Amid headlines of COVID-19 infiltrating nursing homes and large senior care facilities, it’s understandable that many Americans would prefer to avoid assisted living environments as they grow older. But the trend to age in place predates the pandemic. Remaining at home was the first choice for 76% of Americans age 50 and older, according to a 2018 AARP survey.

However, staying at home isn’t always affordable. Among older adults, 80% are concerned about being able to afford home health care costs, according to a 2019 SCAN Health Plan survey. Paying for personalized in-home senior care can add up quickly and isn’t always easy on a fixed income.

If you’re considering getting in-home elderly care, consider the following criteria to see what costs to expect and the different payment options available for this type of care.

In-home care can vary greatly, depending on your health conditions and needs. You might hire helpers if you are recovering at home from an illness or injury. You could also have home care workers help you carry out certain daily activities, like preparing meals and bathing. Home care services often include transportation to and from appointments, monitoring heart rate and blood pressure and in-home physical and cognitive therapy sessions. “For more complicated tasks, a nurse or aide can be hired to help with bed transfers, wound care or tube feeding,” says Sarah Johnson, a health ambassador at Family Assets in Brooklyn, New York.

If you are able to carry out most daily activities on your own, but could use a little help with certain activities, such as cooking or cleaning, home care might be a solid option. “Home care is focused on the service,” says Sam Cross, administrator of Broad Street Home Care in the Chicago area. This type of care is designed to help individuals live independently as long as possible.

When higher levels of care are needed, moving to a different setting where more health support is provided may be necessary. “People who have significant needs may often look to assisted living as an alternative,” Cross says. Assisted living facilities offer more services, such as 24-hour emergency care and ongoing supervision for individuals with Alzheimer’s, dementia or other disabilities.

On average, homemaker services cost $22.50 per hour, according to the 2019 Genworth Cost of Care Survey. Homemaker services usually include tasks to help a person with daily duties like laundry, grocery shopping and light housework. A home health aide charges an average of $23 per hour, according to the Genworth survey. Home health aide services might include giving medicine at scheduled times, supervising and monitoring chronic illnesses and helping with walking aids.

The exact amount you will pay depends on where you live and how much help you need. The monthly cost for in-home care ranges from $4,290 for homemaker services to $4,385 for home health aide care, the Genworth survey found. Home care generally costs more than the monthly median cost for an assisted living facility, but less than the median cost per month for a room at a nursing home facility.

If you have Medicare, you may be able to receive coverage for some short-term home services. To qualify, a doctor will need to indicate that skilled nursing care is required for a temporary period. “Services Medicare will cover include speech therapy, occupational therapy or physical therapy,” Johnson says. “You can also use it to help with the purchase of durable medical equipment and safety additions to your home.” Medicare will not typically cover long-term home care services.

Medicaid will cover some health services at home, such as cleaning and meal preparation, transportation to and from medical visits and personal care. The Programs of All-Inclusive Care for the Elderly is available in some states if you have Medicare or Medicaid. PACE provides some care and services in the home to individuals who need a nursing home level of care. If you have long-term care insurance, some in-home services may be covered by your policy.

If your insurance doesn’t cover in-home care, you might have to pay for it out of your own pocket. “If you need fewer hours of service, home care will be substantially cheaper than facility care,” says Aaron Blight, founder of Caregiving Kinetics in Berryville, Virginia. You may be able to look for ways to reduce costs by having family members help. If you need to hire more help over time, the cost for services will increase accordingly.

If relatives are unable to help you at home regularly or live too far to visit weekly, they may be inclined to help pay for in-home elderly care. “Family financial assistance is often provided,” Blight says. Another option is a reverse mortgage, which allows you to borrow a certain percentage of your home’s value. This amount could be used toward care services while you remain at home. States and communities may have additional programs available to help cover home services. Ask at your local community center or nearby aging organization to see if you’re eligible for free services like transportation, wellness visits or other home care help.