Home Care vs Home Health: What Families Need to Know

Home care and home health sound alike but differ in who provides care, what they do, and who pays. Learn the difference before you hire or request services.

Category: choosing-care · Updated 2026

Home care vs home health is one of the most common points of confusion for families, and the difference decides who pays. Home care is non-medical help with daily living, usually paid privately. Home health is skilled medical care ordered by a physician, sometimes covered by Medicare. Using the wrong term can delay the right service.

This guide explains what each service is, who provides it, and how coverage works. It is educational only and not medical advice.

The core difference

Question	Home care	Home health
Focus	Daily living and supervision	Skilled medical care and therapy
Who provides it	Home care aides, companions	Nurses, therapists, home health aides under a plan
Ordered by a doctor	No	Yes, a plan of care is required
Typical payer	Private pay, some waivers and VA benefits	Medicare for eligible homebound patients, or insurance

Both can happen at the same time. A person recovering from surgery might have a nurse and a therapist for skilled needs and a separate aide for bathing and meals.

What home care covers

Home care, also called personal care or companion care, helps with activities of daily living and household tasks. Common services include bathing and grooming, dressing, toileting and incontinence care, meal preparation, medication reminders, light housekeeping, laundry, transportation, and supervision. It can be scheduled by the hour or provided around the clock.

Home care aides generally do not perform skilled medical tasks such as wound care, injections, or tube feeding. Those fall to home health nurses. See Home Care Costs for pricing models.

What home health covers

Home health is skilled, intermittent care delivered under a physician's plan. It can include skilled nursing for wound care, medication management and teaching, and monitoring of a chronic condition, as well as physical, occupational, and speech therapy, and medical social work. A home health aide may assist with personal care when it is part of the skilled plan.

Medicare's home health benefit has specific conditions. The person must be homebound, need skilled care on an intermittent basis, and be under a physician's plan of care, and the agency must be Medicare certified. Medicare generally pays in full for covered services with no daily copay, though there may be cost sharing for some items. Verify the current rules and your plan's terms.

Who pays for each

Coverage follows the service type:

Home health. Medicare for eligible homebound patients, Medicare Advantage, or private insurance, depending on the plan and need.
Home care. Private pay is the norm. Medicaid home and community based services waivers may cover personal care in some states, VA benefits may help eligible veterans, and long-term care insurance may reimburse if the policy covers home care.

Do not assume a referral for one service authorizes the other. A hospital discharge planner can order home health, but the family usually arranges and pays for home care separately. See How to Pay for Senior Care.

How to set up home health

Home health usually starts with a physician order. After a hospital stay, a discharge planner can arrange a referral. Ask for agencies that are Medicare certified and in network for the person's coverage, and request a copy of the plan of care so you know the goals and the schedule.

Keep a medication list and a written record of visits and vital signs. Ask who to call after hours and what would trigger a change in the plan. When skilled needs end, Medicare coverage ends too, and the family may need to arrange home care for daily living support.

How to set up home care

Home care is arranged by the family. Decide on the tasks, the schedule, and the budget, then choose between an agency, a registry, or direct hire. For agency care, ask about screening, training, supervision, backup coverage, and the after hours contact. For direct hire, confirm payroll and insurance duties.

Put the plan in writing and review it as needs change. Start with a manageable schedule and adjust, rather than committing to a large block before you know how it fits. See Home Care vs Home Health when the need shifts from daily living to skilled care.

Sources: Medicare.gov home health services; Medicaid.gov home and community based services; VA Geriatrics and Extended Care; Eldercare Locator. Informational only, not medical or legal advice.

Related guides

Frequently asked questions

What is the difference between home care and home health?

Home care is non-medical help with daily living, such as bathing, meals, and supervision, and is usually paid privately. Home health is skilled medical care, such as nursing and therapy, delivered under a physician's plan and sometimes covered by Medicare.

Does Medicare pay for home care?

Medicare pays for home health when the person is homebound and needs skilled care under a physician's plan. It does not pay for stand-alone custodial home care. For help with daily living, families use private pay, a Medicaid waiver, VA benefits, or long-term care insurance.

Can you receive home care and home health at the same time?

Yes, and it is common after a hospital stay. A home health nurse or therapist addresses skilled needs while a separate home care aide helps with bathing, meals, and mobility. They are arranged and paid for separately.

Do I need a doctor's order for home care?

No. Home care is arranged directly by the family without a physician order. Home health does require a physician's plan of care, which is why it usually starts through a hospital discharge planner or a doctor's referral.

What happens when home health ends but help is still needed?

When skilled needs end, Medicare coverage ends, but daily living needs may remain. At that point families arrange home care, a Medicaid waiver program if eligible, VA benefits, or another support, and update the care plan.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is informational and is not medical advice. Processing date: 2026-10-05.

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