"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. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/home-health-services,U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualification requirements, home health (govinfo.gov). govinfo.gov. Retrieved Jun 23, 2026, from https://www.govinfo.gov/content/pkg/CFR-2023-title42-vol2/xml/CFR-2023-title42-vol2-sec409-42.xml
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 licensed 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. medicare.gov. Retrieved Jun 25, 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 may legally do the work (a Medicare-certified home health agency for the skilled side, a personal-care provider for the non-medical side), and who pays the bill.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage. medicare.gov. Retrieved Jun 25, 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 | Home health aides, personal-care assistants | Nurses and therapists from a Medicare-certified agency |
| Who orders it | The family chooses it | A physician orders it |
| Who pays | Private pay or NJ FamilyCare; NOT Medicare | Medicare (homebound, intermittent skilled need), or Medicaid |
| How long | Ongoing, as long as needed | Short-term and intermittent |
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. It's the kind of help most older adults need first and longest. 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. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/home-health-services,U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualification requirements, home health (govinfo.gov). govinfo.gov. Retrieved Jun 23, 2026, from https://www.govinfo.gov/content/pkg/CFR-2023-title42-vol2/xml/CFR-2023-title42-vol2-sec409-42.xml 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 time-limited and intermittent, not around-the-clock. Medicare Part A and Part B cover home health, and the beneficiary generally pays $0 for the covered services when two conditions are met.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/home-health-services,U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualification requirements, home health (govinfo.gov). govinfo.gov. Retrieved Jun 23, 2026, from https://www.govinfo.gov/content/pkg/CFR-2023-title42-vol2/xml/CFR-2023-title42-vol2-sec409-42.xml The two that trip families up most:
- Homebound. Leaving home takes considerable, taxing effort, and the person generally needs help or a device to do it. Short, occasional trips out, to a medical appointment or religious services, don't disqualify someone.U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualification requirements, home health (govinfo.gov). govinfo.gov. Retrieved Jun 23, 2026, from https://www.govinfo.gov/content/pkg/CFR-2023-title42-vol2/xml/CFR-2023-title42-vol2-sec409-42.xml
- 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. 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 qualification requirements, home health (govinfo.gov). govinfo.gov. Retrieved Jun 23, 2026, from https://www.govinfo.gov/content/pkg/CFR-2023-title42-vol2/xml/CFR-2023-title42-vol2-sec409-42.xml
The key limit: home health is for skilled needs, not help with daily activities alone, and it's short-term, so it's not a solution for ongoing custodial care. 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, but the personal-care help often continues, and the bill for it shifts to you. Both kinds of care can run at the same time, too: Medicare pays the skilled side, while the non-medical side stays private-pay or Medicaid even when the two overlap in the same week.
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 for people who meet its clinical and financial eligibility, and a notable feature is that home-based MLTSS members keep all of their income, with no patient liability when you live at home.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/home-health-services Veterans may use VA benefits, and some families have long-term-care insurance.
To start an MLTSS assessment, an adult 21 or older contacts their county Area Agency on Aging / Aging and Disability Resource Connection (ADRC), which begins the clinical screening for a nursing-facility level of care.State of New Jersey. (n.d.). Managed Long Term Services and Supports (MLTSS). nj.gov. Retrieved Jun 24, 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 qualification requirements, home health (govinfo.gov). govinfo.gov. Retrieved Jun 23, 2026, from https://www.govinfo.gov/content/pkg/CFR-2023-title42-vol2/xml/CFR-2023-title42-vol2-sec409-42.xml 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. medicare.gov. Retrieved Jun 25, 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, and the dense northern counties tend to run higher than the rest of the state. 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.businesswire.com. (2025). CareScout Releases 2025 Cost of Care Data for New Jersey. Retrieved Jun 25, 2026, from https://www.businesswire.com/news/home/20260302045453/en/CareScout-Releases-2025-Cost-of-Care-Data-for-New-Jersey,Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/home-health-services
| Setting | Median annual cost |
|---|---|
| Assisted living | About $101,550 |
| 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 in-home personal care, with home-based members keeping all of their income.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage. medicare.gov. Retrieved Jun 25, 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. medicare.gov. Retrieved Jun 25, 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. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/home-health-services,U.S. Government Publishing Office. (n.d.). 42 CFR 409.42 — Beneficiary qualification requirements, home health (govinfo.gov). govinfo.gov. Retrieved Jun 23, 2026, from https://www.govinfo.gov/content/pkg/CFR-2023-title42-vol2/xml/CFR-2023-title42-vol2-sec409-42.xml It covers home health, skilled, short-term, intermittent care, when you're homebound and a doctor orders it, and the beneficiary generally pays $0 for the covered services. 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. medicare.gov. Retrieved Jun 25, 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 can fund in-home personal care for eligible members, and home-based MLTSS members keep all their income, with no patient liability.Centers for Medicare & Medicaid Services. (n.d.). Medicare.gov — Home health services coverage. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/home-health-services You must meet MLTSS clinical and financial eligibility; an adult 21 or older starts by contacting their county 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 Jun 24, 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. medicare.gov. Retrieved Jun 25, 2026, from https://www.medicare.gov/coverage/home-health-services They run on separate payment tracks, Medicare for the skilled care and private pay or Medicaid for the personal care, so plan for the moment the home health benefit ends and ongoing home care becomes your responsibility.
Learn More
Find personalized help deciding between home care and home health in New Jersey 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.