$25,000 to $30,000 |
| Skilled nursing (24-hr) | $50 to $90+ / hour | Higher, varies by need |
As the table shows, split-shift care can cost nearly double live-in care, because it pays caregivers for awake, active hours around the clock.
Why Split-Shift Costs More
The price gap comes from paid hours and New York labor rules. New York sets a home care aide minimum wage of $19.65 per hour downstate in 2026 (NYC, Long Island, and Westchester), higher than upstate. Split-shift care pays for all 24 awake hours, while live-in care compensates for a workday plus required sleep and break time.
In addition to wages, a licensed agency rate covers payroll taxes, workers’ compensation, liability insurance, training, and guaranteed scheduling backup, so care never stops if a caregiver is unavailable.
Skilled Nursing Care at Home
If your loved one needs clinical care, such as ventilator management, wound care, or injections, that calls for skilled nursing rather than a home health aide. Expect higher rates, around $50 to $90+ per hour (and roughly $75 to $150 per hour for a registered nurse). See our around-the-clock care for how continuous support is arranged.
Estimate Your 24-Hour Care Cost
Use the calculator below to compare live-in, split-shift, and skilled nursing costs for your schedule. It takes about ten seconds.
NYC 24-Hour Home Care Cost Calculator
Compare live-in vs split-shift pricing in seconds.
Estimates only, based on typical 2026 NYC rates. Live-in care assumes the aide receives sleep and break time; split-shift care covers continuous awake hours. Actual cost depends on care needs, borough, and agency. For an exact quote, contact All Heart Homecare.
See what 24-hour care would cost →| Not sure whether live-in or split-shift is right? Tell us about your loved one’s needs, especially overnight, and we will recommend the right option and show you exactly what it would cost. No pressure, no obligation.See what 24-hour care would cost → |
What Else Drives 24-Hour Care Cost
Beyond the live-in vs split-shift choice, a few factors move the price:
- Agency vs private hire. A licensed agency costs more because the rate covers payroll taxes, workers’ compensation, insurance, training, and 24/7 scheduling backup. Hiring privately can allow rate negotiation but puts the legal, payroll, and insurance burden on your family.
- Geography. New York mandates a higher home care minimum wage in NYC, Long Island, and Westchester than upstate, which raises downstate rates.
- Level of care. Companion-level help costs less than advanced personal care, and skilled nursing costs the most.
Which Is Right for Your Loved One?
A simple way to decide: if your loved one sleeps through the night and mainly needs daytime and evening support, live-in care offers around-the-clock presence at a lower cost. If they wake frequently, wander, need repositioning, or require help at unpredictable hours, split-shift care keeps an awake caregiver on duty at all times.
The safest, most cost-effective choice depends on overnight needs, which a care assessment determines. For how Medicare fits in (and why it will not cover this), see Does Medicare Cover 24-Hour or Live-In Home Care?.
Ways to Pay for 24-Hour Care
24-hour care is a significant expense, so it helps to know your options:
- Private pay. The most flexible, immediate option, with full control over the schedule. Explore private pay home care.
- Medicaid (MLTC). Qualifying New York residents can access home care through Managed Long-Term Care plans, though full 24-hour split-shift approvals can be strict to obtain. See our Medicaid home care page.
- Long-term care insurance. Policies may offset part of the hourly or daily cost, depending on the elimination period and benefit cap.
- Veterans benefits. The VA Aid and Attendance benefit can provide supplemental aid for eligible veterans and spouses. See our Veterans Home Health Care program.
A note on Medicare: it does not cover 24-hour or long-term custodial home care, only short-term skilled care. For the full breakdown of who pays, read The Cost of Home Care: Who Pays and How Much.
Get an Exact 24-Hour Care Quote
Rates and calculators give you a strong estimate, but your real cost depends on your loved one’s overnight needs, the right care type, and your borough. All Heart Homecare will assess the situation, recommend live-in or split-shift care, and build a clear, no-pressure quote. Start with our around-the-clock care, or contact us for a personalized estimate.
Know your exact 24-hour care cost before you decide.
All Heart Homecare provides live-in and split-shift care across NYC, from Brooklyn and Manhattan to the Bronx, Queens, and Staten Island, with clear, upfront pricing. Tell us about your loved one, and we will show you the right option and the cost.
See what 24-hour care would cost.
Frequently Asked Questions
How much does 24-hour home care cost in NYC?
In New York City, 24-hour home care costs about $35 to $42 per hour for split-shift (continuous, awake) care, which comes to roughly $25,000 to $30,000 per month, or $450 to $550 per day for live-in care, which comes to roughly $13,500 to $16,700 per month. Live-in care is less expensive because the aide is given sleep and break time.
What is the difference between live-in and split-shift care?
With split-shift (also called continuous 24-hour) care, two or more aides rotate so someone is awake and available at all hours. With live-in care, one aide stays in the home and is given sleep and break time, so it suits people who don’t need constant overnight intervention. Split-shift costs more because it covers more paid, awake hours.
Is live-in care cheaper than 24-hour shift care?
Yes. Live-in care is generally less expensive than split-shift 24-hour care, often about half the monthly cost, because the live-in aide gets sleep and break time instead of being paid for 24 awake hours. It is best for individuals who are stable overnight and don’t need frequent nighttime help.
How much does live-in care cost per day in NYC?
Live-in care in NYC typically costs about $450 to $550 per day, or roughly $13,500 to $16,700 per month. The exact rate depends on the level of care, the borough, and the agency.
Does Medicare or Medicaid pay for 24-hour home care?
Medicare does not cover 24-hour or long-term custodial home care. New York Medicaid, through Managed Long-Term Care (MLTC) plans, may cover home care for qualifying residents, though full 24-hour split-shift approvals can be difficult to obtain. Long-term care insurance and VA benefits can also help eligible residents.
Why does 24-hour care cost so much?
24-hour care covers many paid caregiver hours. New York’s mandatory home care aide minimum wage is $19.65 per hour downstate in 2026, and licensed agencies also cover payroll taxes, workers’ compensation, insurance, training, and guaranteed scheduling backup. Split-shift care, which pays for 24 awake hours, costs the most.
How much does 24-hour care cost per month in NYC?
Live-in 24-hour care runs roughly $13,500 to $16,700 per month in NYC, while split-shift continuous care runs roughly $25,000 to $30,000 per month. Skilled nursing care at home costs more. The right option depends on how much overnight and active care your loved one actually needs.
