"Home care" and "home health" sound interchangeable, but in Arkansas they're two different services, and the difference decides who pays. Home health is the skilled nursing and therapy a doctor orders, delivered by an agency the Arkansas Department of Health licenses, and it's what Medicare can cover; home care is non-medical daily help it won't.
This guide draws that line so an Arkansas family doesn't pay out of pocket for care a program would have covered, or wait on Medicare coverage that was never coming. What matters isn't the word on the agency's sign, it's whether the care is skilled or non-medical, and which program pays the bill.
In This Guide
- Key Takeaways
- The Two Services, Defined
- Home Health: What Medicare Covers
- Home Care: What It Costs and Who Pays
- Which One Do You Need?
- How to Vet an Agency
- Frequently Asked Questions
The Two Services, Defined
The split is skilled versus non-medical, and in Arkansas the skilled side carries a state license the non-medical everyday help does not.
A home health agency provides skilled, physician-ordered care: nursing and physical, occupational, or speech therapy ordered because the person has a medical need only a licensed professional can meet. Wound care after surgery, IV medication, injections a patient can't manage alone, therapy to rebuild strength after a stroke or a fall. The care is part-time and intermittent, not round-the-clock. In Arkansas, that agency is licensed by the Arkansas Department of Health, which first issues a permit of approval and then a license; a Class A license goes to an agency certified for Medicare.
Non-medical personal care is everyday help with bathing, dressing, grooming, meals, and homemaking, the tasks that keep someone safe at home. The person can be medically stable and still need this help every day. This is the work most people mean when they say "home care."
That separation is what decides the money. The Class A license is the step that lets a home health agency bill Medicare for the skilled care it delivers. Non-medical personal care is care Medicare doesn't pay for at all. So when an Arkansas family hears "home health," that points to the skilled, often Medicare-certified track, and "personal care" or "homemaker" points to the non-medical one.
The same person often needs both at once. Someone discharged after a hip replacement might need home health, a nurse and a physical therapist for a few weeks, and also personal care, an aide for bathing and meals over the months that follow. Those run on separate payment tracks: Medicare pays for the skilled piece, and something else pays for the personal-care piece.
Home Health: What Medicare Covers
Skilled home health in Arkansas comes from an agency licensed by the Arkansas Department of Health, often one holding a Class A license that means it's certified for Medicare. The agency employs the clinical staff, registered nurses and therapists, who carry out the plan of care a physician has ordered. The state license is the floor; Medicare certification is the additional step that lets the agency bill Medicare for those services.
Medicare's home health benefit covers this care only when a beneficiary meets every condition. 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, and the home health aide help 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 personal care, and it's the next section.
Home Care: What It Costs and Who Pays
Non-medical home care covers help with bathing, dressing, grooming, meals, and homemaking. Because it isn't skilled medical care, the payer picture looks nothing like home health, and the cost question lives almost entirely on this side.
Arkansas is one of the more affordable states for senior care. Per the 2024 Genworth/CareScout Cost of Care Survey, the most recent state-level data, a home health aide in Arkansas ran about $59,488 a year and homemaker services about $59,488 a year. Both annual figures are built on a roughly 44-hour week, which works out to about $26 an hour. That matters: a family hiring an aide for only a few hours a day pays a fraction of the annual figure, which assumes a near full-time schedule. These are industry survey medians, not government rates and not a ceiling, so what a specific Arkansas agency charges can land above or below them. For comparison, the same survey put the national medians well higher, with assisted living about $70,800 a year against Arkansas's $56,688, which places the state among the nation's lowest for care costs.
Who pays for personal 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.
- Arkansas Medicaid. For eligible low-income older Arkansans, Medicaid funds non-medical personal care through two programs: ARChoices in Homecare, for in-home personal care, and Living Choices Assisted Living, for care in a Level II assisted living facility. The Office of Long Term Care determines functional eligibility, and these are the state's main home and community-based path so a person can stay out of a nursing home.
- Long-term care insurance. A private policy, if the person holds one, may reimburse personal-care hours.
One line is worth stating plainly. Medicare does not pay for non-medical personal care. A family expecting Medicare to cover an aide for daily help will find it won't, no matter how much that help is needed. The ways to pay are private funds, long-term care insurance, or, for eligible low-income Arkansans, Medicaid's ARChoices in Homecare and Living Choices.
Which One Do You Need?
Start with the need, not the brochure. The table maps the two services across the dimensions that decide what the care is and who pays. Whether the care is skilled is your first clue: skilled, physician-ordered care points to home health, and everyday non-medical help points to personal care.
| Home Health (Skilled) | Home Care (Non-Medical) | |
|---|---|---|
| Arkansas oversight | Home health agency licensed by the Arkansas Department of Health (Class A = Medicare-certified) | Non-medical personal care, not separately licensed as skilled care |
| What it is | Skilled, physician-ordered care: nursing and physical, occupational, or speech therapy under a plan of care, part-time or intermittent | Everyday non-medical help with daily living (bathing, dressing, grooming, meals, homemaking) |
| Who provides it | A licensed home health agency, often Medicare-certified, and its clinical staff (nurses and therapists) | A home care or personal-care agency and its aides |
| Who pays | Medicare (when homebound + intermittent skilled need) | Private pay, long-term care insurance, or Medicaid's ARChoices in Homecare and Living Choices for eligible low-income Arkansans |
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, 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 personal care, and the question becomes whether to pay privately or qualify through Arkansas Medicaid. Both can be in play at once, and plenty of Arkansas families arrange both.
How to Vet an Agency
Once you know which service you need, the checks differ by track. For skilled home health, the license and the certification are the substance, not the marketing:
- Confirm the license and Class A certification. A skilled home health agency must hold a license from the Arkansas Department of Health, and for Medicare billing it needs the Class A license that signals Medicare certification. Ask to see both, and confirm the agency is Medicare-certified before assuming Medicare will pay.
- Match the agency to the doctor's order. Medicare coverage hinges on a physician's plan of care and the homebound and intermittent-skilled tests, so confirm the agency will work from your doctor's order and bill Medicare directly.
For non-medical personal care, the question is fit and payment:
- Clarify the rate and the hours. Ask the hourly rate and any minimums up front, since survey medians are only a benchmark and Arkansas agencies set their own rates.
- Check the Medicaid path early if money is tight. If private pay isn't sustainable, contact the Arkansas Department of Human Services about ARChoices in Homecare or Living Choices before a crisis, because functional eligibility runs through the Office of Long Term Care and takes time.
Frequently Asked Questions
Yes, but only skilled care. Medicare's home health benefit covers physician-ordered nursing and physical, occupational, or speech therapy for a person who is homebound and needs that care on a part-time or intermittent basis, delivered by a Medicare-certified agency. It does not pay for non-medical personal care, the help with bathing, dressing, meals, and everyday support an aide provides, on its own.
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 Arkansas, the skilled home health agency is licensed by the Arkansas Department of Health, with a Class A license signaling Medicare certification; non-medical personal care doesn't carry that skilled-care license.
Per the 2024 Genworth/CareScout Cost of Care Survey, a home health aide in Arkansas ran about $59,488 a year and homemaker services about $59,488 a year, each on a roughly 44-hour week, which is about $26 an hour. Those annual figures assume a near full-time schedule, so a family hiring an aide for only a few hours a day pays far less. The numbers are survey medians, not fixed rates, and Arkansas costs are among the nation's lowest, so a given agency can charge above or below them.
Yes. For eligible low-income older Arkansans, Medicaid funds non-medical personal care through ARChoices in Homecare, for in-home help, and Living Choices Assisted Living, for care in a Level II assisted living facility. The Office of Long Term Care determines functional eligibility, and enrollment runs through the Arkansas Department of Human Services, which is where a family begins.
Yes, and many do. A person recovering from surgery might receive Medicare-covered home health (a nurse and a therapist for a set period) while also needing ongoing personal care (an aide for bathing and meals). The two run on separate payment tracks, Medicare for the skilled care and private pay or Arkansas Medicaid for the personal care, so arranging one does not arrange or pay for the other.
Learn More
- Assisted Living in Arkansas
- Nursing Homes in Arkansas
- Memory Care in Arkansas
- Medicaid Planning Strategies
- Caregiver Burnout: Signs and Support
Find personalized help matching the right in-home service to the need and payer in Arkansas at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.