How is private duty different from a home health agency?

Home health is short-term, doctor-ordered skilled nursing or therapy paid by Medicare after a hospitalization, with a few visits per week. Private duty is open-ended hourly or live-in non-medical care families schedule themselves, with caregivers staying for hours or days at a time. Most families need both at different points: home health right after discharge, private duty for the long stretch of recovery and daily living that follows.

What does a private duty caregiver actually do?

A private duty caregiver assists with activities of daily living (bathing, dressing, toileting, transfers, mobility), instrumental activities (meal prep, laundry, light housekeeping, errands, transportation), medication reminders, companionship and supervision, and communication with the family. They do not administer medications, perform wound care, or provide skilled nursing — those are home health functions.

How much does private duty home care cost in Michigan?

Typical private duty home care rates across Southeast Michigan agencies run roughly $27–$32/hr for companion care, $29–$37/hr for personal care with hands-on ADL support, and $400–$500/day for live-in care when the home meets eligibility. Specialized dementia and Parkinson's care typically runs $35–$42/hr. These are general market ranges for the region — not a quote from any single agency. Rates vary by provider, schedule, and care complexity, so always confirm pricing in writing with the agency you choose.

Who pays for private duty home care?

Most private duty home care is paid out-of-pocket or through long-term care insurance. Other sources include VA Aid & Attendance for wartime-era veterans and surviving spouses, the Michigan MI Choice Medicaid waiver for income-qualified seniors, and life insurance accelerated benefits. Medicare does not pay for private duty — Medicare only covers short-term skilled home health.

Is private duty the same as hiring a caregiver privately?

No. 'Private duty' is the industry term for non-medical home care delivered through a licensed agency — the agency handles employment, taxes, background checks, supervision, and backup coverage. 'Private hire' means a family directly employs an individual caregiver, taking on the tax, insurance, and replacement responsibilities themselves. Both are paid privately, but the legal and operational risk profiles are very different.

Definition Guide

What Is Private Duty Home Care?

Q: What is private duty home care?

Private duty home care is non-medical, one-on-one in-home support that families pay for directly (private pay) or through long-term care insurance, VA Aid & Attendance, or a Medicaid waiver. A private duty caregiver helps with bathing, dressing, meals, transfers, mobility, medication reminders, light housekeeping, and companionship in the client's own home. It is distinct from Medicare-funded home health care, which is short-term, doctor-ordered skilled nursing.

Last Reviewed by Austin Adair · May 2026

Private duty home care is non-medical, one-on-one in-home support a family schedules and pays for directly — out-of-pocket, through long-term care insurance, VA Aid & Attendance, or the Michigan MI Choice Medicaid waiver.

A private duty caregiver helps with bathing, dressing, meals, transfers, mobility, medication reminders, light housekeeping, and companionship, in the client's own home, on a schedule the family controls.

It is fundamentally different from Medicare home health, which is short-term, doctor-ordered, and intermittent. Private duty is open-ended and family-directed.

The Four Things a Private Duty Caregiver Does

A private duty caregiver covers four categories of daily support: activities of daily living, instrumental activities of daily living, medication reminders with supervision, and companionship with family communication. These are non-medical services delivered in the home under an agency's supervision and backup coverage.

Activities of daily living (ADLs)

Bathing, dressing, toileting, transfers, mobility, eating cues — hands-on personal care delivered with dignity protocols.

Instrumental ADLs (IADLs)

Meal prep, light housekeeping, laundry, errands, transportation, grocery shopping, appointment escorts.

Medication reminders & supervision

Verbal reminders, watching for safety risks, fall prevention, wandering supervision in dementia care. We do not administer medication.

Companionship & family communication

Conversation, activity engagement, daily-log notes to family, photo/video updates, coordination with adult children at a distance.

Private Duty vs. Home Health vs. Private Hire

Private duty is paid privately and delivers open-ended non-medical support. Home health is Medicare-funded skilled nursing that is short-term and intermittent. Private hire is an individual the family employs directly with no agency backup, taxes, or replacement coverage. The table below compares them side by side.

	Private Duty (Agency)	Home Health	Private Hire
Who pays	Family / LTC ins / VA / Medicaid waiver	Medicare (after hospitalization)	Family directly
What's delivered	Non-medical ADL/IADL support	Skilled nursing, PT/OT, wound care	Whatever the individual is hired for
Schedule	Open-ended, hours or live-in	Short-term, intermittent visits	Whatever the family arranges
Backup coverage	Yes — agency replaces	Yes — agency replaces	No — family handles gaps
Employer taxes	Agency handles	Agency handles	Family handles (1099 vs W-2)

For a deeper breakdown see private hire vs. agency and home health vs. home care.

Who Hires Private Duty Home Care?

Most private duty clients are adult children coordinating care for a parent who wants to stay home, spouses preventing caregiver burnout, families bridging hospital discharge, long-term care insurance policyholders triggering benefits, wartime veterans qualifying for Aid & Attendance, and sibling teams coordinating shifts across distance.

Adult children coordinating care for a parent who wants to stay home — often the most common situation
Spouses providing primary care who need respite to prevent caregiver burnout
Families discharging a loved one from Beaumont, Henry Ford, Corewell, or Trinity hospitals who need bridge support after Medicare home health ends
Long-term care insurance policyholders triggering benefits for two-or-more ADL impairment
VA wartime-era veterans qualifying for Aid & Attendance
Sibling teams coordinating shifts across distance — one local, one out-of-state

If any of those sound like your situation, start with the Getting Started hub or call 248-419-5010.

FAQ

Private Duty Home Care — Common Questions

Private duty home care is non-medical, one-on-one in-home support a family hires directly — bathing, dressing, meals, transfers, medication reminders, companionship — paid through private funds, long-term care insurance, VA Aid & Attendance, or a Medicaid waiver. It is not the same as Medicare home health.

Home health = short-term, skilled, Medicare-paid, intermittent visits. Private duty = open-ended, non-medical, hourly or live-in, family-paid. Most families use both — see the side-by-side comparison.

ADL hands-on help (bathing, dressing, transfers), IADL support (meals, laundry, errands), medication reminders, companionship, and family communication. See Personal Care and Companion Care for the service breakdown.

Typical Southeast Michigan agency ranges: companion care $27–$32/hr, personal care $29–$37/hr, specialized care $35–$42/hr, live-in $400–$500/day. These are general market figures — not a quote — and vary by provider and schedule. Model your week in the cost calculator.

Private pay, long-term care insurance, VA Aid & Attendance, MI Choice Medicaid waiver, life-insurance accelerated benefits. Medicare does not pay for private duty. See paying for home care for the full breakdown.

No — private duty = agency-delivered. Private hire = family directly employs an individual and assumes employer-tax and replacement risk. See private hire vs. agency.

Estimate your weekly cost Call 248-419-5010