Home health and home care sound alike, and many families use the words interchangeably. They are two different services, with different providers, different rules, and very different bills.
In short: home health is medical care from nurses and therapists, ordered by a doctor, and Medicare can cover it. Home care is hourly help with everyday tasks, usually paid privately. Here is how to tell which one you need, and when a family needs both.
Home health: skilled medical care at home
Home health care is treatment. A doctor orders it, a plan of care is written, and licensed clinicians carry it out during scheduled visits at your home. It includes:
- Skilled nursing, such as wound care, injections, medicine management, and monitoring after a hospital stay.
- Physical therapy, occupational therapy, and speech therapy.
- Medical social work.
- Home health aide visits for bathing and personal care, as part of the skilled plan.
Visits are part time, a few times a week, and each one has a clinical purpose. Home health agencies that bill Medicare must be Medicare-certified, and in California they are licensed by the California Department of Public Health. Comfort Care Home Health Services is Medicare-certified and Joint Commission accredited, and our team serves Los Angeles, Orange, Ventura, and San Bernardino Counties.
Home care: help with daily living
Home care, sometimes called non-medical home care, private duty care, or companion care, is hands-on help with the tasks of daily life. A caregiver comes for a block of hours, or lives in, and helps with:
- Bathing, dressing, and grooming.
- Meals, light housekeeping, laundry, and errands.
- Companionship, reminders, and supervision.
- Rides to appointments.
Home care does not require a doctor's order. Caregivers are not nurses. In California, home care organizations are licensed separately by the Department of Social Services, which you can read about on the CDSS home care services page.
Side by side
| Question | Home health | Home care |
|---|---|---|
| What is it? | Skilled medical care: nursing and therapy | Help with daily tasks and companionship |
| Who provides it? | Nurses, therapists, social workers, home health aides | Caregivers and companions |
| Doctor's order? | Yes, with a plan of care | No |
| Schedule | Part-time visits, a few times a week | Hourly blocks, daily, or live-in |
| Does Medicare pay? | Yes, $0 for covered services if you qualify | No, when it is the only help you need |
| Typical goal | Recover, manage a condition, stay safe at home | Keep daily life running |
What Medicare covers, and what it does not
Original Medicare pays in full for covered home health services when you qualify, according to medicare.gov. It does not pay for 24-hour care, meal delivery, homemaker services, or personal care when that is the only care you need.
The part that confuses families most is the home health aide. An aide can help with bathing and personal care under home health, but only while a nurse or therapist is also treating you. Once the skilled care ends, the aide visits end too. If you need ongoing help with daily tasks, that is home care, and it is usually paid privately or through long-term care insurance. Our guide on what Medicare covers has the full cost picture.
Which one does my parent need?
Ask what the help is for.
- A new medical need: a hospital stay, surgery, a fall, a wound, new medicines, a stroke, or a heart or lung condition that needs watching. That points to home health. Talk with the doctor, or call an agency and ask them to check.
- Everyday tasks are getting hard: cooking, cleaning, bathing, getting to the store, or being alone all day. That points to home care.
- Both at once: very common after a hospital stay. A nurse and therapist visit a few times a week, while a caregiver covers the hours in between. The two teams work side by side.
How to get started
For home health, you can call us first at (818) 579-4012. We check your coverage and work with your doctor on the order. The first nurse visit usually happens within 24 hours after the doctor or hospital sends the order. If you also need home care, our medical social worker can point you toward local options as part of your care plan.
If you are choosing an agency, our guide on how to choose a home health agency in Los Angeles lists the questions worth asking.
If you cannot afford home care
In Los Angeles County and across California, a low-income senior on Medi-Cal may qualify for In-Home Supportive Services (IHSS), which pays for hours of help at home with bathing, meals, and chores. You apply through the county's social services department, and a family member can often be the paid worker. Your home health social worker can help you start the application.
One word that confuses families: on this page, "caregiver" means a paid home care worker. Elsewhere on our site it usually means you, the family member doing the caring. Both matter, and they are different jobs.
Key takeaways
- Home health is medical care ordered by a doctor. Home care is hourly help with daily living.
- Medicare covers home health at $0 if you qualify. It does not cover home care on its own.
- An aide's help with bathing is covered only alongside nursing or therapy.
- Many families use both, and the two teams can work together.
Questions people ask
Is a home health aide the same as a caregiver?
Can Medicare pay for a caregiver to stay with my mother all day?
Can we have home health and home care at the same time?
Who licenses home health and home care agencies in California?
Have a question about home health?
Still not sure which kind of care fits? Call us. We will listen, check your coverage, and tell you honestly whether home health is the right next step.
(818) 579-4012Sources
- Medicare.gov: Home health services
- Medicare & Home Health Care (official booklet, PDF)
- California Department of Social Services: Home care services
This page is general information for families, not medical advice. Talk with your doctor about your situation.