"Home care" and "home health" sound like the same service in Connecticut, but the state regulates them through two different agencies, and that split decides who pays. Skilled home health comes from an agency licensed by the Connecticut Home Health Unit at the Department of Public Health, the kind of care Medicare can cover. Non-medical help comes from a homemaker-companion agency that only registers with the Department of Consumer Protection, and whose workers aren't state-licensed.
This guide draws that line so a Connecticut family doesn't pay out of pocket for care a program would have covered, or count on Medicare coverage that was never coming. The label that matters isn't the agency's name. It's whether the care is skilled or non-medical, which agency stands behind it, and which program pays the bill.
In This Guide
- Key Takeaways
- The Core Difference
- Home Health: The DPH-Licensed Home Health Care Agency
- Home Care: The DCP-Registered Homemaker-Companion Agency
- Which One Do You Need?
- What It Costs
- Frequently Asked Questions
The Core Difference
The split is skilled versus non-medical, and in Connecticut it's written into two completely different oversight tracks. The state doesn't put all in-home care under one rulebook. Skilled care runs through a health license at the Department of Public Health. Non-medical help runs through a consumer-protection registration, which is a different agency doing a different job.
A Home Health Care Agency provides skilled care: nursing and physical, occupational, or speech therapy that a physician orders 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, and the agency holds a health license from DPH.
A homemaker-companion agency provides non-medical support: companionship, homemaking, and help with the everyday activities of daily living that keep someone safe at home. The person can be medically stable and still need this help every day. This agency does not hold a DPH health license. It registers with the Connecticut Homemaker-Companion Agency Registration program at the Department of Consumer Protection, and its workers are not state-licensed.
That difference in oversight is also what decides the money. A Home Health Care Agency may become Medicare-certified, the step that lets it bill Medicare for the skilled care it's licensed to deliver. A homemaker-companion agency provides care Medicare doesn't pay for at all. So when a Connecticut family hears "home health agency," that's shorthand for the skilled, DPH-licensed, often Medicare-certified track, and "homemaker-companion" points to the non-medical, DCP-registered 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 non-medical help (a companion for bathing, meals, and housekeeping for months). Those come from different agencies under different state oversight, and they run on separate payment tracks.
Home Health: The DPH-Licensed Home Health Care Agency
Skilled home health in Connecticut comes from a Home Health Care Agency licensed by the Department of Public Health's Home Health Unit, often one that has also earned Medicare certification. The agency employs the clinical staff, registered nurses and therapists, who carry out the plan of care a physician has ordered. The DPH health 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 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, 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 non-medical care, and it's the next section.
Home Care: The DCP-Registered Homemaker-Companion Agency
Non-medical home care in Connecticut comes from a homemaker-companion agency, which the state treats very differently from a home health agency. It doesn't hold a DPH health license. Instead it registers with the Department of Consumer Protection, and its workers are not state-licensed. That's why vetting matters more on this side: the registration is a consumer-protection step, not a clinical credential, so a family should ask directly about background checks, training, supervision, and how the agency handles a worker who doesn't work out.
Because it isn't skilled medical care, the payer picture looks nothing like home health. 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.
- Connecticut Home Care Program for Elders. For low-income Connecticut residents, this state program funds non-medical in-home services so a person can stay at home rather than enter a facility.
- Long-term care insurance. A private policy, if the person holds one, may reimburse non-medical care hours.
One line is worth stating plainly. Medicare does not pay for non-medical personal care. A family expecting Medicare to cover a companion or homemaker 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 residents, the Connecticut Home Care Program for Elders.
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, who stands behind it, and who pays. The regulator is your first clue: DPH licensure points to skilled care, while a DCP registration points to non-medical help.
| Home Health Care Agency (Skilled) | Homemaker-Companion Agency (Non-Medical) | |
|---|---|---|
| What it is | Skilled, physician-ordered care: nursing and physical, occupational, or speech therapy under a plan of care, on a part-time or intermittent basis | Non-medical companionship, homemaking, and help with everyday activities of daily living that keep someone safe at home |
| Who regulates it | Licensed by the Connecticut Department of Public Health (Home Health Unit); may also be Medicare-certified | Registers with the Connecticut Department of Consumer Protection; workers are not state-licensed |
| Who pays | Medicare (when homebound + intermittent skilled need) | Private pay, long-term care insurance, or the Connecticut Home Care Program for Elders for eligible low-income residents |
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 a homemaker-companion agency, and the question becomes whether to pay privately or qualify through the Connecticut Home Care Program for Elders. Both can be in play at once, and plenty of Connecticut families arrange both.
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 non-medical side, where families pay out of pocket unless a program covers it.
For non-medical home care in Connecticut, a home health aide ran about $80,080 a year in 2024, according to the CareScout/Genworth Cost of Care Survey, on a basis of 44 hours a week, and homemaker services ran about $77,792 a year. That puts Connecticut among the most expensive states in the country for care. These are industry survey medians, not government rates and not a maximum, so what a specific Connecticut agency charges can land above or below them, and the Bridgeport and Fairfield County areas tend to run higher than the rest of the state. A family using fewer hours than the full-week assumption will pay less than the annual figure suggests.
For low-income Connecticut residents who qualify, that private cost can be covered instead through the Connecticut Home Care Program for Elders.
Frequently Asked Questions
No. Medicare does not pay for non-medical personal care, the companionship, homemaking, and everyday help a homemaker-companion agency provides. Medicare's home health benefit covers skilled, physician-ordered care (nursing and therapy) 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 residents, the Connecticut Home Care Program for Elders.
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. Connecticut regulates the two through different agencies: the Department of Public Health licenses the skilled Home Health Care Agency, while the Department of Consumer Protection registers the non-medical homemaker-companion agency.
A homemaker-companion agency provides non-medical support: companionship, homemaking, and help with everyday activities of daily living. Unlike a Home Health Care Agency, it doesn't hold a Department of Public Health health license. It registers with the Department of Consumer Protection, and its workers are not state-licensed, so a family should ask directly about background checks, training, and supervision before hiring.
No. A homemaker-companion agency registers with the Department of Consumer Protection, but its individual workers are not state-licensed. That's the opposite of skilled home health, where the nurses and therapists at a DPH-licensed Home Health Care Agency hold professional licenses. Because the registration is a consumer-protection step rather than a clinical credential, vetting the agency's hiring and oversight matters more on the non-medical side.
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 non-medical help (a companion for bathing, meals, and housekeeping). They come from different agencies under different Connecticut oversight and run on separate payment tracks, so arranging one does not arrange or pay for the other.
Learn More
- Assisted Living in Connecticut
- Nursing Homes in Connecticut
- Memory Care in Connecticut
- Medicaid Planning Strategies
- Caregiver Burnout: Signs and Support
Find personalized help sorting out home care versus home health in Connecticut 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.