The terms “home health” and “home care” sound nearly identical, leading to common confusion about the services they provide. These two models represent distinct service types delivered in a person’s residence. While both aim to support independence and safety at home, they differ fundamentally in their purpose, the tasks performed, the professional staff involved, and the methods of payment. Understanding these differences is necessary for individuals and families seeking the appropriate level of support.
Defining Home Care (Non-Medical Support)
Home care, often referred to as personal care, custodial care, or companion care, involves non-medical support for daily living activities. The focus is assisting individuals who need help maintaining independence and managing personal routines. Providers help with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, transferring, and toileting. This service also extends to Instrumental Activities of Daily Living (IADLs), which support independent living. Examples include light housekeeping, laundry, meal preparation, medication reminders, and running errands. Home care is generally a long-term service that does not require a physician’s order to begin.
Defining Home Health (Skilled Medical Services)
Home health provides medically necessary, goal-oriented services ordered by a physician to treat an illness, injury, or chronic condition. These services are considered skilled because they require the expertise of a licensed healthcare professional, focusing on rehabilitation, recovery, or managing complex medical issues. Skilled care includes nursing tasks like administering injections, performing complex wound care, monitoring unstable health status, and managing intravenous therapy. Home health also encompasses therapeutic services, such as physical therapy, occupational therapy, and speech-language pathology. These services are typically delivered intermittently for a short duration until the medical goal is met.
Key Distinctions in Staffing and Oversight
The staffing and regulatory framework fundamentally distinguish the two care models. Home care services are typically delivered by Home Care Aides (HCAs) or Personal Care Assistants (PCAs). These caregivers receive specialized training focused on personal support and daily living assistance, but they generally do not hold a medical license. In contrast, home health services are provided by licensed medical professionals who have specific credentials. The team may include Registered Nurses (RNs), Licensed Practical Nurses (LPNs), Physical Therapists (PTs), Occupational Therapists (OTs), and Speech-Language Pathologists. Home health agencies must be certified by Medicare and adhere to rigorous federal clinical standards, whereas home care agencies are usually subject to less stringent state-level licensing requirements.
Understanding Payment and Eligibility
The funding and eligibility requirements represent a significant difference for consumers. Home health care is primarily covered by Medicare Part A and Part B, Medicaid, and most private insurance plans, as it is medically prescribed. Coverage requires a physician’s order and that the patient be “homebound.” Homebound status means the individual has trouble leaving home without considerable effort or assistance. Medicare only covers personal care services from a home health aide if the patient is also receiving skilled nursing or therapy services. Home care, being non-medical, is not covered by Medicare. Funding sources for home care include private pay, state-specific Medicaid waivers, and long-term care insurance policies.