How Much Does It Cost to
Start a Home Care Agency?

Most sources quote a range of $40,000 to $80,000 for a non-medical home care agency. Home health agencies with skilled nursing run $150,000 to $350,000. But those ranges hide the real story — costs vary enormously by state.

California's licensing fee alone is over $5,600. Texas charges about $2,600. Some states require surety bonds. Others don't. Workers' comp rates vary by 3-4x across states. Working capital needs depend on your local wage rates and how quickly you can land clients.

The biggest cost categories

• Working capital is usually the largest line item. You need 3-6 months of runway to cover payroll and expenses before revenue catches up.
• Insurance and bonding is the second biggest. General liability, professional liability, workers' comp, and any state-required bonds.
• Licensing fees vary the most state to state. Some states charge a few hundred dollars. Others charge thousands.
• Marketing is where most new agencies under-invest. You need referral sources before you can grow.

Non-medical vs. home health

Non-medical agencies help with daily living — meals, bathing, companionship, transportation. They're simpler to start and cost less. Home health agencies provide skilled nursing and therapy, require Medicare/Medicaid certification, and cost 2-4x more to launch.

This calculator gives you a state-specific estimate for both types. For the full licensing process, timelines, and step-by-step instructions, check our 50-state licensing guide.