"Home care" and "home health" sound like the same thing, but in New Jersey they're two different services with two different payers, and mixing them up can cost you. Home health is skilled, doctor-ordered care that the Medicare home health benefit covers when someone is homebound and needs intermittent skilled care; home care is the everyday non-medical help Medicare won't pay for, though eligible New Jerseyans may cover it through Medicaid.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services,U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42
This guide draws the line between the two, shows what Medicare does and doesn't pay for, gives the New Jersey cost, and explains how NJ FamilyCare can fund ongoing care at home. Getting the distinction 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 coming.
In This Guide
- Key Takeaways
- Home Care vs. Home Health in New Jersey: The Core Difference
- Home Care: What It Is and Who Pays
- Home Health: What Medicare Covers
- Home Care vs. Home Health in New Jersey: Which One Do You Need?
- Paying for In-Home Care in New Jersey
- What It Costs
- Frequently Asked Questions
Home Care vs. Home Health in New Jersey: The Core Difference
The whole thing comes down to one word: medical. Home health is skilled medical care, a nurse changing a wound dressing, a physical therapist rebuilding strength after a hospital stay, ordered by a doctor and delivered by a Medicare-certified agency. Home care is non-medical help with everyday life, bathing, dressing, meals, reminders, companionship, a ride to an appointment.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services The same person often needs both, but they're billed and paid for differently, and that's where families get tripped up.
That distinction isn't just vocabulary. It decides two things a New Jersey family actually cares about: who has to provide the care (Medicare covers skilled home health only from a Medicare-certified home health agency), and who pays the bill.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services
| Home care (non-medical) | Home health (skilled) | |
|---|---|---|
| What it is | Help with daily activities, companionship, housekeeping | Skilled nursing, physical/occupational/speech therapy |
| Who provides it | A non-medical caregiver | Nurses and therapists from a Medicare-certified agency |
| Who orders it | The family chooses it | A doctor or other health care provider orders it |
| Who pays | Private pay or NJ FamilyCare; not Medicare when it's the only care needed | Medicare (homebound, part-time or intermittent skilled need) |
| How long | Ongoing, as long as needed | Part-time or intermittent, while the skilled need lasts |
Home Care: What It Is and Who Pays
Home care keeps someone safe and comfortable at home without medical treatment: an aide who helps your mother bathe and dress, makes lunch, does light housekeeping, and keeps her company. On payment, the key fact is that Medicare does not cover non-medical home care when that's the only care needed.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services,U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42 Families pay privately (in New Jersey, a non-medical caregiver runs about $38 an hour), use long-term-care insurance, or, if eligible, have it funded by New Jersey Medicaid through its MLTSS program.
Home Health: What Medicare Covers
Home health is skilled, medically necessary care a doctor orders, typically after a hospital stay, a fall, surgery, or a change in a chronic condition. It's delivered by a Medicare-certified home health agency and is part-time or intermittent, not around-the-clock. Medicare covers home health, and the beneficiary generally pays $0 for the covered services when Medicare's conditions are met.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services,U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42 The two that trip families up most:
- Homebound. The person is normally unable to leave home and leaving takes a lot of effort, either because it needs help (a cane, walker, wheelchair or another person) or because it isn't recommended for their condition. Leaving for medical treatment, or for short, infrequent outings such as religious services, doesn't disqualify someone.Centers for Medicare & Medicaid Services. (n.d.). Home Health Services Coverage - Medicare.gov. medicare.gov. Retrieved Oct 13, 2026, from https://www.medicare.gov/coverage/home-health-services
- Intermittent skilled need. A physician or allowed practitioner certifies that the person needs skilled nursing or therapy on a part-time or intermittent basis, under a plan of care they establish and review. Under Medicare's rule, "part-time or intermittent" generally means combined skilled nursing and home health aide care of fewer than 8 hours a day and 28 or fewer hours a week (up to 35 hours on case-by-case review).U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42
The key limit: home health is for skilled needs, not help with daily activities alone, and it's part-time or intermittent, so it's not a solution for ongoing custodial care. Medicare does cover part-time or intermittent home health aide help with bathing, grooming, walking and feeding, but only while the person is also getting skilled nursing or therapy, so ask the agency about aide hours during that stretch.U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42 What Medicare home health won't do is staff an aide in the home for general daily help with no skilled-care purpose. That's home care.
Home Care vs. Home Health in New Jersey: Which One Do You Need?
Start with the need, not the brochure. If it's help with the rhythms of daily life, bathing, meals, supervision, company, that's home care, and you'll likely pay privately or through Medicaid. If a doctor has ordered skilled care to recover from or manage a medical event, that's home health, and Medicare may cover it for a while. Many families use home health briefly after a hospitalization and then transition to ongoing home care.
That handoff is exactly the moment to plan for. When the skilled need ends, the Medicare-paid home health stops, including any aide hours Medicare was covering, but the personal-care help often continues, and the bill for it shifts to you.U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42 Both kinds of care can run at the same time, too: Medicare pays the skilled side plus part-time aide help tied to it, while non-medical help beyond that stays private-pay or Medicaid.
Paying for In-Home Care in New Jersey
For ongoing home care, the main payers in New Jersey are private funds and Medicaid. NJ FamilyCare (New Jersey Medicaid) funds in-home personal care through its Managed Long Term Services and Supports (MLTSS) program, which provides services and supports at home as well as in assisted living or a nursing home.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services To qualify, a person must be 65 or older (or under 65 and determined blind or disabled by Social Security or the State) and meet MLTSS clinical and financial eligibility.State of New Jersey. (n.d.). Managed Long Term Services and Supports (MLTSS). nj.gov. Retrieved Oct 13, 2026, from https://www.nj.gov/humanservices/dmahs/individuals-families/familycare/mltss/ Veterans enrolled in VA health care who are eligible for community care and meet VA's clinical criteria may also get personal-care help at home through VA's Homemaker and Home Health Aide program, where it's available.U.S. Department of Veterans Affairs. (n.d.). Homemaker and Home Health Aide Care — VA Geriatrics and Extended Care. va.gov. Retrieved Sep 26, 2026, from https://www.va.gov/GERIATRICS/pages/Homemaker_and_Home_Health_Aide_Care.asp And long-term-care insurance, if a family has it, is private coverage designed to pay for the personal and custodial care at home that Medicare does not.Administration for Community Living. (n.d.). What is Long-term Care Insurance?. acl.gov. Retrieved Oct 12, 2026, from https://acl.gov/ltc/costs-and-who-pays/what-is-long-term-care-insurance
To start an MLTSS assessment, an adult 21 or older living in the community who isn't already on Medicaid contacts their county Area Agency on Aging / Aging and Disability Resource Connection (ADRC) at 1-877-222-3737 for the clinical screening for a nursing-facility level of care; someone already enrolled in Medicaid calls the member services number on their health plan card instead, and someone living in an assisted living facility or nursing home asks the facility's social worker.State of New Jersey. (n.d.). Managed Long Term Services and Supports (MLTSS). nj.gov. Retrieved Oct 13, 2026, from https://www.nj.gov/humanservices/dmahs/individuals-families/familycare/mltss/ You can find your county ADRC and apply for NJ FamilyCare through the New Jersey Department of Human Services. For the full financial picture, see our guide to how to pay for senior care in New Jersey.
What It Costs
Home health, when Medicare covers it, costs the beneficiary nothing for the covered skilled services.U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42 The cost question really lives on the home-care side, where families pay out of pocket unless Medicaid covers it.
For non-medical home care in New Jersey, a non-medical caregiver ran about $86,944 a year per the CareScout 2025 Cost of Care Survey (released March 2026), which works out to roughly $38 an hour on a basis of 44 hours a week.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services Beginning with its 2025 survey, CareScout merged the former separate homemaker and home health aide categories into a single non-medical caregiver line. Those are industry survey medians, not government rates and not a maximum, so what a specific New Jersey agency charges can land above or below them. A family using fewer hours than the full-week assumption will pay less than the annual figure suggests.
To put the home-care figure in context, here is where it sits against New Jersey's other long-term care settings, all CareScout 2025 medians.assets.carescout.com. (2025). CareScout — Cost of Care Survey 2025, Ranked Median Costs by State Data Tables (Assisted Living Community: New Jersey row, rank 5, and the four states above it). Retrieved Sep 6, 2026, from https://assets.carescout.com/x/5c90319b6a/298701.pdf,Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services,assets.carescout.com. (2025). CareScout — Cost of Care Survey 2025, Median Cost Data Tables (New Jersey and USA National annual rows; New Jersey daily row). Retrieved Sep 6, 2026, from https://assets.carescout.com/x/8fcb50422f/282102.pdf
| Setting | Median annual cost |
|---|---|
| Assisted living | About $104,520 |
| Non-medical caregiver (in-home personal care) | About $86,944 |
| Nursing home, semi-private room | About $153,300 |
| Nursing home, private room | About $173,375 |
For eligible New Jerseyans, that private cost can be covered instead through NJ FamilyCare's MLTSS, which provides services and supports at home.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services
Frequently Asked Questions
What's the difference between home care and home health?
Home care is non-medical help with daily activities (bathing, meals, companionship, housekeeping). Home health is skilled medical care (nursing, therapy) ordered by a doctor and delivered by a Medicare-certified agency.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services The same person may need both, but they're paid for differently.
Does Medicare pay for home care in New Jersey?
No. Medicare does not pay for non-medical personal care, the help with bathing, dressing, meals, and everyday support, when that is the only care needed.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services,U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42 It covers home health, skilled, part-time or intermittent care, when you're homebound and a doctor or other health care provider orders it, and the beneficiary generally pays $0 for the covered services. While that skilled care continues, Medicare can also cover part-time aide help with bathing, grooming, walking and feeding.U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42 Ongoing non-medical help is paid privately, through Medicaid, or with long-term-care insurance.
How much does in-home care cost in New Jersey?
A non-medical caregiver ran about $86,944 a year in New Jersey, roughly $38 an hour on a 44-hour-a-week basis, per the CareScout 2025 Cost of Care Survey.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services Costs add up quickly for many hours, which is why families turn to Medicaid or insurance for ongoing needs.
Does New Jersey Medicaid pay for care at home?
Yes. NJ FamilyCare's MLTSS program provides services and supports at home for eligible members.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services You must be 65 or older (or under 65 and determined blind or disabled by Social Security or the State) and meet MLTSS clinical and financial eligibility; an adult 21 or older living in the community who isn't already on Medicaid starts by contacting their county Area Agency on Aging / Aging and Disability Resource Connection (ADRC) for a clinical screening.State of New Jersey. (n.d.). Managed Long Term Services and Supports (MLTSS). nj.gov. Retrieved Oct 13, 2026, from https://www.nj.gov/humanservices/dmahs/individuals-families/familycare/mltss/
Can someone get both home care and home health?
Yes, and many do, especially after a hospital stay: Medicare-covered home health for skilled recovery, plus home care for daily help.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage (what Medicare doesn't pay for; homebound/part-time-or-intermittent test). medicare.gov. Retrieved Aug 1, 2026, from https://www.medicare.gov/coverage/home-health-services They run on separate payment tracks: Medicare pays for the skilled care, plus part-time aide help only while that skilled care lasts, and private pay or Medicaid covers personal care beyond that, so plan for the moment the home health benefit ends and ongoing home care becomes your responsibility.U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualifications for coverage of services (eCFR, current). ecfr.gov. Retrieved Aug 3, 2026, from https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-409/subpart-E/section-409.42
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