On the surface, home care and home health care sound roughly the same — care you receive in your home. While the terms are often used interchangeably, there are important differences between them, including differences in the individual services, who provides the care, costs, and payment options. Understanding these differences is crucial for determining the best type of service for your situation. Here, we’re looking at the similarities and differences between home care and home health care, along with situations when each type of service might be relevant.
Home care
Let’s begin with home care, as it is the most straightforward. This care is considered nonmedical, as it is not offered by licensed medical professionals and does not focus on health or illness-related services (like wound care).
Instead, job titles for those providing care include home care providers and personal care aides. Oddly, the term “home health aide” is also commonly used for home care workers, even though it sounds more appropriate for home health care. While home care workers are not required to have medical training, some may still be trained in specific caregiving or senior support skills.
Services offered
The emphasis on nonmedical care means that home care doesn’t attempt to address a specific health condition. Instead, home care focuses on nonmedical support, assisting with activities of daily living like bathing, dressing, and eating. Home care providers may also help with light housekeeping, meal preparation, and companionship. These services promote independence and enhance the quality of life for seniors at home.
Families can hire home health aides for daily visits or just a few hours per week, depending on their budget and needs. They may use a home care provider as their primary source of care, or if a family member is the primary caregiver, they might use an aide for respite care or for more difficult tasks, such as bathing.
Who is home care for?
Home care is for people who struggle with some areas of their daily life but don’t have considerable long-term medical needs. For example, home care could benefit an aging father who is generally healthy but can’t move around well, an elderly aunt who lives alone and is unable to cook for herself, or someone recovering from surgery who can’t currently bathe or cook independently.
People with significant health conditions may also receive home care, but this type of support would not provide direct care for the medical condition. For example, a person with arthritis might need help with some personal care tasks, as may someone with minor cognitive challenges.
Home care costs
The exact cost of hiring a home care worker is influenced by multiple factors, including:
- Whether the provider is independent or from an agency: Hiring a worker through an agency is generally more expensive, but doing so is simpler and often less stressful than hiring someone independently.
- Location: Costs vary between regions and states.
- Specific tasks: Costs may be higher if your loved one has complex needs.
- Frequency and duration of visits: Some providers charge a per-visit rate, while others charge per hour. Either way, more time with the care recipient leads to higher total fees.
- Provider: Rates can also vary between different agencies and providers. You will need to do some comparison shopping to find the best provider for your needs.
- Extra fees: Additional fees may also apply, such as travel time or paying more for overnight caregiving.
At the national level, the median cost of a home health aide is currently $33 per hour. However, the state-based differences are considerable. For example, in Maine, the average is $42 per hour, while it is just $28 per hour in Texas.
How to pay for home care
Home care is most often paid for out of pocket, with seniors or their family members covering the bill. It can get expensive fast, though, especially when ongoing support is needed for months or years.
However, there are some other options you may be eligible for.
- Medicaid: In some states, Medicaid might cover some of the cost of home care services. Seniors must meet income-based eligibility requirements and demonstrate a need for care to receive this funding. Eligibility criteria vary between states.
- Medicare: While Medicare doesn’t directly cover home care, the service may sometimes be prescribed as medically necessary along with home health care. If so, Medicare may pay for some home care costs for a short time.
- Long-term care insurance: This type of insurance can cover home care services, but coverage and restrictions vary depending on the policy.
- Veterans benefits: Eligible Veterans may be able to use their VA benefits to help cover the cost of care.
Home health care
As the name suggests, home health care focuses on health. Specifically, this is a form of medical care provided in the home by health care professionals like registered nurses and occupational therapists.
Services offered
Most home health care services are medically focused. Services include skilled nursing care, medical testing, medication administration, pain management, physical therapy, and wound care. This care does not include nonmedical personal care on its own, such as help with bathing or homemaker services.
Licensed professionals provide home health care. These professionals may include licensed practical nurses, registered nurses, and physical, occupational, and speech therapists. A doctor needs to prescribe home health care for insurance to cover it.
Who is home health care for?
Home health care is for people with significant medical needs when a hospital stay is not appropriate. It’s commonly used by people recovering from surgery or accidents or those with chronic conditions that they need support with.
For example, a senior with diabetes may require home health care to assist with wound care from a leg ulcer. Some patients may need IV fluids if they are unable to eat. Someone recovering from a serious fall may need physical therapy.
Home health care costs
Home health care costs vary by location, frequency, level of care, provider, and health insurance. The type of care provided under the umbrella of home health care also varies greatly. For example, physical therapy and wound care are distinctly different types of care provided by different medical professionals who charge differently for their services, which makes it difficult to gauge the average cost of home health care.
How to pay for home health care
Medicare covers 100% of home health care services from a Medicare-certified agency when the care is prescribed by a doctor and deemed medically necessary. For Medicare to cover the care, the patient must have difficulty leaving their home without assistance, and the maximum number of hours permitted is 28 per week, with limited exceptions. Eligible individuals may be able to use Medicaid and Veterans benefits to assist with payment.
Private insurance may cover some costs, but policies vary considerably, and only some will help with home health services. If a doctor doesn’t prescribe home health care, the family can pay for it directly.
Where home care and home health care overlap
As the table below shows, home health care and home care are generally distinct, but there are some overlaps in the services. Notably, home health care professionals may sometimes help with personal care and daily living activities while a person is recovering and cannot do these independently. Even so, home health care retains a strong focus on medical services instead of nonmedical ones.
| Home care | Home health care | |
| Activities of daily living (e.g., bathing, dressing, toileting) | Yes | Yes |
| Companionship and social connection | Yes | No |
| Injections, IVs, and wound care | No | Yes |
| Meal prep or delivery | Yes | No |
| Medication reminders | Yes | Yes |
| Medication administration | No | Yes |
| Medical tests | No | Yes |
| Home therapy (physical, occupational, and speech) | No | Yes |
| Light housekeeping | Yes | No |
| Transportation | Yes | No |
| Provided by: | Home care workers and home health aides | Licensed health care professionals, including registered nurses and physical therapists |
| Payment options: | Typically paid out of pocket, although Medicaid and Veterans benefits can help eligible individuals | Typically covered by Medicare for eligible individuals |
It’s important to note that home health care and home care aren’t mutually exclusive. You can independently hire home care support while receiving prescribed home health care. There are even cases where home care may be prescribed and paid for alongside home health care if the doctor deems this medically necessary.
Final thoughts
Despite having similar names, home care and home health care vary considerably, with different services, payment options, and costs. As such, it’s crucial to figure out which service (or combination of services) is best for your situation.
