"Home care" and "home health" sound like the same thing, but in Minnesota the license class draws the line between them. The state licenses home care providers as either Basic (a limited set of non-skilled help) or Comprehensive (skilled care like nursing and therapy), and only a Comprehensive provider can become a Medicare-certified home health agency. That distinction settles who pays.
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 the agency's name, it's whether the care is skilled or non-medical, and which program pays the bill.
In This Guide
- Key Takeaways
- The Core Difference
- Home Health: The Comprehensive, Medicare-Certified Agency
- Home Care: Non-Medical Help and Who Pays
- Which One Do You Need?
- What It Costs
- Frequently Asked Questions
The Core Difference
The split is skilled versus non-medical, and in Minnesota it shows up first in the provider's license. The state doesn't just label agencies loosely. MDH grants a home care provider either a Basic license or a Comprehensive one, and that license sets what the provider may legally do.
A Basic home care license covers a limited set of non-skilled services: help with the activities of daily living and assistive tasks, the everyday support that keeps someone safe at home. The person can be medically stable and still need this help every day.
A Comprehensive home care license covers skilled services, the nursing and therapies a physician orders because the person has a medical need that requires a licensed professional. 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. The care is part-time and intermittent, not round-the-clock.
Here's the piece that decides the money. Only a Comprehensive-licensed provider can go on to become a Medicare-certified home health agency. A Basic provider can't bill Medicare for home health, because it isn't licensed to deliver the skilled care Medicare's benefit pays for. So when a family hears "home health agency" in Minnesota, that's shorthand for a Comprehensive provider that has also cleared Medicare certification.
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 also personal care (an aide for bathing and meals for months). Those can come from different providers, 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 Comprehensive, Medicare-Certified Agency
Skilled home health in Minnesota comes from a Comprehensive-licensed provider that has 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 Comprehensive 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 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 personal care, and it's the next section.
Home Care: Non-Medical Help and Who Pays
Non-medical home care in Minnesota is the help that keeps someone safe and supported at home: assistance with daily activities and the everyday support around them. A Basic-licensed provider can deliver it, and a Comprehensive provider can too, but 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.
- Medical Assistance. For low-income Minnesotans, the state's Medicaid program, Medical Assistance, covers non-medical personal care through personal care assistance and the Elderly Waiver. Eligibility runs through the Minnesota Department of Human Services, so that's where a family starts.
- 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 Minnesotans, Medical Assistance.
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 and who pays. The license class is your first clue: a Comprehensive provider can deliver skilled home health, while non-medical help can come from a Basic or a Comprehensive provider.
| Home Health (Skilled) | Non-Medical Home Care | |
|---|---|---|
| What it is | Skilled, physician-ordered medical care: nursing and therapy under a plan of care, on a part-time or intermittent basis | Everyday non-medical help with daily activities (bathing, dressing, eating, mobility) and the support that keeps someone safe at home |
| Who provides it | A Comprehensive-licensed provider that is also Medicare-certified, and its clinical staff (nurses and therapists) | A Basic-licensed or Comprehensive-licensed provider and its aides |
| Who pays | Medicare (when homebound + intermittent skilled need) | Private pay, long-term care insurance, or Medical Assistance (personal care assistance and the Elderly Waiver) for eligible low-income Minnesotans |
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 non-medical home care, and the question becomes whether to pay privately or qualify through Medical Assistance. Both can be in play at once, and plenty of Minnesota 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 Medical Assistance covers it.
For non-medical home care in Minnesota, a home health aide ran about $98,384 a year in 2024, according to the Genworth/CareScout Cost of Care Survey, which works out to roughly $8,199 a month on a basis of 44 hours a week. That sits well above the national median (about $77,792 a year for the same survey). These are industry survey medians, not government rates and not a maximum, so what a specific Minnesota agency charges can land above or below them, and the Twin Cities metro tends to run higher than rural parts of the state. A family using fewer hours than the full-week assumption will pay less than the annual figure suggests.
For low-income Minnesotans who qualify, that private cost can be covered instead through Medical Assistance, as personal care assistance or through the Elderly Waiver.
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 Minnesotans, Medical Assistance.
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 Minnesota, the provider's MDH license tells you which it can do: a Comprehensive license covers skilled care, while a Basic license covers only the non-skilled help.
The Minnesota Department of Health issues both. A Basic home care license authorizes a limited set of non-skilled services, help with daily activities and assistive tasks. A Comprehensive home care license authorizes skilled services such as nursing and therapy. The practical consequence: only a Comprehensive-licensed provider can become a Medicare-certified home health agency, so a Basic provider cannot bill Medicare for home health.
Yes. For eligible low-income Minnesotans, Medical Assistance, the state's Medicaid program, covers non-medical personal care through personal care assistance and the Elderly Waiver, so a person can stay at home rather than enter a nursing facility. Eligibility runs through the Minnesota Department of Human Services, which is where a family begins.
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 personal care (an aide for bathing and meals). The two run on separate payment tracks, Medicare for the skilled care and private pay or Medical Assistance for the personal care, so arranging one does not arrange or pay for the other.
Learn More
- Assisted Living in Minnesota
- Nursing Homes in Minnesota
- Memory Care in Minnesota
- Medicaid Planning Strategies
- Caregiver Burnout: Signs and Support
Find personalized help arranging care at home in Minnesota 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.