Home Care vs. Home Health: What's the Difference

Home care: non-medical, private pay

Delivered by a caregiver through a Home Care Organization (HCO) licensed by CDSS. Covers bathing, dressing, meal prep, transportation, companionship, and light housekeeping — help with daily living, not medical treatment. It’s ongoing, can run for months or years, and is almost always private pay (Medicare does not cover it; Medi-Cal’s IHSS program is a separate path — see our IHSS guide).

Home health: skilled, physician-ordered, often Medicare-covered

Delivered by a nurse, physical therapist, or other clinician through a Home Health Agency (HHA) — a different, separately licensed and Medicare-certified entity. It requires a doctor’s order and is typically short-term and intermittent: a nurse checking a wound twice a week, or a therapist running a course of physical therapy after a hospital stay. When Medicare’s requirements are met (homebound status, a doctor-certified plan of care), it’s often covered at no cost — but it does not include ongoing help with bathing, meals, or supervision on its own.

Why the confusion causes real problems

Families sometimes assume that because Medicare is paying for “home health” after a hospital discharge, it will also cover the daily custodial help their parent actually needs once the skilled visits end. It won’t. The two are frequently used together — home health for the skilled, time-limited piece, home care layered in indefinitely for everything else — which is exactly the gap covered in our first 72 hours home from the hospital guide.

At a glance

• Home care — HCO license, non-medical, private pay, ongoing.
• Home health — HHA license, skilled/clinical, doctor-ordered, often Medicare-covered, short-term.