In Illinois, "home health" and "home care" are two different services, licensed differently and paid for differently, even though families use the names interchangeably. Home health is skilled, doctor-ordered care from a Home Health Agency that Medicare covers when someone is homebound and needs intermittent skilled care; home care is non-medical help that families pay for privately or, for eligible seniors, cover through the Community Care Program.
This guide draws the line between the two. The label decides who can provide the care, which Illinois 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 Home Health Agency and What Medicare Covers
- Home Care: The Home Services Agency and Who Pays
- Which One Do You Need?
- What It Costs
- Frequently Asked Questions
The Core Difference
The split is medical versus non-medical, and in Illinois it settles three things at once: who provides the care, which IDPH license that provider holds, and which program pays.
Home health is skilled care. A provider 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.
Home care is non-medical. No clinical license is involved in the hands-on work. An aide helps with the activities of daily living, bathing, dressing, getting to the bathroom, preparing meals, light housekeeping, personal laundry, and companionship. The person can be medically stable and still need this help every day.
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 aide for bathing and meals for months). The two run on separate tracks with separate payers, which is exactly why the Illinois provider labels, Home Health Agency and Home Services Agency, are worth knowing before you start making calls.
Home Health: The Home Health Agency and What Medicare Covers
Skilled home health in Illinois is delivered by a Home Health Agency licensed by IDPH. 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 Home Health Agency can bill Medicare, Medicaid, or private insurance for the services it provides.
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 provider certifies that the person needs skilled nursing or therapy on a part-time or intermittent basis, under a plan of care the provider reviews, and the care comes from a Medicare-certified agency. Home health is not round-the-clock care.
When those conditions are met, Medicare pays for the covered skilled services: the nursing visits, the therapy, 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: The Home Services Agency and Who Pays
Non-medical home care in Illinois comes from a Home Services Agency, also licensed by IDPH. A Home Services Agency supplies the aides and personal-care workers who handle bathing, dressing, meals, housekeeping, personal laundry, and companionship. They don't provide medical care, so the two licenses cover genuinely different work: a Home Services Agency is the non-medical side, the Home Health Agency is the skilled side.
Who pays for Home Services Agency care comes down to a few routes:
- Private pay. Most 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.
- The Community Care Program. For Illinoisans age 60 and older, the Community Care Program (CCP), run by the Illinois Department on Aging, provides in-home services such as home care aides and adult day services at no out-of-pocket cost to eligible people, as an alternative to nursing-home placement. Eligibility runs through the Department on Aging and its local Care Coordination Units, which assess need and arrange the services.
- 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 aide 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 older Illinoisans, the Community Care Program.
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) | Home Care (Home Services Agency) | |
|---|---|---|
| What it is | Skilled, physician-ordered medical care: skilled nursing plus therapy or home health aide care tied to that skilled need | Non-medical help with daily living: bathing, dressing, meals, housekeeping, personal laundry, companionship |
| Who provides it | A Home Health Agency and its clinical staff | A Home Services Agency and its aides and personal-care workers |
| Licensed by | Illinois Department of Public Health (IDPH) | Illinois Department of Public Health (IDPH) |
| Who pays | Medicare (when homebound + intermittent skilled need), Medicaid, or private insurance | Private pay, long-term care insurance, or the Community Care Program for eligible seniors age 60+ |
A quick way to place a situation: if a provider 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 home care from a Home Services Agency, and the question becomes whether to pay privately or, for someone 60 or older, look at the Community Care Program. 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 a public program covers it.
For non-medical home care in Illinois, a home health aide and homemaker services each ran about $80,080 a year in 2024, according to the Genworth/CareScout Cost of Care Survey, which works out to roughly $6,673 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 Illinois agency charges can land above or below them, and the Chicago metro tends to run higher than downstate. A family using fewer hours than the full-week assumption will of course pay less than the annual figure suggests.
For older Illinoisans who qualify, that private cost can be covered instead through the Community Care Program, which arranges in-home services at no out-of-pocket cost for eligible people age 60 and older.
Frequently Asked Questions
No. Medicare does not pay for non-medical home care, the help with bathing, dressing, meals, and supervision that an aide 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 seniors age 60 and older, the Community Care Program.
A Home Health Agency provides skilled home health, nursing and therapy and the home health aide services tied to that skilled care; IDPH licenses it, and its care is reimbursable by Medicare, Medicaid, or private insurance. A Home Services Agency provides non-medical home care, also IDPH-licensed, usually paid privately or through the Community Care Program. The simplest test is whether a physician's order and a licensed clinician are involved: if yes, it's a Home Health Agency; if not, it's a Home Services Agency.
Home health is skilled medical care a provider orders and a licensed clinician delivers, covered by Medicare when the person is homebound and needs intermittent skilled care. Home care is non-medical help with daily living that Medicare does not cover. In Illinois the two come from differently licensed providers, a Home Health Agency for home health, a Home Services Agency for home care.
The Community Care Program is Illinois's route to home care, not home health. Run by the Illinois Department on Aging, it provides in-home services such as home care aides and adult day services at no out-of-pocket cost to eligible Illinoisans age 60 and older, as an alternative to nursing-home placement. It does not provide skilled nursing or therapy; for that you need a Home Health Agency. Eligibility runs through the Department on Aging and its local Care Coordination Units.
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 aide 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 Illinois
- Nursing Homes in Illinois
- Memory Care in Illinois
- Medicaid Planning Strategies
- Caregiver Burnout: Signs and Support
Find personalized help arranging care at home in Illinois at brevy.com.
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