How Homecare Works in Ontario: A Guide for Families and Seniors
In this guide
The short answer: is homecare free in Ontario?
Homecare in Ontario is partly publicly funded. If a person qualifies, the Ontario government pays for the care, delivered through Ontario Health atHome, and a valid OHIP card is required. A care coordinator assesses the person's needs and decides which services are provided. Many families then add private homecare, which they arrange and pay for directly, for support the public program does not typically offer, such as companionship, meal preparation, housekeeping, or extra hours.
The best first step is to contact Ontario Health atHome and ask for an assessment. It costs nothing, and it gives you a clear picture of what is covered before you decide on anything else.
How publicly funded homecare works in Ontario
Ontario Health atHome is the organization that arranges publicly funded homecare in Ontario. It assesses care needs, decides eligibility, and builds a care plan. Care is then delivered by its own staff or by service provider organizations, according to Ontario.ca.
The process has five steps:
Make contact. Anyone can start the process: the person who needs care, a family member, a doctor, or a hospital team. Call 1-833-515-1234 or find your local office on the Ontario Health atHome website.
Talk through care needs. A care coordinator, sometimes called a case manager, makes an initial assessment. They may visit the home to see the situation first-hand.
Eligibility is determined. The care coordinator decides which services the person can receive, based on assessed needs and the services available in the community.
A care plan is created. It is built with the person and anyone they choose to involve, such as a family member or friend, and takes cultural, spiritual, language and family preferences into account.
Care starts and is reviewed. If needs or circumstances change, the care coordinator can reassess and adjust the plan.
If a person is not eligible, the care coordinator explains why and can connect them with community services and other resources. Decisions can also be questioned: a complaint can be filed with Ontario Health atHome, and some decisions can be appealed to the Health Services Appeal and Review Board.
Who is eligible for publicly funded homecare?
Ontario residents with a valid OHIP card are eligible for an assessment by a care coordinator. That assessment determines which services the person qualifies for, and some programs have extra requirements that the care coordinator explains (source: Ontario Health atHome).
Homecare is meant for people of all ages who need care at home, including:
seniors and people with chronic conditions
people who need palliative care
people recovering at home after a hospital stay or illness
people with disabilities who need longer-term support to stay safe at home
Why two people with similar needs can have different plans
The services and amount of care in a plan follow the person's assessed needs and the services available in their community. In practice, the assessment looks at the whole situation, which can include whether family or other caregivers are able to help at home.
This is why it helps to be specific during the assessment. Describe a typical hard day, not the best one, and mention who currently helps and how much they can realistically keep doing.
What publicly funded homecare typically covers
The services below are available through Ontario Health atHome when a person is assessed as eligible. The care plan decides which ones apply (source: Ontario.ca).
Type of care | Examples |
Nursing | Help with medications, changing bandages, wound care, recovery after an injury or illness |
Personal support | Bathing, dressing, toileting, eating, mouth care, hair care, skin care, getting in and out of a bed or chair |
Therapy | Physiotherapy, occupational therapy, speech-language pathology |
Other health professionals | Social work for caregivers and families, nutrition counselling |
Homemaking | Housecleaning, laundry, shopping, banking, bill paying, menu planning and preparation, available when personal support is also provided or when constant supervision is needed because of a cognitive impairment or acquired brain injury |
End-of-life care at home | Nursing and personal support, medical supplies and equipment, home hospice visits and respite care by trained volunteers |
Medical supplies and equipment may also be provided, and some fees may apply.
What to expect day to day
Care plans are built around assessed needs, so visits tend to be focused on specific tasks, such as help with bathing in the morning or a nurse checking a wound. Visits are scheduled by Ontario Health atHome and its service provider organizations, so visit length and the caregiver who attends can vary with scheduling and availability.
Homecare through Ontario Health atHome is not designed to provide all-day presence or companionship. Families who want that kind of support usually look at community programs and private homecare, covered in the next sections.
Community support services that can fill in the day
Beyond homecare, many local organizations provide community support services for seniors who want to keep living independently. A care coordinator can refer you to them. Some have a fee or client co-payment, and some are only offered in larger communities (source: Ontario.ca).
Common examples include:
meal services, such as meal delivery
transportation to appointments and errands
adult day programs
friendly visiting and social or recreational programs
caregiver support and respite services
home maintenance and repair
security checks and emergency response services
exercise and falls prevention classes
Where to look
Ask your care coordinator for local referrals.
Search for services near you on Health811.
Call the Seniors' INFOline at 1-888-910-1999 (TTY 1-800-387-5559) to find exercise and falls prevention classes.
For some older adults who need more than scheduled visits but not 24-hour nursing, Ontario also offers Assisted Living Services, usually in supportive housing or apartment buildings where clients live close together. Eligibility is assessed through Ontario Health atHome.
Where private homecare fits alongside public care
Ontario.ca notes that people can also pay for their own care through private companies. Private homecare is arranged and paid for directly by the person or their family. Many families use it alongside the public program, not instead of it, to:
add hours beyond what the care plan provides
have a consistent caregiver or a schedule that suits the household
cover support that is not part of a care plan, such as companionship, meal preparation, errands, or overnight care
get help in place while an assessment is being arranged
Publicly funded (Ontario Health atHome) | Private homecare | |
Who pays | Ontario government, for eligible people with an OHIP card | The person or family, and in some cases private insurance |
How you start | Assessment by a care coordinator | Contact an agency or caregiver directly |
How hours are set | By the care plan, based on assessed needs | By the family, within their budget |
What it covers | Nursing, therapy, personal support, and homemaking in some cases | Flexible, based on what is agreed: personal care, companionship, meals, errands, overnight care |
Scheduling | Arranged by Ontario Health atHome and its service providers | Often arranged around the family's preferences, depending on the provider |
What private homecare costs in the Toronto area
Rates vary by provider, the type of care, and the time of day. As a rough guide in Canadian dollars, a Toronto non-profit, WoodGreen, reported these ranges for personal support worker (PSW) care in a 2023 guide, so current rates may be higher:
Option | Approximate rate |
Non-profit agencies with subsidized rates | $18 to $28 per hour |
Private PSW agencies | $30 to $45 per hour, often with a three-hour minimum per visit |
A PSW or caregiver hired directly | Negotiated with the caregiver |
For example, 10 hours a week at $35 per hour is $350 a week, or roughly $1,500 a month. Always ask for the rate, any minimum hours, and any extra charges for evenings, weekends, or holidays in writing. If you hire a caregiver directly, ask an accountant or lawyer about your responsibilities as an employer.
Some private care costs may qualify as medical expenses on a tax return, depending on the person's situation. An accountant can confirm what applies.
Where to start: a step-by-step plan
This order works for a family supporting a parent and for a senior arranging care for themselves.
Request an assessment. Call Ontario Health atHome at 1-833-515-1234 and ask for a home care assessment. Have the person's OHIP card and family doctor's name on hand.
Prepare before the assessment. Write down which daily tasks are difficult, any falls or near-falls, current medications, and who helps now and how often. Describe a typical hard day.
Take part in the assessment. Seniors can bring a family member or trusted friend. Families should include the person receiving care in the conversation, along with their substitute decision-maker if they have one.
Ask about community services. Ask the care coordinator for referrals to meal services, adult day programs, transportation, and caregiver respite near you.
Look at the week as a whole. Once the care plan is in place, note which times of day, tasks, or evenings still need support.
Decide on additional help. If there are gaps, consider private homecare or help from family. Start small and adjust.
Ask for a reassessment when needs change. A care coordinator can review and adjust the plan if the person's health or circumstances change.
Questions to ask the care coordinator
Which services is the person eligible for, and how often will they be provided?
How are visits scheduled, and who do I call if a visit changes or is missed?
Which community programs are available near us, and do they have fees?
How do I request a reassessment?
How do I make a complaint or appeal a decision if I disagree?
Questions to ask a private homecare provider
Are caregivers employees of the agency or independent contractors?
What screening do you do, such as reference and police record checks?
What insurance and liability coverage do you carry?
What are your rates, minimum hours, and cancellation terms, in writing?
What happens if the regular caregiver is unavailable?
Can we meet the caregiver before care begins?
How will updates be shared with family?
Frequently asked questions
Is homecare free in Ontario?
Partly. If a person qualifies, the Ontario government pays for homecare services arranged through Ontario Health atHome. Services outside the care plan, such as extra hours or companionship, can be arranged privately and paid for by the person or family. Some community support services also have fees.
How do I get homecare in Ontario?
Contact Ontario Health atHome at 1-833-515-1234 and request an assessment. A care coordinator reviews care needs, determines eligibility, and builds a care plan.
Do I need a doctor's referral for homecare in Ontario?
No. Ontario Health atHome states that anyone can make a referral, including the person needing care and their family. Doctors and hospital teams can refer too.
Who is eligible for publicly funded homecare in Ontario?
Ontario residents with a valid OHIP card are eligible for an assessment. The assessment then determines which services the person qualifies for, based on assessed needs and the services available in the community.
Does public homecare in Ontario cover housekeeping and meal preparation?
Sometimes. Homemaking services such as housecleaning, laundry, shopping, and meal planning and preparation may be provided when a person also receives personal support, or needs constant supervision because of a cognitive impairment or acquired brain injury. Meal delivery and similar services are also available through community support services, which may have fees.
Can public and private homecare be used together?
Yes. Many families add private homecare to cover extra hours or tasks outside the care plan. It helps to start with the public assessment so you know what is already covered.
How much does private homecare cost in Toronto?
As a rough guide, private PSW agencies charge about $30 to $45 per hour, often with a three-hour minimum, according to a 2023 WoodGreen guide. Non-profit agencies with subsidized rates charge about $18 to $28 per hour. Always confirm current rates in writing.
What if I don't qualify or disagree with a decision?
You can file a complaint with Ontario Health atHome, and some decisions can be appealed to the Health Services Appeal and Review Board (416-327-8512 in the Toronto area, or toll-free 1-866-282-2179). The Patient Ombudsman can also help with complaints (1-888-321-0339).
Does Ontario Health atHome help with long-term care placement?
Yes. Ontario Health atHome also provides long-term care home placement services. If care needs can no longer be met safely at home, ask your care coordinator about next steps.
About this guide and sources
This guide is published by Livia, a private in-home care and companionship service in the Greater Toronto Area. It is general information, not medical, legal, or financial advice. Program details, phone numbers, and rates change, so confirm current information with Ontario Health atHome before making decisions. Last reviewed: October 9, 2026.
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