You asked what an hour of help costs. The agency gave you a number. That number may be accurate, and it may still tell you almost nothing about what you will actually pay.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
A respite bill is usually shaped by the whole arrangement: how many hours you must book, when you need them, what your parent needs during the visit, whether transportation is involved and what happens when either side cancels. You need the cost of one usable break, not the smallest number in the quote.
Start with the minimum billable visit
Ask each provider, "What is the minimum number of hours I will be billed each time someone comes?" Then ask whether the minimum changes for evenings, weekends, holidays or short-notice requests.
If you need someone only long enough to attend an appointment, a longer minimum shift may still apply. That does not automatically make the service a bad choice. It means you should compare the total charge for the block you can actually book.
Write down four things for every option: the hourly rate, the minimum visit, the minimum number of visits and the shortest commitment. Do not compare providers until you have all four.
Name the care before asking for the rate
A quote for companionship may not cover hands-on help. Tell the provider what may happen during the visit: help standing, toileting, bathing, meal preparation, medication reminders, transfers, supervision for wandering or behavior that requires close attention.
What it costs: The Missouri median for non-medical in-home care is $33 an hour, per the CareScout (Genworth) Cost of Care Survey 2025 state data tables, released March 2026. New Plan Care's standard rate is $34 an hour with a four-hour minimum, so a visit starts at $136 (newplancare.com/services).
Ask, "Which of these tasks are included in the quoted rate, which require a different worker and which will you not provide?" If two people are required for a transfer, ask whether both workers are billed. If your parent uses equipment, ask whether the assigned worker must have specific training.
A lower quote is not lower if the worker cannot perform the task that keeps you from leaving.
Find every rate that can replace the quoted rate
Ask for the written rate schedule, then check for evening, overnight, weekend, holiday and urgent-start rates. Ask when each rate begins and ends. Your break can cross into a different billing period even when it feels like one visit.
Also ask about mileage, transportation time, parking, errands, care-plan visits, assessments and fees for using a payment method. Do not ask only, "Are there extra fees?" Ask about each category separately and request a sample invoice for a visit like the one you need.
Read the cancellation rule from both directions
You need to know what you owe if your parent refuses care, goes to the hospital or has a family member unexpectedly arrive. Ask how much notice avoids a charge and whether you pay the full minimum when you cancel late.
Then turn the question around: "What happens if your worker cancels?" Ask whether the agency sends a replacement, how quickly it tells you and whether you are charged anything if no replacement comes. A service that regularly leaves you covering the shift yourself has a cost that never appears on its invoice.
Do not assume Medicare will turn respite into covered home health
Medicare distinguishes skilled home health services from ongoing personal or custodial care. It says personal care such as bathing or dressing is not covered when that is the only care needed, and it does not cover round-the-clock care at home (Medicare, Home Health Services Coverage). Ask the plan or provider about your parent's specific coverage, but do not build your break around a vague promise that Medicare should pay.
Medicaid may cover personal care or other community services for people who meet state eligibility and care-need rules (Medicare, Medicaid). Ask the state program or local aging agency which program applies, whose income and assets are reviewed, whether an assessment is required, whether there is a waiting list and whether you must use an approved provider.
Ask about public help before deciding private care is impossible
The National Family Caregiver Support Program funds caregiver supports through state and local agencies, including respite, but eligibility and available services depend on the local program (Administration for Community Living, National Family Caregiver Support Program).
If your parent lives in St. Louis, St. Charles, Franklin or Jefferson County, Aging Ahead lists a Family Caregiver Support Program and respite among its community services. Ask whether your situation meets the caregiver and care-recipient rules, what assessment is required, whether funding is available and whether the program pays a provider directly or reimburses you. The questions matter because an eligible program is not the same thing as an immediately available shift.
You can find the local starting points on Local Help for Caregivers in St. Louis. If you are outside that service area, ask your Area Agency on Aging for the same categories of help.
Compare one real week
Pick the break you actually want. Use the day, start time, end time and tasks your parent will need. Then ask every provider to price that exact arrangement in writing.
Your comparison page should show the billable hours, rate for those hours, recurring fees, transportation charges, cancellation exposure and whether a backup worker is included. Add the costs you will pay while you are out, such as transportation or parking. Leave wages you hope to earn off the page unless the work is already scheduled.
Then ask yourself one blunt question: "Can I repeat this without scrambling for money each time?" A single break can rescue a day. A repeatable break changes the week.
Use the quote to make a smaller decision
You do not have to solve care forever. Decide what you are buying first: enough coverage for an appointment, one protected block each week, or a trial visit to see whether your parent will accept another person.
Get the total in writing. Get the cancellation rule. Ask what could change the rate. Apply for public help before assuming you will not qualify. Then choose the smallest arrangement that gives you a real exit from the house, not another hour spent managing care from the next room.
The public references behind these coverage distinctions are collected on the Sources page.