"Home care" and "home health" sound interchangeable, but Utah licenses them as two separate services, and the difference decides who pays. The state licenses a Home Health Agency to deliver skilled, doctor-ordered care that Medicare can cover, and separately licenses a Personal Care Agency for the non-medical daily help it won't.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services
This guide draws that line so a Utah 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 in Utah
- Home Health: What Medicare Covers
- Home Care: The Personal Care Agency and Who Pays
- Which One Do You Need?
- What Home Care Costs in Utah
- Frequently Asked Questions
The Core Difference in Utah
The split is skilled versus non-medical, and in Utah it's written into two different licenses. Utah doesn't lump in-home care under one rulebook. It licenses a Home Health Agency under Utah Administrative Code R432-700 to deliver skilled care, and it licenses a Personal Care Agency under Utah Administrative Code R432-725 to deliver non-medical help.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services
A Home Health Agency provides skilled, physician-ordered care: nursing and physical, occupational, or speech therapy ordered because the person has a medical need only a licensed professional can meet. Wound care after surgery, IV medication, injections a patient can't manage alone, therapy to rebuild strength after a stroke or a fall. The care is part-time and intermittent, not round-the-clock.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services
A Personal Care Agency provides non-medical support: help with everyday living such as bathing, dressing, grooming, meals, toileting, and medication reminders, the tasks that keep someone safe at home. The person can be medically stable and still need this help every day.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services
That separation is what decides the money. A Home Health Agency may also become Medicare-certified, which is the step that lets it bill Medicare for the skilled care it's licensed to deliver.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services A Personal Care Agency provides care Medicare doesn't pay for at all. So when a Utah family hears "home health agency," that's shorthand for the skilled, often Medicare-certified track, and "personal care" points to the non-medical one.
The same person often needs both 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 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: What Medicare Covers
Skilled home health in Utah comes from a Home Health Agency licensed under R432-700, often one that has also earned Medicare certification.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services The agency employs the clinical staff, registered nurses and therapists, who carry out the plan of care a physician has ordered. The state 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 every condition.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. Medicare's test has two parts, and the person must meet both: leaving home isn't recommended because of their condition, or they have trouble leaving without help; and they're normally unable to leave, and leaving takes a lot of effort. Homebound isn't housebound: trips out for medical treatment, or short, infrequent outings such as religious services or adult day care, don't disqualify someone.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 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
- 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. "Part-time or intermittent" generally means combined skilled nursing and aide help under 8 hours a day and 28 or fewer hours a week.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
When those conditions are met, Medicare pays for the covered skilled services, and the beneficiary generally pays $0: the nursing visits, the therapy, and the home health aide help that's attached to that skilled care.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 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 Care Agency and Who Pays
Non-medical home care in Utah comes from a Personal Care Agency, separately licensed under R432-725 to provide help with everyday living such as bathing, dressing, grooming, meals, toileting, and medication reminders.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services Because it isn't skilled medical care, the payer picture looks nothing like 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.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services
- Utah Medicaid. For Utahns who meet Medicaid's financial rules and need a nursing-facility level of care, Utah Medicaid's Aging Waiver (age 65 and older) and New Choices Waiver fund home and community-based services so a person can stay at home rather than enter a facility. The Aging Waiver covers personal attendant, homemaker, and chore services, but it serves a limited number of people, and each participant gets only the services they're assessed as needing.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services,Centers for Medicare & Medicaid Services. (2026). CMS - 2026 SSI and Spousal Impoverishment Standards (CMCS Informational Bulletin, December 9, 2025). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/federal-policy-guidance/downloads/cib12092025.pdf
- 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 on its own.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 A family expecting Medicare to cover an aide for daily help, with no skilled nursing or therapy alongside it, 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 Utahns who need a nursing-facility level of care, Utah Medicaid's Aging and New Choices waivers.
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 is your first clue: a Home Health Agency delivers skilled care, while a Personal Care Agency delivers the non-medical help.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 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
| Home Health Agency (Skilled) | Personal Care Agency (Non-Medical) | |
|---|---|---|
| Utah license | R432-700 | R432-725 |
| What it is | Skilled, physician-ordered care: nursing and physical, occupational, or speech therapy under a plan of care, on a part-time or intermittent basis | Everyday non-medical help with daily living (bathing, dressing, grooming, meals, toileting, medication reminders) |
| Who provides it | A licensed Home Health Agency, often Medicare-certified, and its clinical staff (nurses and therapists) | A separately licensed Personal Care Agency and its aides |
| Who pays | Medicare at $0 for covered services (when homebound + intermittent skilled need) | Private pay, long-term care insurance, or Utah Medicaid's Aging and New Choices waivers for eligible Utahns who need a nursing-facility level of care |
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 a Personal Care Agency, and the question becomes whether to pay privately or qualify through Utah Medicaid. Both can be in play at once, and plenty of Utah families arrange both.
What Home Care Costs in Utah
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 non-medical side, where families pay out of pocket unless Utah Medicaid covers it.
For non-medical home care in Utah, a non-medical caregiver runs about $39 an hour, which works out to roughly $89,804 a year at 44 hours of care a week, per the 2025 CareScout Cost of Care Survey (Utah median). That's above the national median of $35 an hour ($80,080 a year).Genworth Financial. (2025). CareScout Releases 2025 Cost of Care Survey Results. investor.genworth.com. Retrieved Sep 6, 2026, from https://investor.genworth.com/news-events/press-releases/detail/1054/carescout-releases-2025-cost-of-care-survey-results Beginning with the 2025 survey, CareScout merged the former "homemaker" and "home health aide" categories into this one "non-medical caregiver" rate. These are industry-survey medians, not government rates and not a maximum, so what a specific Utah agency charges can land above or below them. A family using only a few hours a day will pay far less than the annual figure suggests: at the survey's rate, a few hours of help each day costs a fraction of a full-week schedule.Genworth Financial. (2025). CareScout Releases 2025 Cost of Care Survey Results. investor.genworth.com. Retrieved Sep 6, 2026, from https://investor.genworth.com/news-events/press-releases/detail/1054/carescout-releases-2025-cost-of-care-survey-results
For Utahns who meet Medicaid's financial rules and need a nursing-facility level of care, that private cost can be covered instead through Utah Medicaid's Aging and New Choices waivers.Centers for Medicare & Medicaid Services. (2026). CMS - 2026 SSI and Spousal Impoverishment Standards (CMCS Informational Bulletin, December 9, 2025). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/federal-policy-guidance/downloads/cib12092025.pdf,Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services Utah Medicaid's long-term care and waiver programs page is the place a Utah family begins.
Frequently Asked Questions
Does Medicare cover home health in Utah?
Yes, but only skilled care. Medicare's home health benefit covers physician-ordered nursing and physical, occupational, or speech therapy for a person who is homebound and needs that care on a part-time or intermittent basis, delivered by a Medicare-certified agency, and the beneficiary generally pays $0 for the covered 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 does not pay for non-medical personal care, the help with bathing, dressing, meals, and everyday support an aide provides, on its own.
What is the difference between home care and home health in Utah?
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 on its own.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services Utah licenses the two separately: a Home Health Agency under R432-700 for the skilled care, a Personal Care Agency under R432-725 for the non-medical help.
How much does home care cost in Utah?
Per the 2025 CareScout Cost of Care Survey, a non-medical caregiver in Utah runs about $39 an hour, or roughly $89,804 a year at 44 hours a week (Utah median), above the national median of $35 an hour.Genworth Financial. (2025). CareScout Releases 2025 Cost of Care Survey Results. investor.genworth.com. Retrieved Sep 6, 2026, from https://investor.genworth.com/news-events/press-releases/detail/1054/carescout-releases-2025-cost-of-care-survey-results That annual figure assumes a near full-time schedule, so a family hiring an aide for only a few hours a day pays far less. The numbers are survey medians, not fixed rates, and a given Utah agency can charge above or below them.
Does Utah Medicaid cover personal care?
Yes, for those who qualify. For Utahns who meet Medicaid's financial rules and need a nursing-facility level of care, Utah Medicaid's Aging Waiver (age 65 and older) and New Choices Waiver fund home and community-based services so a person can stay at home rather than enter a facility; the Aging Waiver's covered services include personal attendant, homemaker, and chore services.Centers for Medicare & Medicaid Services. (2026). CMS - 2026 SSI and Spousal Impoverishment Standards (CMCS Informational Bulletin, December 9, 2025). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/federal-policy-guidance/downloads/cib12092025.pdf,Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services The Aging Waiver serves a limited number of people, and Utah Medicaid's long-term care and waiver programs page is where a family begins.
Can someone get both home health and personal care at the same time?
Yes, and many do.Centers for Medicare & Medicaid Services. (n.d.). Medicare - Home health services coverage (what is and is not covered, who's eligible, provider requirements, how often, costs). medicare.gov. Retrieved Sep 6, 2026, from https://www.medicare.gov/coverage/home-health-services 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 Utah Medicaid for the personal care, so arranging one does not arrange or pay for the other.
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