"Home care" and "home health" sound like the same thing, and mixing them up is one of the most expensive mistakes families make. Home care is non-medical help with daily life. Home health is skilled, doctor-ordered medical care at home. The difference decides who pays, because Medicare covers one and usually not the other. This guide lays out the distinction, what each costs, who pays, and how the rules shift from state to state.

In This Guide

The Core Difference

The two services solve different problems.

Home care is non-medical, custodial help. Under Medicaid it's defined as personal care services: help with the activities of daily living such as bathing, dressing, eating, and getting around, plus tasks like meals and light housekeeping. An aide or companion provides it, and no physician order is required.

Home health is skilled, clinical care that a doctor orders. Medicare covers it only when the person is homebound, is under a plan of care established and reviewed by a physician, and needs intermittent skilled care, specifically skilled nursing, physical therapy, speech-language pathology, or occupational therapy. Licensed clinicians provide it under that plan of care.

In short: home care helps you live day to day; home health treats a medical need. Many families end up using both.

Who Pays for Each

This is where the distinction hits your wallet.

Medicare pays for home health, not home care. For covered home-health services, Original Medicare pays $0 when you're homebound, under a physician's plan of care, and need intermittent skilled care. But Medicare does not pay for non-medical home care, the help with bathing, dressing, and meals, when that personal care is the only help you need.

Medicaid can pay for both, with a catch. Medicaid covers skilled home health as a state-plan benefit, available in every state under federal law. Medicaid can also cover non-medical personal care, but personal care is an optional Medicaid state-plan benefit under Section 1905(a)(24) of the Social Security Act, which means each state decides whether and how to offer it. That's why home-care coverage looks different from one state to the next.

Anything Medicaid doesn't cover is generally paid out of pocket or through long-term-care insurance.

What Each Costs

For home care, the cost is straightforward and it adds up. Nationally, a non-medical caregiver runs about $35 an hour, which works out to roughly $80,080 a year at 44 hours of care a week. Part-time help costs proportionally less, but round-the-clock care is expensive.

For home health, the question isn't really what it costs, it's whether you qualify. When you meet Medicare's homebound and skilled-care criteria, covered home-health services are $0 to you. So the cost story for home health is about eligibility, not price.

How It Differs by State

The skilled side, home health, is consistent: it's a Medicaid state-plan benefit in all 50 states, and Medicare's rules are federal. The non-medical side is where states diverge. Because personal care is an optional Medicaid benefit, which non-medical home-care services your state's Medicaid program covers, and through which program, varies. Some states offer generous personal-care and self-direction options; others cover far less outside of a waiver.

States also set their own rules for home-care agency licensing and aide training, so who can provide care and what credentials they need differ too. The practical takeaway is the same one that runs through eldercare: check your own state. That's what the directory below is for.

Find Your State

Find Your State's Home Care vs. Home Health Guide

Pick your state for a full guide to home care and home health where you live: what each covers, who pays, and how to find help.

AlabamaView guide AlaskaView guide ArizonaView guide ArkansasView guide CaliforniaView guide ColoradoView guide ConnecticutView guide DelawareView guide FloridaView guide GeorgiaView guide HawaiiView guide IdahoView guide IllinoisView guide IndianaView guide IowaView guide KansasView guide KentuckyView guide LouisianaView guide MaineView guide MarylandView guide MassachusettsView guide MichiganView guide MinnesotaView guide MississippiView guide MissouriView guide MontanaView guide NebraskaView guide NevadaView guide New HampshireView guide New JerseyView guide New MexicoView guide New YorkView guide North CarolinaView guide North DakotaView guide OhioView guide OklahomaView guide OregonView guide PennsylvaniaView guide Rhode IslandView guide South CarolinaView guide South DakotaView guide TennesseeView guide TexasView guide UtahView guide VermontView guide VirginiaView guide WashingtonView guide West VirginiaView guide WisconsinView guide WyomingView guide
All 50 states

Frequently Asked Questions

What's the difference between home care and home health?

Home care is non-medical help with daily life, bathing, dressing, meals, and companionship, with no doctor's order needed. Home health is skilled, doctor-ordered clinical care such as nursing and therapy.

Does Medicare cover home care?

Medicare covers home health, not non-medical home care. It pays $0 for covered home-health services when you're homebound, under a physician's plan of care, and need intermittent skilled care, but it does not pay for personal care alone.

Does Medicaid cover home care?

It can. Medicaid covers skilled home health in every state, and it can cover non-medical personal care, but personal care is an optional state-plan benefit, so coverage varies by state.,

What does home care cost?

Nationally, a non-medical home caregiver runs about $35 an hour, roughly $80,080 a year at 44 hours a week. Part-time help costs less; more hours cost more.

How do I find home care or home health where I live?

Open your state's guide from the directory above. It covers what each service includes, who pays in your state, and how to find help.

Learn More

Care TypesWhat Are Personal Care Services? A Family's Guide to Non-Medical In-Home CarePersonal care services are non-medical help with daily tasks like bathing and dressing. See what aides do, how it differs from home health, and who pays. Care TypesThe Cost of Senior Care by StateThe 2026 national median cost of assisted living, memory care, nursing homes, and in-home care, why your state differs, and your state's own cost guide. Care TypesAssisted Living by StateWhat assisted living costs, how licensing and Medicaid coverage differ from state to state, plus a guide to all 50 states so you can jump straight to yours. FinancialHow to Pay for Senior CareHow to pay for senior care: what it costs nationally and how Medicaid, Medicare, VA benefits, and private pay each fit. Who qualifies, what's covered, in 2026.
Your next step Not sure whether your parent needs home care, home health, or both? Brevy's care navigator can help you tell them apart and find help in your state.

Find personalized help understanding your care options 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.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.