Home Care or Home Health? Telling the Two Apart

The names are similar, yet home care and home health differ in who delivers the service, what it includes, and who pays. Understand the distinction before hiring or requesting help.

Updated 2026

This guide is informational and is not medical advice.

Category: choosing-care · Updated 2026

Few distinctions confuse families more than the one between home care and home health, and that distinction determines who pays. Home care means non-medical assistance with daily living, generally paid out of pocket. Home health is skilled medical care prescribed by a physician, sometimes covered by Medicare. Asking for the wrong one can stall the service you actually need.

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

The fundamental distinction

Point of comparison	Home care	Home health
Primary focus	Help with daily living and supervision	Skilled medical care and therapy
Who delivers it	Home care aides and companions	Nurses, therapists, and home health aides working from a plan
Requires a doctor's order	No	Yes, a written plan of care is required
Usual payer	Private pay; certain waivers and VA benefits	Medicare for homebound patients who qualify, or insurance

The two can run side by side. Someone recovering from surgery might have a nurse and a therapist attending to skilled needs, plus a separate aide for bathing and meals.

Services included in home care

Home care — also known as personal care or companion care — assists with daily living activities and household chores. Typical services cover bathing and grooming, dressing, toileting and incontinence care, meal preparation, medication reminders, light housekeeping, laundry, transportation, and supervision. Scheduling can be hourly or around the clock.

Skilled medical tasks such as wound care, injections, or tube feeding typically fall outside a home care aide's scope. Those belong to home health nurses. See Home Care Costs for pricing models.

Services included in home health

Under a physician's plan, home health provides skilled care on an intermittent schedule. It may involve skilled nursing for wound care, medication management and instruction, and monitoring of a chronic condition, along with physical, occupational, and speech therapy, and medical social work. When personal care is written into the skilled plan, a home health aide may provide it.

Medicare's home health benefit comes with specific conditions. The patient must be homebound, require skilled care intermittently, and be under a physician's plan of care, and the agency must hold Medicare certification. For covered services, Medicare as a rule pays in full with no daily copay, though some items may involve cost sharing. Confirm the current rules and the terms of your plan.

Payment sources for each service

Coverage depends on which service is delivered:

Home health. Medicare for homebound patients who qualify, Medicare Advantage, or private insurance, based on the plan and the need.
Home care. Private pay is standard. In some states, Medicaid home and community based services waivers may cover personal care; VA benefits may assist eligible veterans; and long-term care insurance may reimburse when the policy includes home care.

Never assume a referral for one service authorizes the other. A hospital discharge planner can order home health, yet home care is normally arranged and paid for by the family on its own. See How to Pay for Senior Care.

Setting up home health

A physician order generally launches home health. Following a hospital stay, the discharge planner can set up a referral. Look for agencies with Medicare certification that are in network for the person's coverage, and ask for a copy of the plan of care so the goals and schedule are clear.

Maintain a medication list and a written log of visits and vital signs. Find out who to contact after hours and what events would prompt a change to the plan. Once skilled needs conclude, Medicare coverage concludes as well, and the family may need to arrange home care for help with daily living.

Setting up home care

Families handle home care arrangements themselves. Settle on the tasks, schedule, and budget, then pick among an agency, a registry, or a direct hire. With an agency, ask about screening, training, supervision, backup coverage, and the after-hours contact. With a direct hire, verify payroll and insurance obligations.

Commit the plan to writing and revisit it as needs change. Begin with a schedule you can manage and adjust from there, instead of locking into a large block before you know how well it works. 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. For information only; not medical or legal advice.

Related guides

Frequently asked questions

How do home care and home health differ?

Home care covers non-medical assistance with everyday tasks — bathing, meals, supervision — and families generally pay for it themselves. Home health involves clinical care from nurses or therapists, follows a doctor's plan, and may be covered by Medicare.

Will Medicare cover home care?

Medicare covers home health when the patient is homebound and requires skilled care under a physician's plan. Stand-alone custodial home care is not covered. For everyday assistance, families rely on private pay, a Medicaid waiver, VA benefits, or long-term care insurance.

Is it possible to get home care and home health together?

Yes, and it often happens after a hospital stay. A home health nurse or therapist attends to skilled needs while a separate home care aide helps with bathing, meals, and mobility. The two are arranged and paid for independently.

Does home care require a doctor's order?

No. Families arrange home care directly, with no physician order involved. Home health, by contrast, does require a physician's plan of care, which is why it typically begins through a hospital discharge planner or a doctor's referral.

What if home health ends but help is still required?

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

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is provided for information and is not medical advice. Processing date: 2026-10-06.

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