In Arizona, "home health" and "home care" sound like the same thing, but they're different services with different rules about who provides the care and who pays. Home health is skilled, doctor-ordered care from a Home Health Agency that Medicare covers when someone is homebound and needs intermittent skilled care; non-medical home care is everyday help that Medicare won't pay for, though low-income Arizonans may cover it through Medicaid.
This guide draws the line between the two. The label decides which provider can deliver the care, which Arizona license that provider holds, and which program pays the bill. Getting it right is how a family avoids paying out of pocket for care a program would have covered, or waiting on Medicare coverage that was never going to come.
In This Guide
- Key Takeaways
- The Core Difference
- Home Health: The Medicare-Certified Home Health Agency
- Home Care: ALTCS Attendant Care and Private Pay
- Which One Do You Need?
- What It Costs
- Frequently Asked Questions
The Core Difference
The split is medical versus non-medical, and in Arizona it settles three things at once: who provides the care, which license that provider holds, and which program pays.
Home health is skilled care. A physician orders it because the person has a medical need that requires a licensed professional: a nurse, or a physical, occupational, or speech therapist. Wound care after surgery, IV medication, injections a patient can't manage alone, therapy to rebuild strength after a stroke or a fall: those are skilled needs. The care is part-time and intermittent, not round-the-clock.
Home care is non-medical help. Much of what this care covers is help with the activities of daily living, bathing, dressing, getting to the bathroom, preparing meals, light housekeeping, and supervision. The person can be medically stable and still need this help every day. In Arizona this is delivered as attendant care, personal care, and homemaker services.
The same person often needs both. Someone discharged after hip surgery might get home health (a nurse and a physical therapist for a few weeks) and also need home care (an attendant for bathing and meals for months). The two run on separate tracks with separate payers, which is exactly why the distinction is worth knowing before you start making calls.
Home Health: The Medicare-Certified Home Health Agency
Skilled home health in Arizona is delivered by a Home Health Agency that ADHS licenses and that is Medicare-certified. The agency employs the clinical staff, registered nurses and therapists, who carry out the plan of care a physician has ordered. Because the care is skilled and physician-ordered, a certified Home Health Agency can bill Medicare for covered services.
Medicare's home health benefit covers this Home Health Agency care when a beneficiary meets the conditions. The two that trip families up most:
- Homebound. Leaving home takes considerable, taxing effort, and the person generally needs help or an assistive device to do it. Short, occasional trips out, to a medical appointment or to religious services, don't disqualify someone.
- Intermittent skilled need. A physician certifies that the person needs skilled nursing or therapy on a part-time or intermittent basis, under a plan of care the physician reviews, and the care comes from a Medicare-certified agency.
When those conditions are met, Medicare pays for the covered skilled services: the nursing visits, the therapy, the medical social services, and the home health aide help that's attached to that skilled care. What Medicare home health will not do is staff an aide in the home for general daily help with no skilled-care purpose. That's home care, and it's the next section.
Home Care: ALTCS Attendant Care and Private Pay
Non-medical home care in Arizona is the everyday help that keeps someone safe and supported at home: attendant care, personal care, homemaker services, and supervision. It isn't skilled medical care, so it doesn't run through a Medicare-certified Home Health Agency, and the payer picture looks different.
Who pays for non-medical home care comes down to a few routes:
- Private pay. Many families pay out of pocket, by the hour. This is the default when no one qualifies for a public program and the need is non-medical.
- ALTCS. For low-income Arizonans, the Arizona Long Term Care System, Arizona's Medicaid program for long-term care, funds in-home care as direct care services: attendant care, personal care, and homemaker services. ALTCS also offers member-directed options, where the member chooses and directs the worker, which can let a family member be hired and paid for the care. Eligibility runs through ALTCS, which is administered by Arizona's Medicaid agency, so that's where a family starts.
- Long-term care insurance. A private policy, if the person holds one, may reimburse home care hours.
One line is worth stating plainly. Medicare does not pay for non-medical home care. A family expecting Medicare to cover an attendant for daily help will find it won't, no matter how much that help is needed. The ways to pay for home care are private funds, long-term care insurance, or, for eligible low-income Arizonans, ALTCS.
Which One Do You Need?
Start with the need, not the brochure. The table maps the two services across the dimensions that decide who provides the care and who pays.
| Home Health (Home Health Agency) | Non-Medical Home Care | |
|---|---|---|
| What it is | Skilled, physician-ordered medical care: nursing, therapy, medical social services, and home health aide care tied to that skilled need | Everyday non-medical help: attendant care, personal care, homemaking, supervision, and companionship |
| Who provides it | A Home Health Agency and its clinical staff | Direct care workers (attendants and personal-care aides), including a family member under a member-directed option |
| Licensed / certified by | ADHS-licensed and Medicare-certified | Funded through ALTCS direct care services for eligible members; private agencies serve private-pay clients |
| Who pays | Medicare (when homebound + intermittent skilled need) | Private pay, long-term care insurance, or ALTCS for eligible low-income Arizonans |
A quick way to place a situation: if a physician has ordered skilled care and the person is homebound, you're looking at home health from a Home Health Agency, and Medicare is the payer to check first. If the need is ongoing help with everyday tasks and there's no skilled medical component, you're looking at non-medical home care, and the question becomes whether to pay privately or qualify through ALTCS. Plenty of families arrange both at once.
What It Costs
Home health, when Medicare covers it, costs the beneficiary nothing for the covered skilled services. The cost question really lives on the home care side, where families pay out of pocket unless ALTCS covers it.
For non-medical home care in Arizona, a home health aide ran about $82,368 a year in 2024, according to the Genworth/CareScout Cost of Care Survey, which works out to roughly $6,864 a month on a basis of 44 hours a week. Those are industry survey medians, not government rates and not a maximum, so what a specific Arizona agency charges can land above or below them, and the Phoenix and Tucson metros tend to run higher than rural counties. A family using fewer hours than the full-week assumption will of course pay less than the annual figure suggests.
For low-income Arizonans who qualify, that private cost can be covered instead through ALTCS as attendant care, personal care, and homemaker services.
Frequently Asked Questions
No. Medicare does not pay for non-medical home care, the help with bathing, dressing, meals, and supervision that an attendant provides. Medicare's home health benefit covers skilled, physician-ordered care (nursing and therapy) from a Home Health Agency for people who are homebound and need it on an intermittent basis. For non-medical home care, the options are private pay, long-term care insurance, or, for eligible low-income Arizonans, ALTCS.
Home health is skilled medical care a physician orders and a licensed clinician delivers, covered by Medicare when the person is homebound and needs intermittent skilled care. Non-medical home care is everyday help with daily living that Medicare does not cover. In Arizona, home health comes from an ADHS-licensed, Medicare-certified Home Health Agency, while non-medical home care is delivered by direct care workers and, for eligible people, funded through ALTCS.
Attendant care is one of the direct care services the Arizona Long Term Care System funds for eligible members: hands-on help with daily activities such as bathing, dressing, and mobility, along with related personal care and homemaker support. ALTCS also offers member-directed options, where the member chooses and directs the worker, which in some cases lets a family member be hired and paid for the care. Eligibility runs through ALTCS, Arizona's Medicaid program for long-term care.
Yes. A Home Health Agency that provides skilled home health in Arizona is licensed by the Arizona Department of Health Services and, to bill Medicare, must also be Medicare-certified. That licensing and certification is what separates a skilled Home Health Agency from a provider of non-medical home care.
Yes, and many do. A person recovering from surgery might receive Medicare-covered Home Health Agency care (a nurse and a therapist for a set period) while also needing ongoing non-medical home care (an attendant for bathing and meals). The two run on separate tracks with separate payers, so arranging one does not arrange or pay for the other.
Learn More
- Assisted Living in Arizona
- Nursing Homes in Arizona
- Memory Care in Arizona
- Medicaid Planning Strategies
- Caregiver Burnout: Signs and Support
Find personalized help arranging care at home in Arizona at brevy.com.
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