Home Care vs. Home Health Care: Differences & Costs

When an aging parent begins struggling at home, families often hear two similar terms: home care and home health care. They sound almost identical, but they can refer to different services, different professionals, and different ways of paying for care.

One may help your loved one bathe, get dressed, prepare meals, and maintain a daily routine. The other may provide skilled nursing, physical therapy, wound care, or other qualifying healthcare services at home.

Choosing the right option matters. The wrong assumption could leave an important need unmet — or lead a family to expect insurance coverage that does not apply.

The short answer: Non-medical home care generally supports everyday living, while home health care provides healthcare services at home. Some people need one, some need the other, and some benefit from both.

This guide explains the differences, compares services and costs, clarifies Medicare coverage, and shows you how to decide which type of care may be appropriate for your family.

1. What Is Home Care?

Home care is a broad term that can describe assistance provided to someone in their own home. In the context of this article, home care refers primarily to non-medical support with everyday activities.

It is often helpful for older adults who want to continue living at home but need assistance with some of the tasks involved in daily life.

A home care caregiver may help someone get ready in the morning, prepare lunch, do laundry, go grocery shopping, or enjoy companionship during the day.

The goal is to make everyday life more manageable while helping the person maintain as much independence as possible.

What services does non-medical home care include?

Services vary by provider, but may include:

• Personal care: A caregiver may assist with bathing, dressing, grooming, toileting, and mobility, provided the task is within the caregiver's training and permitted duties.
• Companion care: Companion care focuses on social interaction and everyday engagement. Activities may include conversation, games, reading, hobbies, walks, and help staying connected with friends and family.
• Meal preparation: Caregivers may help plan meals, prepare food, serve meals, and clean up afterward.
• Light housekeeping: This may include laundry, washing dishes, tidying commonly used rooms, and other routine household tasks.
• Transportation and errands: Depending on the provider, a caregiver may accompany someone to appointments, grocery stores, community activities, or family visits.
• Medication reminders: Some caregivers can remind clients to follow an established medication schedule. Reminders are not the same as clinical medication management or medication administration, which may be subject to additional requirements.
• Respite care: Home care can give family caregivers scheduled breaks while another person provides agreed-upon support.

Not every home care provider offers every service. Families should request a written description of the services available and confirm which tasks are permitted under applicable state rules. For the full breakdown of services, costs, and how to choose a provider, see our complete guide to non-medical home care.

Who may benefit from home care?

Non-medical home care may be useful for someone who:

• Wants to remain at home but struggles with certain daily tasks.
• Needs help with bathing, dressing, meals, or household responsibilities.
• Lives alone and would benefit from companionship.
• Has mobility limitations that make errands difficult.
• Needs help maintaining a daily routine.
• Has a family caregiver who needs additional support.

For example, an older adult who can manage their medications, communicate their needs, and move around independently may still benefit from help with grocery shopping, meal preparation, and laundry.

That person may not need skilled nursing. They may simply need practical assistance to make living at home easier.

2. What Is Home Health Care?

Home health care refers to healthcare services delivered in a person's home. These services may be appropriate when someone needs skilled medical attention, rehabilitation, or other qualifying healthcare services outside a hospital or healthcare facility.

Unlike non-medical home care, home health care generally involves qualified healthcare professionals working within their scope of practice and the applicable care plan.

Depending on the person's needs, services may be delivered by nurses, physical therapists, occupational therapists, speech-language pathologists, and other qualified professionals.

What services does home health care include?

• Skilled nursing: A nurse may provide medically necessary services such as certain wound care, injections, clinical assessments, and monitoring related to an illness or injury.
• Physical therapy: Physical therapy may help someone work on strength, balance, mobility, or functional recovery following an illness, injury, or operation.
• Occupational therapy: Occupational therapy can help a person develop or regain skills needed for everyday activities, including dressing, bathing, and other tasks affected by a health condition.
• Speech-language pathology: A qualified professional may help address certain speech, communication, or swallowing difficulties when the service is clinically appropriate.
• Medical social services: Depending on eligibility and the care arrangement, medical social services may help address social or emotional concerns related to an illness and connect the person with relevant resources.
• Home health aide services: A home health aide may provide limited personal assistance as part of a qualifying home health arrangement. Under Original Medicare, aide services are covered only when the person also meets the requirements for qualifying skilled services.

The exact services available depend on the person's medical needs, the provider, the care plan, and the applicable coverage rules.

Who may need home health care?

Home health care may be appropriate for someone who:

• Needs skilled nursing services at home.
• Is recovering from surgery or an illness and needs qualifying rehabilitation.
• Requires certain medically necessary wound care.
• Needs a healthcare professional to assess or monitor a qualifying condition.
• Has a clinician-identified need for physical, occupational, or speech therapy at home.

For example, a person returning home after surgery may need a nurse to provide ordered wound care and a physical therapist to work on mobility. Those needs are different from needing someone to cook meals or do laundry.

A healthcare professional should assess the person's situation and determine whether home health services are appropriate.

For Medicare's current requirements and covered services, see the official Home Health Services Coverage page.

3. Home Care vs. Home Health Care: Key Differences

Although both services can be delivered at home, they address different needs.

• Primary purpose: Non-medical home care supports daily living and independence; home health care provides qualifying healthcare services.
• Typical focus: Non-medical home care focuses on everyday activities, routines, and companionship; home health care focuses on clinical care, rehabilitation, and skilled services.
• Common providers: Non-medical home care is provided by home care aides, personal care aides, and companions; home health care is provided by nurses, physical therapists, occupational therapists, and other qualified professionals.
• Typical services: Non-medical home care covers meal preparation, light housekeeping, personal care, and errands; home health care covers skilled nursing, qualifying therapy, wound care, and certain clinical services.
• Who arranges it: Non-medical home care is arranged by the individual, family, agency, or relevant program; home health care is often arranged through a healthcare provider and home health agency.
• Scheduling: Non-medical home care may range from occasional visits to extensive support; home health care is based on clinical needs, orders, eligibility, and the care plan.
• Medicare coverage: Routine custodial care alone is generally not covered by Original Medicare; certain qualifying home health services may be covered.
• Medicaid coverage: Non-medical home care may be available through qualifying state programs; home health care may be available under applicable program rules.
• Can both be used? Yes — both non-medical home care and home health care can be used together, when appropriate.

The simplest way to remember the difference

Think about the primary reason help is needed.

• If the person needs help living day to day, non-medical home care may be the relevant starting point.
• If the person needs skilled healthcare services, home health care may be appropriate.
• If the person needs both practical assistance and healthcare, both services may be worth exploring.

These are general guidelines, not a substitute for an individual assessment. The exact boundaries between services depend on the task, the provider, professional qualifications, state requirements, and the person's care plan.

Does home health care replace a regular caregiver?

Not necessarily.

A home health professional may visit to provide a particular service and leave when that visit is complete. The visit does not automatically provide someone to prepare dinner, help with housekeeping, or stay with the person for the rest of the day.

For instance, someone might receive a physical therapy visit and still need a caregiver to help with meals and daily activities.

Families should plan separately for needs that are not included in the healthcare service.

4. Examples: Which Type of Care Does Someone Need?

It can be easier to understand the distinction by considering common family situations.

Scenario 1: An older adult struggles with meals and housekeeping

Margaret lives alone and can walk around her home. However, grocery shopping has become difficult, and she no longer prepares regular meals. Her family is concerned that she is eating poorly.

Potential starting point: Non-medical home care.

A caregiver may help with groceries, meal preparation, laundry, and other agreed-upon daily tasks.

If Margaret also has a health condition affecting her nutrition, a healthcare professional may need to evaluate that concern separately.

Scenario 2: Someone returns home after surgery

Robert has returned home after a surgical procedure. His clinician has ordered wound care and rehabilitation services.

Potential starting point: Home health care, if eligible.

A qualified healthcare professional can determine which services are medically appropriate and whether the person meets the relevant coverage requirements.

Robert may also need help with meals, bathing, or household tasks. Those needs should be discussed separately because they may not be covered by the home health arrangement.

Scenario 3: A person has both medical and everyday support needs

Linda has a chronic health condition and has recently become less mobile. Her healthcare team recommends qualifying home health services, while her daughter is struggling to keep up with meals, laundry, and personal assistance.

Potential option: Both services.

Home health professionals may address the qualifying healthcare needs, while a non-medical caregiver may help with daily activities.

The family should confirm each provider's responsibilities and avoid assuming that one service includes everything the other provides.

Scenario 4: An older adult needs help getting dressed and taking a shower

James has difficulty dressing and bathing but does not currently require skilled nursing or therapy.

Potential starting point: Non-medical personal care.

A home care agency may be able to provide hands-on assistance, depending on its services and applicable requirements.

If James's difficulties are new, worsening, or related to a medical problem, he should also be assessed by an appropriate healthcare professional.

Scenario 5: A family is unsure why a loved one has become weaker

Susan's family has noticed that she is increasingly unsteady and having difficulty standing up from a chair.

Potential starting point: A healthcare assessment.

The family should not assume that this is simply an aging-related need for a caregiver. A clinician can assess possible causes and determine whether treatment, rehabilitation, home health services, personal care, or a combination may be appropriate.

Sudden weakness, sudden confusion, difficulty breathing, or other severe symptoms may require emergency medical attention.

What if you are still unsure?

Start by listing the tasks the person needs help with. Separate them into two categories:

• Everyday activities, such as bathing assistance, meal preparation, housekeeping, and companionship.
• Healthcare needs, such as skilled nursing, prescribed rehabilitation, and clinical treatment.

Then discuss the healthcare needs with the person's clinician and ask potential home care providers which daily activities they can safely support.

This approach helps families identify the right services without assuming that one type of care will meet every need.

5. Does Medicare Cover Home Care or Home Health Care?

Medicare coverage is one of the most important differences families need to understand.

Original Medicare generally does not cover ongoing custodial care when that is the only care a person needs. It can cover certain home health services when the person meets the applicable eligibility and service requirements.

This distinction matters because a person may genuinely need help at home without qualifying for Medicare-covered home health services.

When may Medicare cover home health care?

According to Medicare.gov, eligibility generally requires that the person:

• Be under the care of a doctor or other allowed healthcare provider.
• Have a qualifying need for part-time or intermittent skilled services.
• Meet Medicare's homebound criteria.
• Receive services under an established care plan.
• Use a Medicare-certified home health agency.

A healthcare provider must assess the person, confirm the need, and order the relevant services as required by Medicare rules.

Homebound status does not necessarily mean a person can never leave home. Medicare's rules consider whether leaving home is normally difficult or requires considerable effort because of an illness or injury, along with the other applicable criteria.

Eligibility should be confirmed for the individual's circumstances.

What home health services can Medicare cover?

For eligible individuals, covered services may include:

• Medically necessary part-time or intermittent skilled nursing.
• Physical therapy.
• Occupational therapy when applicable requirements are met.
• Speech-language pathology services.
• Certain medical social services.
• Part-time or intermittent home health aide services when the person is also receiving qualifying skilled services.
• Certain medical supplies and durable medical equipment under applicable rules.

The exact covered services depend on eligibility, medical necessity, and Medicare's requirements.

What does Medicare generally not cover?

Original Medicare does not cover:

• Twenty-four-hour-a-day care at home.
• Home-delivered meals as a home health benefit.
• Homemaker services, such as shopping and cleaning, when unrelated to the covered care plan.
• Custodial or personal care when that is the only care needed.

For example, if an older adult primarily needs someone to prepare meals, do laundry, and provide companionship, those needs generally do not qualify for Medicare-covered home health care by themselves.

If that person also qualifies for skilled nursing or therapy, certain home health services may be covered. However, coverage of those services does not automatically mean Medicare will pay for all additional personal care or household help.

How much does Medicare-covered home health care cost?

For covered home health services, Original Medicare generally has no cost-sharing for the covered services themselves. Separate cost-sharing rules apply to certain durable medical equipment, for which beneficiaries generally pay 20% of the Medicare-approved amount after meeting the Part B deductible.

Services or supplies that Medicare does not cover may result in out-of-pocket expenses. Before services begin, ask the agency which items are covered, which are not, and what you may owe.

If you have a Medicare Advantage plan, check the plan's rules and network requirements directly with the insurer.

Important: Coverage rules can change, and individual circumstances matter. Verify current requirements through the official Medicare home health coverage page before making financial decisions.

6. Does Medicaid Pay for Home Care?

Medicaid may help eligible individuals receive certain home and community-based services, including some forms of personal care and in-home assistance.

However, Medicaid is administered by states within federal requirements. Eligibility, covered services, provider rules, and program availability can vary significantly.

Medicaid and non-medical home care

Depending on the state and program, Medicaid-funded services may include personal assistance, homemaker services, respite care, or other supports that help someone remain at home.

Some services are provided through state plan benefits, while others may be available through home and community-based services programs or waivers.

A person's financial circumstances, functional needs, program eligibility, and the availability of services can all affect access.

Medicaid and home health care

Medicaid may also cover qualifying home health services under applicable program rules. The specific requirements depend on the state's Medicaid plan and the type of service.

Do not assume that Medicaid coverage is identical to Medicare coverage or that every service is available through every program.

How to check eligibility

If your family is considering Medicaid-funded care:

• Contact the state Medicaid agency.
• Ask about home-based personal care and home health services separately.
• Ask whether an assessment is required.
• Confirm financial and functional eligibility requirements.
• Ask about approved providers, enrollment limits, waiting lists, and service authorization.
• Obtain written information about covered services and any applicable costs.

The official Medicaid Home and Community-Based Services page provides an overview of these programs.

7. How Much Does Each Type of Care Cost?

There is no single price for either home care or home health care. Costs depend on the services required, location, provider, schedule, and payment arrangement.

It is also important to compare like with like. An hourly rate for a non-medical caregiver is not directly comparable with a healthcare provider's rate for a skilled clinical visit.

Non-medical home care costs

Non-medical home care is commonly priced by the hour, although agencies may have minimum visit lengths, overnight rates, or other pricing arrangements.

Costs depend on:

• Local caregiver wages and availability.
• The number of hours required.
• Whether personal care or specialized support is needed.
• Evening, weekend, or holiday scheduling.
• Minimum shift requirements.
• Transportation and other additional charges.

As a budgeting illustration, suppose a family receives a quote of $35 per hour. At that rate, the estimated monthly cost by weekly schedule is:

• 5 hours per week: about $758 per month.
• 10 hours per week: about $1,517 per month.
• 20 hours per week: about $3,033 per month.
• 40 hours per week: about $6,067 per month.

These estimates assume the same hourly rate throughout the year and calculate an average month using 52 weeks divided by 12. They are illustrations, not local quotes or a guarantee of current pricing. For Illinois-specific rates and monthly estimates, see how much home care costs in Illinois.

Home health care costs

Home health care may be priced by the visit, service, or another billing arrangement, depending on the provider and payer.

The amount a family pays out of pocket depends on several factors:

• Whether the service is medically necessary and covered.
• Whether the person meets eligibility requirements.
• Whether the provider meets the payer's requirements.
• The person's Medicare, Medicaid, or private insurance coverage.
• Whether any recommended services fall outside the covered benefit.

If Medicare covers the qualifying home health services, the person generally pays nothing for those covered services under Original Medicare, although separate cost-sharing rules apply to certain equipment. Uncovered services may cost extra.

How to compare the costs fairly

Before choosing a service, ask each provider for a written estimate and clarify:

• What services are included?
• How are visits or hours billed?
• Are there minimum visit lengths?
• Are supplies, equipment, transportation, or other items charged separately?
• Which services does insurance or a public program cover?
• What will the family owe out of pocket?
• How might the cost change if the person's needs increase?

A lower quoted rate does not always mean a lower overall cost. The more useful comparison is the cost of meeting the person's actual needs.

8. Can Someone Receive Both Home Care and Home Health Care?

Yes. In some circumstances, using both services can help address different needs.

Home health care may provide qualifying clinical services, while non-medical home care helps with everyday activities that are not included in the healthcare plan.

For example, a person recovering at home may need:

• A nurse to provide ordered skilled care.
• A physical therapist to work on rehabilitation.
• A caregiver to prepare meals and help with household routines.
• Personal assistance with bathing or dressing, if arranged through an appropriate provider.

The exact combination will depend on the person's needs and eligibility.

How to coordinate both services

If your loved one receives both types of care, ask each provider to clarify its role.

Create a clear list of responsibilities. Identify which provider handles clinical services and which handles everyday tasks.

Share relevant information appropriately. With the person's permission and in accordance with applicable privacy rules, make sure providers have the information they need to support safe care.

Clarify who to contact. Families should know whom to call for scheduling questions, changes in daily needs, clinical concerns, and emergencies.

Review the arrangement regularly. Needs can change after an illness, hospitalization, or change in mobility. The care plan may need to be reassessed.

Avoid assuming services overlap. If a home health aide provides certain personal assistance during an eligible visit, that does not mean the person has ongoing help for the rest of the day.

Coordination is especially important when family members are managing appointments, medications, meals, and multiple providers.

9. How to Choose the Right Type of Care

The best starting point is to understand the person's needs rather than choosing a service based on its name.

Step 1: Identify the main need

Ask what has become difficult.

Is the person struggling with everyday tasks such as meals, laundry, bathing, or errands? Or do they need clinical care, rehabilitation, or skilled nursing?

They may need both types of support.

Step 2: Speak with a healthcare professional when appropriate

If the person has a new medical problem, is recovering from surgery, has worsening symptoms, or may need skilled services, ask their healthcare provider to assess the situation.

Do not rely on a non-medical caregiver to diagnose a condition or determine whether clinical treatment is needed.

Step 3: List the daily tasks that require help

Write down the activities the person needs assistance with and how often that assistance is required.

For example:

• Morning dressing and bathing.
• Preparing meals.
• Grocery shopping.
• Help with mobility.
• Companionship during the afternoon.
• Household tasks.
• Overnight supervision, if needed and available.

This list can help you request a more accurate home care estimate.

Step 4: Confirm eligibility and coverage

If you believe the person may qualify for Medicare-covered home health services, contact their healthcare provider and verify the requirements.

If you are exploring Medicaid, veterans' benefits, or long-term care insurance, contact the relevant program or insurer to confirm eligibility, approved services, and any limits.

Do not make a financial commitment based on an assumption that a service will be covered.

Step 5: Compare providers

For non-medical home care, ask agencies about screening, training, services, scheduling, backup coverage, and costs. Our guide to how to choose a home care agency in Illinois covers the questions that separate a good agency from a risky one.

For home health care, ask about the services ordered, provider qualifications, visit scheduling, communication with the healthcare team, and coverage.

If both are involved, confirm how the services will fit together.

Step 6: Reassess when needs change

A person who initially needs only a few hours of weekly assistance may eventually need more support. Someone recovering from surgery may need home health care temporarily and different services later.

Review the plan when the person's abilities, health, or living circumstances change.

10. Questions to Ask Before Arranging Care

Use these questions when speaking with a home care agency, home health agency, healthcare provider, or insurer.

Questions about the person's needs

• What specific tasks does my loved one need help with?
• Does the person need everyday assistance, skilled healthcare services, or both?
• Is a clinical assessment appropriate before services begin?
• Can the person's needs be met safely at home?
• What additional support might be needed outside scheduled visits?

Questions for a non-medical home care agency

• Do you provide personal care, companionship, meal preparation, and housekeeping?
• Which tasks are your caregivers trained and permitted to perform?
• How do you screen and train caregivers?
• What is your minimum visit length?
• What happens if the assigned caregiver is unavailable?
• What is the total expected cost, including additional fees?
• How do you communicate concerns or changes in needs?

Questions for a home health agency

• Which services have been ordered?
• Which eligibility requirements must be met?
• How often are visits expected to occur?
• Which professionals will provide the services?
• How will the agency communicate with the treating healthcare provider?
• Which services are covered by Medicare or the person's insurance?
• What services, if any, may result in additional charges?

Questions for Medicare or another insurer

• Does this specific service qualify for coverage?
• What conditions must be met?
• Must the provider be approved or certified?
• Are there plan-specific network or authorization requirements?
• Which items or services are excluded?
• What out-of-pocket costs should we expect?

Write down the answers and request written estimates or coverage information where possible. This can prevent misunderstandings later.

11. How to Get Started

If you are arranging care for a parent or loved one, you do not have to solve every part of the plan at once.

Begin with these practical steps.

Talk with your loved one. Ask what help would make everyday life easier and which routines they want to preserve. If that conversation is the hard part, start with what to do when a parent refuses help at home.

Write down the needs. Separate everyday support from possible medical or rehabilitation needs.

Contact the appropriate professionals. Speak with a healthcare provider if clinical assessment or home health services may be needed.

Verify payment options. Check Medicare eligibility, Medicaid programs, insurance benefits, or other relevant funding options before assuming coverage.

Request written estimates. Compare providers based on services, qualifications, scheduling, and total cost.

Agree on a plan. Make sure the person understands who will visit, what assistance will be provided, and whom to contact with questions.

Review how it is working. Revisit the arrangement after the first visits and whenever the person's needs change.

The right arrangement should address practical needs while respecting the person's preferences, dignity, and independence.

12. Frequently Asked Questions

Is home care the same as home health care?

No. In this guide, home care refers to non-medical assistance with everyday living, while home health care refers to healthcare services delivered at home. Services and terminology can vary, so ask providers to specify exactly what they offer.

Which is better: home care or home health care?

Neither is universally better. The right choice depends on what the person needs. Everyday assistance may call for non-medical home care, while qualifying clinical needs may call for home health care. Some people benefit from both.

Does Medicare pay for non-medical home care?

Original Medicare generally does not cover ongoing custodial care when that is the only care needed. It may cover certain qualifying home health services, including limited home health aide services when the applicable skilled-care requirements are met.

Does Medicare cover bathing assistance at home?

Medicare may cover part-time or intermittent home health aide services when the person meets the requirements for covered home health services and is also receiving qualifying skilled services. Bathing assistance alone generally does not qualify for Medicare-covered home health care.

Can someone receive home health care without being homebound?

For Medicare-covered home health services under Original Medicare, the person generally must meet Medicare's homebound criteria as well as the other eligibility requirements. Other payment arrangements and programs may have different rules.

How often does a home health professional visit?

The schedule depends on the person's clinical needs, the services ordered, the care plan, and applicable program rules. Home health care should not be assumed to provide continuous daily supervision or round-the-clock assistance.

Can I hire a caregiver while my parent receives home health care?

Yes, if the arrangement is appropriate for the person's needs. Families may arrange non-medical assistance for tasks not provided through the home health service. Clarify responsibilities, costs, and scheduling with each provider.

Is home health care only for older adults?

No. People of different ages may qualify for home health services when they meet the applicable requirements. Eligibility is based on the person's circumstances and the relevant program, not simply their age.

Does Medicaid cover both home care and home health care?

Medicaid may cover certain services in both categories, depending on the state, program, eligibility requirements, and service. Contact the state Medicaid agency to verify the options available to the individual.

What if my parent needs help after a hospital stay?

Ask the discharge team and treating healthcare provider what services are recommended and which ones have been ordered. Confirm eligibility and coverage for home health services, and separately identify any everyday assistance the person will need after returning home.

Can home care replace nursing care?

Non-medical home care does not replace skilled nursing when clinical services are required. A caregiver may help with daily activities, but clinical needs should be assessed and managed by appropriately qualified professionals.

How do I know whether my loved one needs both services?

Consider whether there are separate everyday and clinical needs. A person may need rehabilitation or skilled nursing while also needing help with meals, bathing, transportation, or household tasks. Ask the healthcare team and potential home care provider to clarify which needs each service can address.

13. Conclusion: Choose Care Based on the Need, Not Just the Name

Understanding the difference between home care and home health care can help families make better decisions about supporting a loved one at home.

Non-medical home care generally helps with everyday activities, personal assistance, companionship, and household routines. Home health care provides qualifying healthcare services, such as skilled nursing and therapy, when the person's needs and eligibility meet the applicable requirements.

Neither service automatically replaces the other. Some families need practical daily assistance, some need clinical care, and some need a combination.

Start by identifying the person's needs, speak with the appropriate healthcare professionals, verify coverage, and compare providers carefully. With a clear plan, families can make more informed decisions while helping their loved ones maintain comfort, dignity, and independence.

14. Sources and Further Reading

For accuracy and further information, consult these official resources:

• Medicare.gov: Home Health Services Coverage
• Medicare.gov: Long-Term Care Coverage
• Medicaid.gov: Home and Community-Based Services
• Medicare.gov: Nursing Home Care

This article provides general information and is not a substitute for individualized medical, insurance, legal, or financial advice. Coverage and service requirements can change; confirm the applicable rules with the relevant provider or program.