If you have started looking for help for a parent, you have probably seen both terms: "home care" and "home health care." They are often used interchangeably in conversation, but they mean different things to agencies, insurers, and Medicare. Knowing the difference helps you ask for the right kind of help and avoid surprises about who pays.
Home care: non-medical help at home
Home care, sometimes called in-home care, personal care, or companion care, is help with the everyday activities that become harder with age, illness, or memory loss. It is non-medical. Typical tasks include:
- Bathing, dressing, grooming, and toileting.
- Getting in and out of bed or a chair, and walking safely.
- Preparing meals and encouraging good eating and drinking.
- Light housekeeping and laundry.
- Medication reminders (not giving medications).
- Rides to appointments, errands, and companionship.
- Supervision for someone with memory loss.
In Illinois, agencies that provide this kind of help are licensed as home services agencies. Learn what to check in how to choose a licensed home care agency.
Home health care: skilled medical care at home
Home health care is skilled care ordered by a doctor or other qualified provider and delivered by licensed professionals. It is usually short-term and focused on recovery or managing a condition. It can include:
- Skilled nursing, such as wound care, injections, or monitoring a health condition.
- Physical, occupational, or speech therapy.
- Medical social services.
- Some home health aide help, as part of the skilled plan.
Side by side
| Home care | Home health care | |
|---|---|---|
| Type of help | Non-medical daily living help | Skilled nursing and therapy |
| Who provides it | Caregivers from a home services agency | Nurses, therapists, aides from a home health agency |
| How it starts | Family or the person calls an agency | A doctor orders it |
| How long | As long as needed, often ongoing | Usually short-term, visit-based |
| Who usually pays | Mostly private pay; sometimes LTC insurance, VA, or Medicaid | Often Medicare or health insurance when criteria are met |
Who pays for each
Because home health care is medical and doctor-ordered, Medicare and many health insurance plans may cover it when eligibility rules are met. Home care, by contrast, is usually paid privately. Medicare does not pay for custodial care when that is the only help needed. Our guide to Medicare and home care explains the rules in plain language, and the Naperville cost guide shows planning ranges for private-pay home care.
How each one starts
Starting home care
You can usually call a home care agency directly. Most will schedule an assessment, often at the home, then write a care plan and propose a schedule. No doctor's order is required, although a long-term care insurance policy may ask for documentation.
Starting home health care
Home health care typically starts with a referral from a doctor, a hospital discharge planner, or a rehabilitation facility. If your parent is leaving the hospital, ask the discharge planner whether home health is being ordered and which agencies are options.
Many families use both
It is common for a parent to receive home health visits for a few weeks after a hospital stay while a home care agency covers help with meals, showers, and safety in between. When home health ends, the home care often continues.
If you think your parent needs non-medical help at home, you can request help and a licensed Illinois home care provider can follow up. To estimate costs first, use the care cost calculator.