Understanding care
Home Care vs. Home Health Care: What's the Difference?
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The short answer
Home care is non-medical help with daily living, such as bathing, dressing, meals, and getting around, and it can continue long term. Home health care is skilled medical care, such as nursing or physical therapy, ordered by a doctor and usually short term. Medicare covers home health for people who qualify, but not ongoing personal care; in Michigan, Medicaid programs such as Home Help and the MI Choice Waiver can cover home care.
Key takeaways
- Home care (also called non-medical, non-skilled, or personal care) helps with activities of daily living. No doctor's order is needed.
- Home health care is skilled care from licensed clinicians, such as nurses and therapists. A doctor must order it.
- Medicare covers home health care for people who are homebound and need skilled care, but it does not pay for personal care when that is the only care someone needs.
- In Michigan, Medicaid can pay for home care through the Home Help Program, the MI Choice Waiver, and Community Living Supports.
- Many families use both at once, for example after a hospital stay.
"Home care" and "home health care" sound almost the same, and many people use them interchangeably. They are different services, with different caregivers, different rules, and different ways to pay. Knowing which one your loved one needs makes it much easier to get the right help, and to get it covered.
The short version
Home care helps with everyday life. A caregiver helps with bathing, dressing, using the toilet, moving around safely, meals, light housekeeping, and reminders to take medications. It is often called non-medical, non-skilled, or personal care. It can be a few hours a week or many hours a day, for as long as it is needed.
Home health care is medical care delivered at home by licensed clinicians: registered nurses, physical therapists, occupational therapists, and speech therapists. It treats an illness or injury, for example wound care, injections, or rehab after surgery. A doctor orders it, and it is usually short term.
What home care includes
Home care focuses on activities of daily living, often called ADLs, and the everyday tasks around them:
- Bathing, showering, and personal hygiene
- Dressing and grooming
- Toileting and continence care
- Moving around the home, transferring from bed to chair, and fall prevention
- Reminders to take medications on schedule
- Preparing meals and light housekeeping
- Companionship, and support to stay active in the community
Home care caregivers do not perform nursing tasks, such as giving injections, changing sterile dressings, or adjusting medications.
What home health care includes
- Skilled nursing, such as wound care, IV therapy, injections, and monitoring a serious condition
- Physical, occupational, and speech therapy
- Teaching a patient and family how to manage a new diagnosis or device
- Some home health aide visits, but only alongside skilled care
Who pays for each
Medicare
Medicare covers home health care when a person meets all the requirements, which include being under a doctor's care with a plan of care, needing intermittent skilled nursing or therapy, being homebound, and having a doctor certify the need. Medicare pays the home health agency directly.
Medicare does not pay for 24-hour care at home, meal delivery, homemaker services, or personal care such as bathing and dressing when that is the only care a person needs. This is the gap many families discover after a hospital stay.
Michigan Medicaid
In Michigan, Medicaid can pay for ongoing home care through several programs:
- Home Help Program. Helps Medicaid members who need hands-on help with daily activities. An MDHHS adult services worker assesses the need.
- MI Choice Waiver. For adults who medically qualify for nursing home care but want to stay at home. It covers a wider set of in-home services.
- Community Living Supports (CLS). Helps people stay independent and active at home and in the community, usually arranged through a Community Mental Health agency or a waiver program.
Some programs also let a family member be hired and paid as the caregiver. See how to get paid to care for a family member in Michigan.
Private pay and long-term care insurance
Families can also pay for home care privately, by the hour, or use a long-term care insurance policy, many of which cover personal care at home.
Which one does your loved one need?
Home care is usually the right fit when someone:
- Is medically stable but needs help with bathing, dressing, or getting around
- Is living with memory loss and needs supervision or cueing
- Has a family caregiver who needs regular breaks (respite care)
- Wants to stay at home instead of moving to assisted living or a nursing home
Home health care is usually the right fit when someone:
- Was just discharged from the hospital or a rehab facility
- Has a new wound, a new medical device, or a condition that needs a nurse to monitor it
- Needs physical, occupational, or speech therapy at home
Many families use both
The two often work together. After a hip replacement, for example, a home health agency may send a nurse and a physical therapist a few times a week, while a home care aide helps every day with bathing, dressing, and meals. When the home health episode ends, home care can continue for as long as it is needed.
Frequently asked questions
Is home care the same as home health care?
No. Home care is non-medical help with daily living, like bathing and dressing. Home health care is skilled medical care, like nursing and therapy, ordered by a doctor.
Does Medicare pay for home care?
Medicare does not pay for personal care at home when that is the only care someone needs. It covers home health care for people who are homebound and need skilled nursing or therapy. Medicaid, long-term care insurance, or private pay usually cover ongoing home care.
Do I need a doctor's order for home care?
Not for private-pay home care. Medicaid programs may require a medical professional to certify the need for help as part of the application.
Can a home care aide give medications?
Home care aides can remind someone to take medications at the right time. They do not give injections, set up or change doses, or perform other nursing tasks.
Sources
This article is general information to help families plan care. It is not medical advice and does not replace a conversation with your own doctor or care team. If someone is hurt or in danger, call 911.