Home health vs home care: what's the difference?

Home health is short-term, goal-directed clinical care. A patient recovering from surgery, a hospital stay or a flare of a chronic condition receives visits from nurses and therapists who carry out the physician's plan. The goal is recovery and independence, and the episode ends when goals are met. Medicare covers home health for patients who qualify (Medicare.gov).

Home care, sometimes called personal care or private duty care, helps people with daily living when they need ongoing support but not skilled clinical services. It can be a few hours a week or round-the-clock. It is often the right answer for long-term needs, such as an older adult who is medically stable but can no longer manage household tasks alone.

In Texas, both services are licensed by Texas Health and Human Services as Home and Community Support Services Agencies, under different license categories. Agencies licensed only for personal assistance services may provide attendant care such as bathing, dressing or toileting, but may not provide skilled services such as therapy or nursing. You can look up any agency's license and categories with the state's provider search (Texas LTC Provider Search).

Yes. Many families combine them: home health for the skilled recovery work, and home care to cover hours of personal help between visits. When a home health episode ends, our social worker can explain community options for ongoing support.

When the Medicare requirements are met, Medicare pays for covered home health services with no copay for the visits themselves; durable medical equipment may have a 20% coinsurance (Medicare.gov). Medicare Advantage plans cover home health too, though they may require prior authorization or use specific agencies.

Home care is usually paid privately, by the hour. Some long-term care insurance policies, veterans' benefits and Texas Medicaid programs can help pay for personal attendant services when a person qualifies. Because rules and rates change, ask each provider for written pricing and confirm coverage with your plan before services begin.

Whether you choose home health or home care, a few questions help you compare providers fairly:

• Is your agency licensed by Texas HHS, and what is your license number?
• For home health, are you Medicare-certified, and what are your scores on Care Compare?
• How quickly can you start, and who will be my main contact?
• How are caregivers and aides trained, screened and supervised?
• How do you handle complaints, and how do I reach someone after hours?
• Do you offer interpreters or caregivers who speak my language?

A good provider will answer every one of these clearly and in writing if you ask.

Ask two questions. Does the person need care that only a nurse or therapist can safely provide? Is it hard for them to leave home? If the answer to both is yes, start with home health and talk with the physician. If the main need is help with daily tasks, home care is likely the better fit.