Home Care vs Home Health: What's the Difference in Pennsylvania?
Home Care vs Home Health: What's the Difference in Pennsylvania?
Short answer: Home health provides short-term, skilled medical care prescribed by a doctor, like physical therapy. Home care offers ongoing, non-medical help with daily living activities, like bathing and meal prep.
- Home health is medical care (nursing, therapy) covered by Medicare for homebound patients.
- Home care is non-medical support (personal care, companionship) paid privately or through Medicaid waivers.
- You can receive both services at the same time, often after a hospital stay.
- Home care caregivers do not perform skilled nursing tasks like wound care or giving injections.
The Difference in One Table
Families often use the terms interchangeably, but home care and home health mean different things under Pennsylvania law. Choosing between these care options depends on whether your loved one needs medical treatment or daily living support.
| Feature | Home Health | Home Care |
|---|---|---|
| Who provides it | Licensed nurses, physical therapists, occupational therapists | Direct care workers, caregivers, companions |
| Services | Skilled medical care (wound care, injections, rehab) | Non-medical support (bathing, dressing, meal prep) |
| Doctor’s order needed? | Yes | No |
| Must be homebound? | Yes (required by Medicare) | No (you can leave the house) |
| Primary payer | Medicare, health insurance | Private pay, Medicaid waivers (CHC), VA programs |
| Duration | Short-term, intermittent | Ongoing, long-term, up to 24/7 |
What Home Health Covers Under Medicare
Home health care is clinical care designed to treat an illness or injury. According to the federal government, Medicare home health covers part-time or intermittent skilled nursing, physical therapy, occupational therapy, and speech therapy. It also covers medical social services and durable medical equipment.
To qualify for Medicare coverage at $0 cost, a doctor must prescribe the care. The patient must also be certified as homebound, meaning leaving the house requires a major effort or the help of another person or device.
Medicare home health limits how often and how long a nurse or therapist visits. It does not cover 24-hour care. It also does not cover personal care—like bathing or dressing—if that is the only care you need. Understanding the limits of Medicare vs Medicaid helps families plan for long-term needs.
What Home Care Covers
Home care provides non-medical support to help older adults live safely at home. Under Pennsylvania home care law (28 Pa. Code Chapter 611), a home care agency supplies employees to provide services as directed by the consumer. These are non-skilled services. Caregivers do not perform wound care, give injections, manage IVs, or conduct nursing assessments.
Pennsylvania defines several types of home care services:
- Personal care: Assistance with ambulation, bathing, dressing, toileting, transferring, feeding, and self-administered medications.
- Companionship services: Socialization, support, and help with instrumental activities of daily living (IADLs) like meal prep, laundry, and shopping.
- Respite care: Short-term personal care and IADL help provided to relieve the person normally providing the care.
- Specialized care: Non-skilled services unique to the consumer’s needs, such as support for dementia, Parkinson’s disease, or stroke recovery.
How Home Care is Paid
Because Medicare does not pay for ongoing non-medical care, families use other methods to cover the cost.
Medicaid Community HealthChoices (CHC): The CHC waiver pays for Personal Assistance Services (PAS). PAS includes help with daily activities, cueing for people who cannot safely be left alone, health maintenance routines, and accompanying the person into the community for grocery shopping or the pharmacy. The CHC waiver also covers non-medical transportation, home adaptations, and personal emergency response systems. Read our PA Medicaid for home care guide to learn about eligibility.
Private Pay: Families paying out of pocket pay agency rates. The CareScout Cost of Care Survey reports the 2025 Pennsylvania statewide median for a non-medical caregiver is $34 per hour. At the PA median of $34 per hour, 24 hours of hourly care equals $816 per day, or $5,712 per week.
Veterans Programs: Enrolled veterans who meet clinical criteria may qualify for VA Homemaker and Home Health Aide Care or Veteran-Directed Care. Veterans should ask their VA social worker about local availability.
New Century Home Care serves Philadelphia, Bucks, Montgomery, Delaware, and Chester counties. Call 215-974-0000 or contact us online. Choose “I am a client” and “I need services” on the form. Our office staff speaks English, Russian, and Ukrainian.
Using Both at Once
Many older adults receive both home health and home care at the same time. This is especially common after a hospital stay or a fall. More than one out of four older people falls each year, often resulting in injuries that require rehabilitation.
If your loved one comes home after a fall or surgery, the doctor may order Medicare home health: part-time visits from a nurse or therapist.
However, the patient still needs help getting out of bed, showering, using the toilet, and preparing meals the rest of the week. This is where non-medical home care fills the gap. An agency caregiver provides post-surgery support for the hours in between, helping with transfers, bathing and household tasks.
Home Health Aide vs Caregiver
A home health aide usually works for a Medicare-certified home health agency under the direct supervision of a registered nurse. They provide brief personal care only while the patient is actively receiving skilled nursing or therapy.
A non-medical caregiver works for a licensed home care agency to provide ongoing daily support. In Pennsylvania, home care workers must meet strict competency standards before they work with clients. They must pass the agency’s competency exam or complete a formal training program. The training covers confidentiality, infection control, recognizing abuse, dealing with difficult behaviors, and personal care tasks like bathing and transferring. A Certified Nursing Assistant (CNA) license is not required for non-medical home care.
For a detailed breakdown of job duties and training, read our home health aide vs caregiver comparison.
Need non-medical home care in the Philadelphia area? Call New Century Home Care at 215-974-0000 or fill out our contact form, selecting “I am a client” and “I need services.”
Frequently asked questions
What is the difference between a home health aide and a caregiver?
A home health aide provides basic personal care under the supervision of a nurse, usually as part of a short-term medical treatment plan. A caregiver provides non-medical support, such as help with bathing, dressing, and meal preparation, through a licensed home care agency for ongoing daily needs.
What are the disadvantages of home health care?
Home health care is limited to part-time or intermittent visits. You must be certified as homebound by a doctor, and it does not cover long-term, continuous help with daily activities like bathing and dressing if that is the only care you need.
Is home health care covered by Medicare?
Yes. Medicare covers part-time, skilled home health services at $0 for eligible individuals. This includes skilled nursing, physical therapy, occupational therapy, and speech therapy. It requires a doctor’s order and the patient must be homebound.
What are the different types of home care?
Under Pennsylvania law, non-medical home care includes personal care (help with bathing, dressing, toileting), companionship (socialization and housekeeping), respite care (short-term relief for family caregivers), and specialized care for specific needs like dementia or stroke recovery.
Non-medical home care in Philadelphia, Bucks, Montgomery, Delaware and Chester counties. Medicaid CHC (Keystone First), VA programs and private pay. We speak English, Russian and Ukrainian.
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