Whether due to a chronic health condition, a medical emergency, or simply aging, many seniors develop a need for long-term care. If you or one of your loved ones are in need of assistance in daily activities, you might want to consider custodial care. 

Main Points

  • Custodial care is a type of long-term, non-medical caregiving.
  • Skilled nursing care is a type of caregiving and requires medical training.
  • Custodial care is for people who need assistance with daily activities like bathing, dressing, eating, etc. 
  • Custodial care isn’t usually covered by Medicare.

What Is Custodial Care?

Custodial care is a form of non-medical, lifelong caregiving. Caregivers in custodial care do not need any medical training as they do not assume medical roles. This type of care may be prescribed by a medical professional but is typically provided by a non-medically trained caregiver. The caregiver helps the beneficiary with everyday activities or ADLs (activities of daily living) they can’t do on their own, including but not limited to: 

  • Cooking and grocery shopping 
  • Moving throughout the home 
  • Transportation 
  • Dressing and laundry 
  • Using the bathroom 
  • Bathing 
  • Running errands

Custodial Care vs. Skilled Nursing Care 

Although there are similarities, there are also a few critical differences between custodial care and skilled nursing care regarding both the caregivers and beneficiaries. While custodial caregivers do not need medical training as they only help the beneficiaries with day-to-day activities, caregivers in skilled nursing care must be licensed medical professionals as their primary duty is to provide medical care. 

Skilled nursing care providers offer medical care to those in recovery, palliative care, or end-of-life care. Skilled nursing care includes medical services like medication management, wound care, physical therapy, intravenous injections, etc. 

Lastly, skilled nursing care is usually provided at a skilled nursing facility (SNF) (though skilled nursing care can also be administered by a home health aid), while custodial care is typically provided at a senior’s residence – either their own home or at an assisted living facility or nursing home.

Custodial CareSkilled Nursing Care
Long termShort term and long term
No medical training requiredRequires specific medical training
Assistance with day-to-day activities like eating, bathing, dressing, etc.Offer medical services like catheter care, wound care, dispense medication, offer physical therapy, etc.

Who Needs Custodial Care? 

Custodial care is a type of long-term care (LTC) helpful for people who, due to aging or a medical condition, need help with everyday activities. You might be qualified for custodial care if certain medical, physical, and mental conditions prevent you from doing daily life activities independently. 

If you are unsure whether custodial care would be beneficial for you or a loved one, a primary care physician can be a good sounding board

A custodial caregiver will be able to help you bathe, dress, eat, use the bathroom, move around the house, and even run errands for you if you live in your home. On the other hand, caregivers in skilled nursing care are medically trained individuals and can provide medical services as per your needs. 


How Much Does Custodial Care Cost?  

If you or a loved one require custodial care, you must be wondering about the cost of such care. There are a few circumstances that can play a role in the overall cost of the custodial care, such as: 

  1. Who you hire: You can get custodial care services from an agency or someone you hire personally. Hiring an agency will cost more as they will make sure you only get high-quality caregivers. By hiring someone personally, you will have to sift through candidates yourself. 
  2. Where the beneficiary receives custodial care: Custodial care is provided as in-home care, adult day-care, or as part assisted living community. 
  3. Length of residency: A beneficiary can receive part-time, full-time, or as-needed custodial care. 
  4. State of the beneficiary: The custodial care will cost more if the beneficiary has certain mental or physical conditions as they do require special care. 
  5. Location: Custodial care costs may differ depending on the city or state.

According to Genworth, a financial services company, the annual estimate of custodial care cost include the following prices:

  • Homemaker services $59,488 per year
  • Home Health Aide $61,776 per year
  • Adult Day Health Care $20,280 per year
  • Assisted Living Facility $54,000 per year
  • Semi-Private Room $94,900 per year
  • Private Room $108,405 per year

Does Medicare Pay for Custodial Care? 

Custodial care is a type of long-term care that generally helps seniors with everyday tasks and activities, but excludes medical care. If you or a loved one only need custodial care and no other kind of care, Medicare will not cover the cost. For Medicare to cover the cost of your custodial care, you need to meet two requirements

  1. Custodial care services are deemed medically necessary by your physician due to also needing skilled care. 
  2. The healthcare provider who offers you custodial services participates in Medicare.

Similarly, Medicare will not cover assisted living or nursing home care unless the requirements above are met.

How to Pay for Custodial Care 

If you cannot afford custodial care entirely, you can at least check for different ways to cut down its cost. Based on your specific needs and circumstances, you might qualify for a couple of federal programs that provide health coverage. Here are some ways through which you may be able to cover the cost of custodial care: 

  1. Medicaid: Medicaid will cover long-term custodial care, but most people will not fall below the financial requirements to qualify for Medicaid.
  2. Medicare: This federal program covers custodial care expenses for 100 days or less if you have a condition that requires medical care simultaneously. 
  3. Long Term Care Insurance (LTCI): This remains the best solution for those who don’t meet the Medicaid or Medicare requirements. For the ideal long-term care insurance rates, it is often advisable to apply for coverage when you are in your late 50’s to receive the best rates on long-term care insurance.

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