"Home care" and "home health" sound like the same service, but in Indiana the license type draws the line, right down to what an agency is allowed to call itself. The Indiana Department of Health licenses a Home Health Agency under IC 16-27-1 for skilled, doctor-ordered care, and a separate Personal Services Agency under IC 16-27-4 for non-medical help. That distinction settles who pays the bill.
This guide draws that line so a family doesn't pay out of pocket for care a program would have covered, or wait on Medicare coverage that was never coming. The label that matters isn't what's on the agency's sign, it's whether the care is skilled or non-medical, and which program pays.
In This Guide
- Key Takeaways
- The Core Difference
- Home Health: The Home Health Agency
- Home Care: The Personal Services Agency
- Which One Do You Need?
- What It Costs
- Frequently Asked Questions
The Core Difference
The split is skilled versus non-medical, and in Indiana it shows up first in which license the provider holds. IDOH doesn't license in-home care under one umbrella. It runs two separate statutes, and the statute an agency operates under sets what it may legally do.
A Home Health Agency, licensed under IC 16-27-1, delivers skilled, medical care in the home: nursing, wound care, and physical, occupational, or speech therapy. This is the care a physician orders because the person has a medical need that requires a licensed professional. An agency licensed this way may also be Medicare-certified, which is the additional step that lets it bill Medicare for those services.
A Personal Services Agency, licensed under IC 16-27-4, delivers non-medical attendant care, homemaker, and companion services: help with bathing and dressing, meals and housekeeping, and supervision that keeps someone safe at home. The person can be medically stable and still need this help every day.
Indiana writes the difference into the name itself. By law, a Personal Services Agency may not advertise as a home health agency, and it may not use the words "health" or "nursing" in its name. That rule is a quiet gift to families: if a provider's name carries "health," it's licensed for skilled medical care; a non-medical agency literally cannot borrow that word. The sign on the door is regulated, so it actually tells you something.
The same person often needs both kinds of help at once. Someone discharged after a hip replacement might need home health (a nurse and a physical therapist for a few weeks) and personal care (an aide for bathing and meals for months). Those can come from different agencies, and they run on separate payment tracks: Medicare pays for the skilled piece, and something else pays for the personal-care piece.
Home Health: The Home Health Agency
Skilled home health in Indiana comes from a Home Health Agency licensed under IC 16-27-1. The agency employs the clinical staff, registered nurses and therapists, who carry out the plan of care a physician has ordered. The IDOH 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 personal care, and it's the next section.
Home Care: The Personal Services Agency
Non-medical home care in Indiana comes from a Personal Services Agency licensed under IC 16-27-4. It's the help that keeps someone safe and supported at home: attendant care, homemaker services, and companionship. Because it isn't skilled medical care, the payer picture looks different from home health.
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.
- Indiana Medicaid. For low-income Hoosiers, non-medical personal care is generally funded through Indiana Medicaid's long-term care programs, including PathWays for Aging, the state's managed long-term services and supports program for older adults.
- 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 for personal care are private funds, long-term care insurance, or, for eligible low-income Hoosiers, Indiana Medicaid.
Which One Do You Need?
Start with the need, not the brochure. The table maps the two agency types across the dimensions that decide what the care is and who pays. The license type is your first clue, and in Indiana the agency's name backs it up, since a Personal Services Agency can't call itself a home health agency.
| Home Health Agency (Skilled, IC 16-27-1) | Personal Services Agency (Non-Medical, IC 16-27-4) | |
|---|---|---|
| What it is | Skilled, physician-ordered medical care: nursing, wound care, and physical, occupational, or speech therapy under a plan of care, on a part-time or intermittent basis | Non-medical attendant care, homemaker, and companion services: help with bathing, dressing, meals, housekeeping, and supervision |
| Who provides it | An IDOH-licensed Home Health Agency, which may also be Medicare-certified, and its clinical staff (nurses and therapists) | An IDOH-licensed Personal Services Agency and its aides (it may not use "health" or "nursing" in its name) |
| Who pays | Medicare (when homebound + intermittent skilled need); the beneficiary pays nothing for covered skilled services | Private pay, long-term care insurance, or Indiana Medicaid (including PathWays for Aging) for eligible low-income Hoosiers |
A quick way to place a situation: if a physician has ordered skilled care and the person is homebound, you're looking at 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 a Personal Services Agency, and the question becomes whether to pay privately or qualify through Indiana Medicaid. Both can be in play at once, and plenty of Indiana 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 Indiana Medicaid covers it.
For non-medical home care in Indiana, a home health aide ran about $75,504 a year in 2024, according to the CareScout/Genworth Cost of Care Survey, on a basis of 44 hours a week. That figure sits roughly in line with the national median for the same survey. These are industry survey medians, not government rates and not a maximum, so what a specific Indiana agency charges can land above or below them, and the Indianapolis metro and northern markets generally run higher than rural areas. A family using fewer hours than the full-week assumption will pay less than the annual figure suggests.
For low-income Hoosiers who qualify, that private cost can be covered instead through Indiana Medicaid, including PathWays for Aging.
Frequently Asked Questions
No. Medicare does not pay for non-medical personal care, the help with bathing, dressing, meals, and everyday support that an aide 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 Hoosiers, Indiana Medicaid.
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 Indiana, the agency's IDOH license tells you which it can do: a Home Health Agency (IC 16-27-1) provides skilled care, while a Personal Services Agency (IC 16-27-4) provides only the non-medical help.
No. By law, an Indiana Personal Services Agency may not advertise as a home health agency, and it may not use the words "health" or "nursing" in its name. The rule works in a family's favor: if a provider's name carries "health" or "nursing," it's licensed for skilled medical care, because a non-medical agency cannot legally use those words.
Generally yes, for eligible low-income Hoosiers. Non-medical personal care at home is funded through Indiana Medicaid's long-term care programs, including PathWays for Aging, the state's managed long-term services and supports program for older adults. This lets a person receive help at home rather than enter a nursing facility, and eligibility and enrollment run through the state's Medicaid program.
Yes, and many do. A person recovering from surgery might receive Medicare-covered home health (a nurse and a therapist for a set period) from a Home Health Agency while also needing ongoing personal care (an aide for bathing and meals) from a Personal Services Agency. The two run on separate payment tracks, Medicare for the skilled care and private pay or Indiana Medicaid for the personal care, so arranging one does not arrange or pay for the other.
Learn More
- Assisted Living in Indiana
- Nursing Homes in Indiana
- Memory Care in Indiana
- Medicaid Planning Strategies
- Caregiver Burnout: Signs and Support
Find personalized help sorting out in-home care in Indiana 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.