These two terms sound alike but mean very different things. Mixing them up is a common reason families are surprised by what insurance will and won’t pay.
| Home health care | Non-medical in-home care | |
|---|---|---|
| What it is | Skilled medical care: nursing, physical/occupational/speech therapy, medical social services | Help with daily living: bathing, dressing, meals, housekeeping, companionship |
| Who orders it | A doctor or other qualified provider, under a care plan | You or your family |
| Who provides it | Licensed nurses and therapists; aides under supervision | Caregivers, personal care aides, companions |
| How long | Part-time or intermittent visits, often short-term | Anything from a few hours a week to around-the-clock |
| Medicare | Covered for eligible people when provided by a Medicare-certified agency (details) | Not covered when personal care is the only care you need (Medicare.gov) |
| Other ways to pay | Medicare Advantage, Medicaid, some private insurance | Private pay, long-term care insurance, Medicaid home and community-based services, some VA programs |
What Medicare says it doesn’t pay for
Medicare.gov lists these as not covered under the home health benefit:
- 24-hour-a-day care at home
- Home meal delivery
- Homemaker services (like shopping and cleaning) unrelated to your care plan
- Custodial or personal care (like bathing, dressing, or using the bathroom) when this is the only care you need
Source: Medicare.gov, Home health services.
When families use both
A common pattern: after a hospital stay, a Medicare-certified agency sends a nurse and a physical therapist for a few weeks. The family also arranges a private-pay caregiver for a few hours a day to help with bathing and meals. When the home health care ends, the non-medical care may continue.
Tip: When you call an agency, ask directly: “Are you a Medicare-certified home health agency, a licensed non-medical home care agency, or both?” Some companies offer both kinds of service under different licenses.
Finding each kind of provider
- Medicare-certified home health agencies: search Medicare’s Care Compare, which shows services offered and quality star ratings.
- Non-medical home care agencies: these aren’t in Medicare’s database. Check your state’s licensing agency, ask your local Area Agency on Aging via the Eldercare Locator, or send us a request.
Ready to talk to local agencies?
Tell us what you need. We share your request with up to 3 agencies near you, only with your permission.