Home Care vs. Home Health in Arkansas (2026)

"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 that first needs a Permit of Approval from a commission of the Arkansas Department of Health, and it's what Medicare can cover; home care is non-medical daily help it won't.1

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
• Home Care vs. Home Health in Arkansas: The Two Services
• Home Health: What Medicare Covers
• Home Care: What It Costs and Who Pays
• Home Care or Home Health: Which Do You Need in Arkansas?
• How to Vet an Agency
• Frequently Asked Questions

Home Care vs. Home Health in Arkansas: The Two Services

The split is skilled versus non-medical, and in Arkansas the skilled side starts with a state Permit of Approval for the home health agency.1

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 must first get a Permit of Approval from the Arkansas Health Services Permit Agency, a commission of the Arkansas Department of Health. The agency takes applications only four times a year (February 1, May 1, August 1 and November 1), charges a $3,000 application fee, and has 90 days to approve or deny once an application is complete.1

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."1

That separation is what decides the money. Medicare pays for home health only when a Medicare-certified home health agency provides the skilled care.1 Non-medical personal care is care Medicare doesn't pay for when it's the only care a person needs. 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 that first got a Permit of Approval from the Arkansas Health Services Permit Agency, and for Medicare to pay, the agency must also be Medicare-certified.1 The agency employs the clinical staff, registered nurses and therapists, who carry out the plan of care a physician has ordered.

Medicare's home health benefit covers this care only when a beneficiary meets every condition.1 The two that trip families up most:

• Homebound. Medicare's test has two parts: leaving home isn't recommended because of the person's condition, or is difficult without help, and the person is normally unable to leave home, with leaving taking a lot of effort.
• Intermittent skilled need. A physician or allowed practitioner certifies that the person needs skilled nursing or therapy on a part-time or intermittent basis, under a plan of care that practitioner 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. For those covered home health services a beneficiary generally pays $0; the exception is durable medical equipment, where the beneficiary pays 20% of the Medicare-approved amount after the Part B deductible.4 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.1

Arkansas is one of the more affordable states for senior care. Per the CareScout 2025 Cost of Care Survey (released in March 2026, the most recent state-level data, with figures gathered July through November 2025), a non-medical caregiver for in-home personal care in Arkansas ran about $57,200 a year.2 That figure is built on a roughly 44-hour week, which works out to about $25 an hour. The 2025 survey combined what used to be the separate "homemaker" and "home health aide" lines into this single non-medical caregiver category. That annual basis matters: a family hiring an aide for only a few hours a day pays a fraction of it, since the figure 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 a non-medical caregiver about $80,080 a year nationally (about $35 an hour) against Arkansas's $57,200, and assisted living about $74,400 a year nationally against Arkansas's $55,644 in CareScout's data tables (its March 2026 Arkansas press release gives $54,744 for the same line), which places the state among the more affordable for care costs.2

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.1
• 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 the two programs share common income and resource requirements. Both serve Arkansans aged 21 through 64 with a physical disability, or aged 65 and older, and both require an intermediate level of care as determined by that office; a person who needs skilled care is not eligible for either.1,3
• 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 when that's the only care a person needs.1 A family expecting Medicare to cover an aide for daily help, with no skilled nursing or therapy alongside it, 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.

Home Care or Home Health: Which Do You Need in Arkansas?

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.1 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.

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 state permit and the Medicare certification are the substance, not the marketing:

• Confirm state approval and Medicare certification. A skilled home health agency must first get a Permit of Approval from the Arkansas Health Services Permit Agency, and Medicare pays only when a Medicare-certified agency provides the care.1 Ask about 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.1

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.2
• 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.3

Learn More

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.