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Home Care or Home Health Care?
Two services with almost the same name. What home care and home health care each do, who qualifies, who pays, and how the two can work together.
When a parent is getting ready to come home from the hospital, families often hear two phrases that sound almost the same: home health care and home care. They are different services, with different rules and different ways to pay. Knowing which is which makes the conversations with doctors and discharge planners much easier.
The short answer
- Home health care is medical care at home, ordered by a doctor. A nurse or therapist visits on a schedule, usually for a limited time. Medicare can pay for it when certain conditions are met.
- Home care is non-medical help with daily life: bathing, dressing, meals, light housekeeping, medication reminders, rides to appointments, and company. It is usually paid privately, and it can continue for as long as it is needed.
Many people need only one. Some need both at the same time, because the two do different jobs.
What home health care is
Home health care is provided by a Medicare-certified home health agency, under a plan of care that a doctor or other allowed practitioner sets up and reviews. The visits are part time: a nurse or therapist comes, does the skilled work, and leaves.
When the conditions are met, Medicare covers:
- Part-time or intermittent skilled nursing
- Physical therapy, occupational therapy, and speech-language therapy
- Medical social services
- Part-time home health aide care, but only while skilled nursing or therapy is also being provided
- Durable medical equipment and medical supplies
Who qualifies under Medicare
Medicare lists four conditions. The person must:
- Be homebound. Leaving home takes a considerable and taxing effort, or needs help from another person, a device such as a walker or wheelchair, or special transportation. Short trips for medical care, religious services, or adult day care are still allowed.
- Be under the care of a doctor or allowed practitioner who sets up and regularly reviews the plan of care.
- Have a face-to-face visit with that doctor or practitioner, related to the main reason for home health, within the 90 days before care starts or the 30 days after.
- Need skilled care: intermittent skilled nursing, physical therapy, speech-language therapy, or continued occupational therapy.
Under Original Medicare, covered home health services cost $0. For durable medical equipment, you pay 20% of the Medicare-approved amount after the Part B deductible.
What Medicare home health does not cover
According to Medicare, home health does not cover:
- 24-hour care at home
- Meals delivered to the home
- Homemaker services like shopping, cleaning, and laundry when they are not related to the plan of care
- Personal care like bathing, dressing, or using the bathroom when that is the only care needed
That last point matters. If your parent needs help with showers and meals but no longer needs a nurse or therapist, Medicare home health will not cover that help.
What home care is
Non-medical home care helps with the parts of the day that have become hard to manage alone. A caregiver comes to the home on a set schedule and helps with whatever the plan calls for.
In Ohio, agencies that provide this hands-on help must be licensed by the Ohio Department of Health, a requirement that began on October 1, 2022. Under state law, nonmedical home health services include:
- Help with bathing, dressing, walking, and using the bathroom
- Meal preparation and help with eating
- Help managing the home and personal affairs
- Help with taking one's own medications
- Homemaking, such as light housekeeping and laundry
- Respite for family caregivers
- Errands, such as picking up groceries and prescriptions
Medicare calls this kind of help custodial care, and it does not pay for custodial care when that is the only care a person needs. Solura Home Care is a licensed Ohio non-medical home care agency (license 4574HHN), and our care is private pay.
Side by side
Who provides it
- Home health: nurses and therapists from a Medicare-certified home health agency
- Home care: trained caregivers from a licensed home care agency
What it focuses on
- Home health: treatment and recovery, such as wound care, injections, therapy exercises, and teaching after a hospital stay
- Home care: daily life, such as showers, meals, a tidy home, reminders, rides, and company
How long it lasts
- Home health: while the skilled need lasts and the Medicare conditions are met. Skilled nursing and aide visits combined are generally limited to less than 8 hours a day and no more than 28 hours a week.
- Home care: as long as it is needed. Hours are set by the family. At Solura, care starts at 5 hours a week.
How it starts
- Home health: a doctor's order
- Home care: a phone call to the agency. No doctor's order is needed.
Who pays
- Home health: Medicare, when the conditions above are met
- Home care: usually the family. A few other options are worth checking:
- Medicare Advantage plans may offer extra benefits that Original Medicare does not, and some include limited in-home support. Benefits vary from plan to plan, so call your plan and ask.
- Long-term care insurance policies differ. Check your policy for in-home care benefits.
- PASSPORT, Ohio's Medicaid waiver program, can cover in-home help with personal care and chores for Ohioans 60 and older who qualify financially and need a nursing-home level of care. Your Area Agency on Aging handles PASSPORT intake.
How the two can work together
Here is one way they fit together after a hospital stay. A nurse visits twice a week to check a healing incision, and a physical therapist works on strength and balance. Between those visits, a home care caregiver helps with the morning shower, makes lunch, does the laundry, and drives to the follow-up appointment.
When the nurse and therapist finish, home health ends. Home care can continue, or taper off, as strength returns.
Questions to ask before a hospital discharge
For the first days home, see our checklist Hospital discharge: the first 72 hours at home.
- Does my parent qualify for Medicare home health? Which agency, and when is the first visit?
- What will the nurse or therapist do, and how often will they come?
- What help will my parent need between visits, with bathing, meals, the stairs, or getting to appointments?
- Is it safe for my parent to be alone? For how long?
- What changes should we watch for, and who do we call if we see them?
Free help with Medicare questions
- OSHIIP, the Ohio Senior Health Insurance Information Program, offers free, unbiased one-on-one Medicare counseling: (800) 686-1578.
- Medicare Care Compare lets you look up Medicare-certified home health agencies near you: medicare.gov/care-compare.
If you are sorting out what help a parent will need at home, call us at (216) 770-4886. We can talk through what home health is likely to cover and where everyday help could fill the gaps.
Sources
- Medicare.gov, Home health services
- Medicare.gov, Long-term care
- CMS, Home health services compliance tips
- Ohio Revised Code, Section 3740.01
- Ohio Department of Health, Home health agencies
- Ohio Department of Aging, PASSPORT
Checked October 2026. Medicare rules change from time to time, so confirm details with Medicare or OSHIIP before making decisions.