What are you choosing between?
Four kinds of help can come into a home: Medicare home health, private nursing (private duty or concierge nursing), non-medical home care, and hospice. They differ in who pays, how many hours they cover and whether a nurse leads. Decide which you need first, then compare providers.
Medicare home health is part-time or intermittent skilled care for people who are homebound, ordered by a provider (Medicare.gov). Hospice is end-of-life care for people with illnesses that cannot be cured (Medicare.gov). Medicare does not pay for personal care such as bathing and dressing when that is the only care needed (Medicare.gov). The side by side is in our guide to concierge nursing.
What questions should you ask a concierge nursing provider?
Ask about licenses, who leads the care, the doctor's role, the hours and the paperwork. Each question below comes with the reason to ask it, so you can judge the answer rather than just collect it.
Five things to check
Licenses and people
- What is each nurse's license type and number? You can check it on the DCA License Search, which shows whether a license is current, expired, or has been subject to disciplinary action. See how to verify a nurse's license.
- Is the person leading the care a registered nurse? RN practice includes judging whether symptoms are abnormal and then reporting or referring (California BRN).
- Who will come to the home, and will it be the same people each time? Ask how the provider handles sick days and holidays.
- Who directs LVNs and aides? An LVN works under the direction of an RN or physician. See who can legally do what.
The doctor and the nursing care
- How do you work with our doctors? An RN gives medicines ordered by a physician or other authorized prescriber (California BRN), so the nurse needs the current orders.
- Who keeps the medicine list current across every prescriber? One list, one owner.
- What happens if something changes at 2 a.m.? Ask who answers, and when the doctor is called.
- What will you not do? Diagnosis and prescribing stay with physicians, and some providers do not offer services such as therapy or dialysis. Ask before you need it.
Hours, plan and paperwork
- What hours do you recommend, and why?
- Is the care plan written down, and who gets a copy?
- How are changes in hours arranged, and with how much notice?
- What does the price include, and what is billed separately?
- Will invoices list the nursing services separately? The IRS counts amounts paid for nursing services as medical expenses, but if an attendant also does household work, only the nursing part counts (IRS Publication 502).
- Do you bill Medicare or insurance? If not, ask what documents you will get for a long-term care insurance claim.
- How do we pause or end care?
What should a concierge nursing plan include?
A written plan should name the nurse who leads, say whose orders the nurse follows, list what the nurse will monitor and which medicines and treatments the nurse helps with, explain how and when the doctor and family hear about changes, and set out the hours, including nights.
Nursing care
- Monitor the signs that matter for this person, such as eating, sleeping, breathing, skin and new confusion.
- Help with the medicines and treatments the physician ordered, within the RN's scope (California BRN).
- Report changes to the doctor, with a clear rule for what gets a same-day call.
Coordination and advocacy
- Coordinate one medicine list across every prescriber, plus follow-up visits, equipment and the other people helping at home.
- Advocate for the person at appointments and during any hospital stay.
For the family
- Teach the family what to watch for and who to call.
- Update the family on a set schedule, including relatives who live far away.
For the full list of what our service covers, see what is included in a concierge nursing service.
How much does concierge nursing cost?
There is no single price. Costs depend on the hours, the license level and how complex the care is. As national market context, CareScout's 2025 Cost of Care Survey put the median for skilled nursing in the home at $90 an hour and for a non-medical caregiver at $35 an hour. These are national medians, not California figures and not our rates.
CareScout itself warns that "the cost for any particular provider may differ significantly from the median cost of care for similar providers in your location" (CareScout). For figures reported for private nurses after plastic surgery in Southern California, see what a private nurse costs after plastic surgery and our cost guide.
WholeHealth Concierge does not publish its rates. We go through the hours and the level of care with you on a free 15-minute consultation.
What changes the cost of concierge nursing?
The total moves with the number of hours, the time of day, the license level of the nurse, how complex the care is, and how long care lasts. Ask each provider to show how each one changes their quote, and to put it in writing.
- Hours a week. A few visits, longer shifts, or care every day.
- Nights and 24-hour care. Overnight and around-the-clock nursing need more hours and more people. See overnight, 24-hour and live-in nursing.
- License level. An RN, an LVN and an aide do different work. See who can legally do what.
- Complexity. Wounds, many medicines, memory changes or a recent hospital stay can mean more nursing time.
- Length of care. A few days after surgery is a different plan from months of care at home. See how many hours of care someone needs.
Who pays for concierge nursing?
Concierge nursing is usually paid privately. Medicare does not pay for 24-hour care at home or for long-term custodial care. Long-term care insurance, VA Aid and Attendance and a medical expense tax deduction can each help in some cases, and Medicare Advantage members should check with their plan.
| Source | What it may cover | What to check |
|---|---|---|
| Original Medicare | Part-time or intermittent home health for people who are homebound, on a provider's order; you pay nothing for covered home health services (Medicare.gov) | It does not pay for 24-hour-a-day care at home, or personal care when that is the only care needed (Medicare.gov) |
| Medicare Advantage | Home health benefits set by the plan | Check with your plan (Medicare.gov) |
| Long-term care insurance | Depends on the policy | The benefit terms and claim documents. For tax-qualified care, the IRS describes a chronically ill person as unable to do at least two activities of daily living without substantial help for at least 90 days, or needing substantial supervision because of severe cognitive impairment (IRS Publication 502). Free counseling: HICAP, 1-800-434-0222 (California Department of Aging) |
| VA Aid and Attendance | Monthly payments added to a VA pension for qualified veterans and survivors (VA.gov) | Eligibility includes needing another person's help with daily activities like bathing, feeding and dressing (VA.gov); amounts are on the VA rates page |
| Tax deduction | Amounts paid for nursing services, including in the home, count as medical expenses (IRS Publication 502) | Only medical expenses above 7.5% of adjusted gross income are deductible on Schedule A, and only the nursing part of an attendant's pay counts (IRS Publication 502) |
| Private pay | Any hours and level of care the family chooses | Get the plan, the hours and the costs in writing |
- 24-hour-a-day care at your home (Medicare.gov)
- Homemaker services, like shopping and cleaning, unrelated to your care plan (Medicare.gov)
- Custodial or personal care, like bathing and dressing, when that is the only care you need (Medicare.gov)
- Long-term care, also called custodial care (Medicare.gov)
WholeHealth Concierge is private pay only and does not bill Medicare or insurance. For more, see how to pay for in-home care in California, long-term care insurance for home nursing, can you deduct in-home care on taxes and does Medicare cover private duty nursing.
What should you have ready for the first call?
A few sentences on what is happening, any hospital or discharge papers, the current medicine list, the doctors' names, a rough idea of the hours, and any insurance or VA details you plan to use. It is fine to call without all of it.
- What is happening, in a few sentences
- Recent hospital records or discharge summaries, if available
- The current medicine list
- Names of the doctors involved
- The hours you think you need, including nights
- Any long-term care insurance policy or VA details
- The city and county where care will happen