In-Home Care · Buncombe County
In-Home Care in Buncombe County
By Asheville Senior Care Guide · Updated July 2026
For most families, in-home care is the first step. It lets someone stay in the house they love while getting help with the things that have become harder, and it can scale up as needs change. But “in-home care” actually covers two very different services that are easy to confuse, and the difference determines both what you get and who pays. This guide sorts it out, explains what it costs in Asheville, and lists the agencies serving Buncombe County.
Home care vs. home health
These terms get used interchangeably, but they are not the same thing, and mixing them up is the single most common source of confusion and surprise bills.
Non-medical
Home Care
Help with daily living: bathing, dressing, meals, medication reminders
Companionship, transportation, errands, light housekeeping
No doctor’s order required
Paid out of pocket, long-term care insurance, VA benefits, or a Medicaid waiver — not regular Medicare
Skilled / medical
Home Health
Skilled nursing, wound care, physical, occupational, or speech therapy
Delivered by licensed clinicians
Requires a physician’s order and medical necessity
Often covered by Medicare or Medicaid when short-term and medically necessary
In plain terms: if the need is help getting through the day, that is home care. If the need is medical treatment or rehab at home, that is home health. Many families use both at once.
What in-home care costs in Asheville
Non-medical home care from an agency in the Asheville area generally runs somewhere in the range of $28 to $38 an hour in 2026, depending on the agency, the level of care, and how many hours you book. Costs have been climbing steadily year over year. A few hours a day is very affordable compared to a facility, but the math changes fast at higher hours.
Watch the hourly-to-round-the-clock cliff. Four hours a day, five days a week, might run roughly $2,400 to $3,000 a month. But once you need close to around-the-clock coverage, in-home care can cost more than assisted living or even skilled nursing. That crossover point is often where families start weighing a facility. Our Compare Your Options guide lays the numbers side by side.
How to pay for it
Because standard Medicare does not pay for non-medical home care, families piece funding together from several sources. The most common are private savings and long-term care insurance. Veterans and surviving spouses may qualify for the VA’s Aid & Attendance benefit, which can be used for in-home care. Lower-income older adults may qualify for North Carolina Medicaid’s Community Alternatives Program for Disabled Adults (CAP/DA), a waiver that pays for in-home services specifically to help people avoid a nursing home. And the Council on Aging of Buncombe County can point you to local subsidy and volunteer programs.
See VA Benefits, Long-Term Care Insurance, and our Paying for Care overview for the details on each funding path.
How to choose an agency
Not all agencies are equal. Before you sign anything, ask: Is the agency licensed by the state of North Carolina? Are caregivers employees (screened, bonded, insured, and covered by workers’ comp) or independent contractors? Who covers a shift if your regular caregiver is sick? Is there a nurse who supervises and adjusts the care plan? What are the minimum hours and the cancellation policy? A reputable agency answers all of these without hesitation and puts it in writing.
Home care agencies serving Buncombe County
A starting list of established agencies serving Asheville and Buncombe County is below. This is an independent resource; no agency pays to be listed. Always confirm current services, availability, and pricing directly, and verify state licensing before hiring.
| Agency | Phone | Type | Notes |
|---|---|---|---|
| Council on Aging of Buncombe County | (828) 277-8288 | Personal care + resource hub | Nonprofit; the central starting point for aging services and referrals |
| Home Instead | (828) 274-4406 | Personal / companion care | 1550 Hendersonville Rd, Ste 206, Asheville |
| Visiting Angels | (828) 665-3944 | Personal / companion care | 24 Sardis Rd, Asheville 28806 |
| FirstLight Home Care of Asheville | (828) 505-4337 | Personal / companion care | Serves Asheville, Buncombe & Biltmore Forest |
| Asheville Home Health | (828) 676-6176 | Skilled home health | 417 Biltmore Ave, Ste 5D, Asheville |
Other agencies serving the county include Givens Home First (a local nonprofit aging-in-place program), All Ways Caring HomeCare, A New Hope Home Care (skilled pediatric and adult care), and CarePartners Home Health (part of Mission Health, for skilled home health). For hands-on help — subsidies, volunteer support, and care management — the Council on Aging of Buncombe County is a valuable local partner. For sorting through the options themselves, start with our guides above.
Not sure if in-home care is the right fit?
Tell us about your situation and a local guide will help you weigh in-home care against other options. Free, and no sales pressure.
Frequently asked questions
What is the difference between home care and home health?
Home care is non-medical help with daily living such as bathing, meals, and companionship. Home health is skilled medical care like nursing and therapy that requires a doctor’s order. Medicare covers home health when medically necessary, but not non-medical home care.
How much does in-home care cost in Asheville?
Non-medical home care from an agency generally runs about $28 to $38 an hour in 2026, depending on the agency, level of care, and hours booked.
Does Medicare pay for in-home care?
Medicare pays for short-term skilled home health, but not ongoing non-medical home care. That is paid privately, through long-term care insurance, VA benefits, or a Medicaid waiver.
Related guides
Home Care Agencies · Respite Care · Compare Your Options · Adult Day Services