Private Home Care in Ontario: When to Pay Privately, What It Costs & How to Choose an Agency

Private home care in Ontario is care you arrange and pay for directly, usually through an agency, at about $28 to $40 an hour for a personal support worker in 2026. Families turn to it when the publicly funded hours aren't enough, when they need care to start now, or when they want the same trusted caregiver at the times that suit their parent.

Our advice is simple, and we give it on almost every call: apply for publicly funded care through Ontario Health atHome first, take every hour you're offered, and pay privately for the gaps. Private care works best as the layer that makes the whole plan fit your parent's life, not as a replacement for care the province will cover.

This guide covers when private care is worth it, what each level costs, what the higher end buys, and how to choose an agency you'll trust with someone you love.

When should you pay for private home care?

When the funded hours don't match what your parent needs. Ontario Health atHome assesses your parent and funds personal support, nursing and therapy at no cost, but the hours are set by assessed need and local capacity. A parent might be approved for a few visits a week and still need help every morning and evening.

The situations where we see Ontario families go private:

• The funded hours stop short, and evenings, weekends or overnight are uncovered
• Care needs to start now, not after an assessment and wait
• A hospital discharge needs more help at home for the first few weeks than the public plan provides
• Consistency matters, especially with dementia, where the same familiar caregiver makes a real difference
• A parent wants more than the basics, like companionship, outings, meal preparation or help getting to appointments
• Round-the-clock care is needed so a parent can stay home instead of moving

None of these means the public system failed you. It's designed as a base, and most Ontario families end up using both.

What does private home care cost in Ontario?

Hours drive everything. Here's what each level looks like in 2026:

Figures match our Ontario home care cost guide. A PSW runs about $28 to $40 an hour, with Toronto and the GTA at the top of the range. Nursing costs more, often $60 to $90 a visit. Most agencies set a minimum visit of two to three hours.

What does premium private home care include?

At the higher end, you're paying for more than hours. The best private agencies in Ontario offer:

• A care manager or nurse who oversees the plan, visits regularly and adjusts care as needs change
• Consistent caregivers, matched to your parent, with a named backup when the regular one is away
• Specialized training in dementia, palliative care or post-hospital recovery
• Nursing on staff for wound care, injections and medication management, not just personal support
• Clear communication, such as visit notes or a family app, so you know what happened each day
• 24/7 on-call support when something goes wrong at 2 a.m.

That's what separates a premium agency from a staffing service. When you're paying $5,000 or more a month, the supervision and consistency are worth as much as the hours themselves.

Is 24-hour private home care worth it?

Sometimes, and it's the decision where families most need to do the math. Keeping a parent at home with round-the-clock care can cost $15,000 to $25,000 a month. A retirement home with 24-hour staffing and a care package often costs a fraction of that.

Round-the-clock home care makes sense when your parent has a strong reason to stay home, the need is time-limited (after surgery, or at end of life), or the home setting matters for someone living with advanced dementia. Live-in care, with one caregiver who sleeps in, can bring the cost down when nights are quiet.

If it's likely to be long-term, run the numbers side by side before you commit. Our guide to 24-hour and live-in home care walks through the choice, and you can compare the best 24-hour home care agencies in Toronto or Ottawa.

Should you use an agency or hire a caregiver privately?

For most families paying privately, use an agency. A caregiver hired directly off an online ad may charge $20 to $30 an hour instead of $28 to $40, but you become the employer. That means payroll deductions, WSIB and insurance questions, and no backup when they're sick or quit.

An agency screens and trains staff, carries insurance, handles payroll and sends a replacement when needed. That peace of mind is most of what you're paying for. Our private vs agency home care guide covers when hiring directly can still make sense.

How do you choose a private home care agency in Ontario?

Start with trust signals, then interview. Ontario doesn't license private home care agencies the way it licenses retirement homes, so the checking falls to you.

A few things you can verify yourself:

• PSWs: Ontario's Health and Supportive Care Providers Oversight Authority keeps a public register of personal support workers. Registration is voluntary for now, so a registered PSW is a plus, not a requirement.
• Nurses: RNs and RPNs must be registered with the College of Nurses of Ontario, which publishes a public register.
• Reviews: read them for patterns about consistency and communication, not just the stars.

Across the 758 Ontario home care agencies in our directory, the average Google rating is 4.45 out of 5, so a strong rating is common. What sets the best apart is how they answer your questions.

Ask every agency:

1. Who supervises the care plan, and how often do they visit?
2. Will my parent have the same caregiver, and who covers when they're away?
3. What training do your caregivers have in dementia or palliative care?
4. What's your minimum visit length, and your notice period to change or cancel?
5. Are caregivers employees or contractors, and are they insured and covered by WSIB?
6. How will you keep our family updated after each visit?

How do Ontario families pay for private home care?

Mostly from pensions, savings and home equity, with some help at tax time.

• The Ontario Seniors Care at Home Tax Credit is refundable and worth up to $1,500 a year: 25% of claimable expenses (above 3% of net income) up to $6,000.
• The federal medical expense tax credit can cover attendant care costs, so keep every receipt.
• CPP and OAS give most retirees a monthly base to build on.
• Veterans Affairs Canada can help eligible veterans with home care costs.

Private long-term care insurance, if your parent has a policy, often pays a daily amount toward home care. Check it early, since many policies have waiting periods.

Where should you start?

Call Ontario Health atHome and ask for an assessment, even if you plan to pay privately. Then interview two or three agencies, starting with our lists of the best-reviewed dementia home care and in-home nursing agencies in Toronto, or browse home care in your city.

You don't have to have the whole plan figured out on day one. Start with the hours you need now, and let a good agency help you adjust as things change. If you'd like help comparing options, our advisors are here, free and with no pressure.