What is the difference between home care and home health care?
Key facts
- Home health payer
- Medicare (when criteria met)
- Home care payer
- Private pay, LTC insurance, VA, Medicaid waivers
- Medicare home-health window
- Typically 30–60 days
- Home care rate band, Southeast MI
- $27–$42/hr
- Common overlap pattern
- Both run together first 1–4 weeks home
Home health and home care look similar from the outside but are two different products with two different payors. Home health is what Medicare pays for: a Medicare-certified agency sends a Registered Nurse, physical therapist, or occupational therapist for short visits — typically 30–60 minutes, 2–3 times per week — for 30 to 60 days after a qualifying hospital or skilled-nursing discharge.
Home care is what Medicare does not pay for: hands-on, daily, non-medical support. Bathing, dressing, transfers, toileting, meal preparation, medication reminders, supervision, transportation. It is ongoing rather than episodic, billed hourly in Michigan at $27–$42/hr depending on acuity tier, and paid privately or through long-term care insurance, VA Aid & Attendance, or the MI Choice waiver.
Most Southeast Michigan families running a hospital discharge need both at once: a Medicare home-health nurse visits 2–3× per week while a private non-medical caregiver covers the daily hours the nurse does not. When the Medicare window closes, the private hours often continue.
The two services are complementary, not interchangeable. A home-health PT can prescribe a gait pattern; a home-care caregiver reinforces it across the 165 other hours of the week.
For the full breakdown, see the cornerstone: Home Health Care vs. Home Care guide.
Related questions
- Can I get both at the same time?
- Yes — and most Southeast Michigan families do, especially in the first 1–4 weeks after a hospital discharge.
- Does the same agency provide both?
- Usually not. Home health agencies are Medicare-certified clinical providers. Home care agencies are non-medical and private-pay.
- Which one comes first after a hospital stay?
- Both typically start within a week of discharge. The hospital case manager refers home health; the family arranges home care.
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