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.