Assisted Living vs. In-Home Care: Comparing Costs in Bellingham
Staying at home is what most older adults in Bellingham want, and in-home care can make that possible. But home care in Whatcom County is expensive by national standards, and as a parent needs more hours of help, the monthly bill climbs fast. At some point, a residential setting such as an adult family home or assisted living facility may cost less while offering more. This guide compares 2025 costs, shows how hours change the math, and explains how Washington's programs can help in either setting.
The 2025 numbers
CareScout's 2025 Cost of Care Survey reports these medians for the Bellingham area (CareScout Cost of Care tool):
| Type of care (Bellingham area, 2025) | Median cost |
|---|---|
| Home health aide, hourly | $46 an hour |
| Home health aide, 44 hours a week | $8,771 a month |
| Assisted living, private one-bedroom | $6,650 a month |
Statewide, Washington's 2025 home care median was $45 an hour, and the assisted living median was $7,600 a month (Genworth and CareScout 2025 Cost of Care Survey summary).
In Bellingham, full-time home care costs about $2,100 a month more than the assisted living median, before housing, food, and utilities.
How costs change with hours
The survey's monthly figure assumes 44 hours a week. Using the $46 hourly median:
| Hours of home care per week | Approximate monthly cost |
|---|---|
| 10 hours | About $1,992 |
| 20 hours | About $3,984 |
| 44 hours | $8,771 (survey figure) |
| 60 hours | About $11,951 |
| Around the clock | About $33,500 or more |
These estimates multiply the hourly median by hours and by about 4.33 weeks a month. Agencies may set minimum visit lengths or charge more for nights and weekends.
What each option includes
In-home care
- Help with bathing, dressing, and personal care
- Light housekeeping and meal preparation
- Companionship and reminders
- Help only during scheduled hours
At home, your parent still pays for housing, utilities, groceries, insurance, and upkeep.
Assisted living or an adult family home
- A private or shared room
- Meals and snacks
- Help with personal care and medications
- Laundry and housekeeping
- Activities and company
- Supervision around the clock
Adult family homes serve two to six residents in a house, or up to eight with state approval (DSHS adult family home information sheet). Their rates are not reported in the CareScout survey. See our guide to adult family homes versus assisted living in Bellingham.
A worked example
A Bellingham father needs help each morning and evening with dressing, bathing, and medications, about four hours a day, every day. That is 28 hours a week, about $5,577 a month at the $46 median. Add rent or property taxes, utilities, and food, and the total can pass the $6,650 assisted living median, which includes meals and overnight supervision. If he starts needing help at night, home care costs rise well beyond that.
When in-home care makes sense
- Your parent needs a few hours of help a day
- Your parent is safe alone the rest of the time
- Family members can reliably fill gaps
- The home is safe and accessible
When a residential setting may make more sense
- Help is needed at unpredictable times or overnight
- Your parent is lonely or isolated
- Home upkeep, from gutters to the yard in the rainy months, has become a burden
- Family caregivers are exhausted
- Home care hours are approaching residential costs
How Washington programs help
Medicaid. DSHS explains that if you are eligible, Medicaid pays for long-term care services in your own home, in an adult family home or assisted living facility, or in a nursing facility. Programs such as Medicaid Personal Care and COPES pay for personal care, and a qualified family member can be hired as an individual provider (DSHS, Medicaid and long-term care services for adults).
WA Cares Fund. Since July 1, 2026, eligible people can use WA Cares benefits, up to $36,500 in 2026, for services such as in-home personal care, meal delivery, home modifications, and respite, as well as care in assisted living or adult family homes (WA Cares Fund benefits). WA Cares says the full benefit could cover around 20 hours a week of home care for about six months (WA Cares Fund FAQ).
Local help. Northwest Regional Council can explain in-home options and Medicaid in Whatcom County at (360) 738-2500 (Northwest Regional Council).
Hidden costs at home
- Grab bars, ramps, or a stair lift
- A medical alert system
- Meal delivery or extra groceries
- Rides to appointments, errands, and the pharmacy
- Higher heating and utility bills when someone is home all day
- Lost income for family caregivers
The family caregiver's share
In many Bellingham families, a spouse or adult child provides much of the care without pay. When comparing costs, estimate honestly how many hours family members provide, and what it would cost to replace them if a caregiver got sick or could not continue. A plan resting on one exhausted person is fragile.
Questions for a home care agency
- What are your rates for weekdays, nights, weekends, and holidays?
- Is there a minimum visit length?
- How are caregivers screened, trained, and supervised?
- What happens if a caregiver is sick?
- Can the same caregiver come regularly?
- Are you a registered WA Cares provider, and do you accept Medicaid?
Mixing options
Some families combine a few hours of paid help with family care, an adult day program, and occasional respite stays in a care home. Respite gives a family caregiver a real break, and lets a parent try a small residential setting without a long-term commitment. Ask Northwest Regional Council about caregiver support and respite options in Whatcom County.
Revisit the plan
Needs change. Many families start with a few hours of help and review the plan every few months or after any fall or hospital stay. Our article on signs it may be time for assisted living can help you know when to look again.
About Gracious Living Adult Family Home
Gracious Living Adult Family Home is a small residential home at 1511 Edwards Street in Bellingham. Please call (360) 746-2481 to confirm whether the home is currently accepting residents and to compare its rates with care at home.
Frequently asked questions
Is in-home care cheaper than assisted living in Bellingham?
At a few hours a week, yes. At full-time hours, no: 44 hours a week of home care had a 2025 Bellingham median of $8,771 a month, compared with $6,650 for assisted living.
How much is home care per hour in Bellingham?
CareScout's 2025 survey reports a median of $46 an hour for a home health aide in the Bellingham area.
Does Washington Medicaid pay for in-home care?
Yes, for eligible people. Programs such as Medicaid Personal Care and COPES pay for personal care services at home.
Can WA Cares pay for home care?
Yes. In-home personal care is among the covered services, for people who meet the contribution and care needs requirements.
Sources
- CareScout Cost of Care Survey tool (2025 data)
- Genworth and CareScout 2025 Cost of Care Survey summary (PDF)
- DSHS: Adult family home information sheet (PDF)
- DSHS: Medicaid and long-term care services for adults (PDF)
- WA Cares Fund: Benefits
- WA Cares Fund FAQ
- Northwest Regional Council: Aging and Disability Resources