Care.com is a monthly subscription service. However, they do not provide you with any receipts of transactions or send confirmation when payments are made. A few months after signing up we discovered they had billed our card over $500 when the monthly rate was only $39. When we contacted the company they told us the additional charges were just temporary holds on the card and that they would be refunded. They never were so we had to get AMEX involved on fraudulent charges. Such a scam, and the worst kind, taking advantage of sick and elderly looking for help!