Home care vs. home health care: what’s the difference?

Home care is non-medical help with daily life — bathing, dressing, meals, companionship, housekeeping, transport. Home health care is short-term skilled medical care at home — nursing, wound care, physical or occupational therapy — ordered by a doctor. They are different services, delivered by different kinds of provider, licensed separately by the State of Maryland, and paid for in different ways.

Many families end up using both. Here is how to tell them apart and work out what you need.

Home care (non-medical)

What it is: ongoing help with the activities of daily living so someone can stay safely at home. Bathing, dressing and grooming; meals; light housekeeping and laundry; medication reminders; companionship; transportation and errands; supervision for someone with dementia; respite for a family caregiver.

Who provides it: caregivers — also called personal care aides or home care aides — employed by a licensed home care agency. In Maryland these agencies are Residential Service Agencies (RSAs), licensed by the Department of Health’s Office of Health Care Quality.

How long: as long as it’s needed — months or years — from a few hours a week up to daily or live-in care.

Who pays: usually the family, privately or through long-term care insurance, Veterans benefits, or a Maryland Medicaid waiver. Medicare does not generally pay for non-medical home care.

What it doesn’t include: wound care, injections, IVs, catheter care, physical therapy, or any task that requires a nurse or therapist.

Home health care (skilled, medical)

What it is: short-term, goal-based skilled care ordered by a physician — typically after a hospital stay, surgery, or a change in a medical condition. Skilled nursing (wound care, medication management, monitoring), physical therapy, occupational therapy, speech therapy, and sometimes a home health aide for personal care during the skilled episode.

Who provides it: a Medicare-certified home health agency, staffed by registered nurses and licensed therapists.

How long: weeks, not years. It ends when the goal is met — the wound heals, mobility improves, the person is “homebound” no longer.

Who pays: Medicare Part A or B covers it in full when you qualify (a doctor’s order, a skilled need, and homebound status). Medicaid and private insurance may also cover it.

A quick way to tell which you need

• Does a doctor need to order it, and is there a nurse or therapy goal? That’s home health.
• Is it ongoing help with everyday life — getting washed, eating well, not being alone, getting to appointments? That’s home care.
• Is the person medically stable but no longer safe managing alone? Home care.
• Are they recovering from something specific with a clear endpoint? Home health, often followed by home care once the skilled episode ends.

How they work together

A common pattern after a hospital discharge: a home health agency sends a nurse and a physical therapist for a few weeks to manage recovery, while a home care agency provides a caregiver every morning for bathing, breakfast and safety. When the home health episode ends, the home care continues for as long as it helps.

Selectives Home Care provides the non-medical side. If your family needs skilled home health, we’ll tell you plainly and help you find a Medicare-certified agency — and we can keep providing the day-to-day support alongside it.

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Not sure which one fits your situation? A care coordinator can help you work it out on a short call — free, and with no obligation.

This article is general information, not medical, legal or financial advice. For clinical questions, speak to your doctor.