The two terms sound almost identical, and agencies don't always help by using them loosely. But they describe different services, provided by different people, paid for in different ways. Knowing which one you need saves a lot of phone calls.
Home health care is medical
Home health care is skilled care ordered by a doctor: nursing, physical therapy, occupational therapy, speech therapy, and sometimes medical social work. Typical reasons include recovery after surgery or a hospital stay, wound care, managing a new medication, or rebuilding strength after a stroke.
Visits are usually short and intermittent — a nurse might come twice a week, a therapist three times — and the goal is recovery or stabilization. Agencies that bill Medicare for this care must be Medicare-certified. For a clear description of what skilled nursing at home includes, see TideCare's page on skilled home health care.
Home care is everyday help
Home care (sometimes called personal care, private duty or non-medical care) covers the tasks of daily living: bathing, dressing, toileting, meals, light housekeeping, medication reminders, errands, transportation and companionship. Shifts can run from a few hours a week to around-the-clock.
The goal is safety and independence over the long term. Caregivers are usually personal care aides or certified nursing assistants rather than nurses.
Side by side
- Who orders it: Home health requires a doctor's order and plan of care. Home care can be arranged directly by the family.
- Who provides it: Home health uses nurses and licensed therapists. Home care uses aides and companions.
- How long it lasts: Home health is usually weeks, tied to a medical goal. Home care can continue for months or years.
- Who pays: Home health is commonly covered by Medicare or health insurance when criteria are met. Home care is usually private pay, long-term care insurance, VA benefits, or Virginia Medicaid waiver programs.
Many families need both
A common pattern after a hospital stay: Medicare covers a nurse and therapist for a few weeks, while the family pays for an aide a few hours a day to help with bathing and meals. Some agencies offer both services; others focus on one. When you call an agency from our directory, ask which they provide.
