Patient Guide

Home Health and Home Care Are Not the Same

Families often use “home care” and “home health” interchangeably, but Medicare treats them very differently. Understanding the distinction helps you know what Medicare may cover and what you may need to plan for privately.

5 min read

Published by Holistat Home Health · CMS-certified Medicare agency · Updated August 16, 2026

Key takeaway

Medicare home health is skilled, physician-ordered medical care at home. Home care (personal care) is non-medical help with daily activities and is usually not covered by Medicare unless it is part of a qualifying skilled plan of care.

Side-by-side comparison

Medicare home health Home care (personal care)
Type of help Skilled nursing, wound care, PT/OT/ST, disease education Bathing, dressing, grooming, meals, companionship
Who provides it RN, LVN, PT, OT, ST under a plan of care Caregivers or home care aides (non-skilled)
Physician order Required Not required for basic personal care
Medicare coverage May be covered when eligibility criteria are met Generally not covered for custodial care alone
Typical payment Medicare Part A or B (when eligible) Private pay, long-term care insurance, or Medicaid (if eligible)
Visit pattern Intermittent skilled visits Often several hours per day or live-in arrangements

Examples of Medicare home health

Holistat provides physician/practitioner-ordered skilled services such as:

  • Wound assessment and dressing changes after surgery or hospitalization
  • Physical therapy after hip replacement or stroke
  • Medication teaching and monitoring for heart failure or COPD
  • Skilled observation when a condition is unstable

Explore our full list of skilled home health services.

Examples of home care (personal care)

  • Help getting in and out of the shower when no skilled need exists
  • Meal preparation and light housekeeping
  • Supervision for dementia when skilled nursing is not ordered
  • Transportation and companionship

These services improve quality of life but are considered custodial unless tied to a Medicare skilled plan of care.

When families need both

After hospital discharge, a patient might receive Medicare home health for wound care and physical therapy while also hiring private home care for morning routines and overnight supervision. Medicare covers the skilled portion when criteria are met; personal care is arranged separately.

If you are unsure which type of help you need, start with your physician or hospital discharge planner. To begin skilled care, call Holistat intake at (682) 200-7472 or review getting home health after a hospital stay.

Medical disclaimer: Coverage rules vary by payer and individual circumstances. This article summarizes common Medicare distinctions and is not legal or billing advice.

Related questions

Does Medicare pay for home care aides?

Medicare home health may include a home health aide only when you are also receiving skilled nursing or therapy and the aide's services are part of the physician-ordered plan of care. Medicare does not pay for custodial or personal care alone.

What is the main difference between home health and home care?

Home health provides skilled medical services such as nursing, wound care, and therapy under physician orders. Home care (personal care) provides non-medical help with bathing, dressing, meal preparation, and companionship and is usually private pay or covered by other programs—not Medicare for custodial care alone.

Can I receive home health and home care at the same time?

Yes. Many patients use Medicare-certified home health for skilled needs while hiring a private home care agency for daily personal care. The services complement each other but are billed separately.

Need Medicare Home Health in DFW?

Holistat’s intake team can help verify eligibility and coordinate skilled care at home across Tarrant, Dallas, Collin, and Denton counties.