Sheet 04 · Which product you are buying

Non-medical home care vs home health: what is the difference

Published September 10, 2026. Desk byline, no clinician. Every fact links to its source.

The one distinction that sorts out most of the confused phone calls is non-medical home care vs home health, what is the difference. The discharge planner said “home health has been ordered.” You heard “someone is coming.” A nurse came for a visit and left. Nobody was there at 2am. You are hiring the second thing. Medicare does not pay for a companion. This sheet puts the two side by side so you stop waiting for a service that was never coming, and so you know which one you are actually hiring.

Does Medicare pay for a caregiver to come to the house?

For skilled home health, sometimes, if the person qualifies. Medicare.gov says you must need part-time or intermittent skilled services and be homebound to qualify, and you will not qualify if you need more than part-time or intermittent skilled care. You pay nothing for covered home health services. Medicare.gov says that, in most cases, “part-time or intermittent” means you may be able to get skilled nursing care and home health aide services up to 8 hours a day combined, for a maximum of 28 hours a week.

That is visits, not presence. Medicare also prints what home health does not pay for: 24-hour-a-day care at your home, home meal delivery, homemaker services like shopping and cleaning unrelated to your care plan, or custodial or personal care that helps you with daily living activities when that is the only care you need. The long-term care page says the same thing in one line: Medicare does not pay for long-term care, and you pay all costs for non-covered services, including most long-term care. So does Medicare pay for a caregiver to come to the house to sit, to cook, to do the 2am bathroom trip? No. Not when that is the only care needed.

Medicare.gov notes that although you are not eligible for long-term care under Medicare, you may be eligible for it through Medicaid if you meet eligibility requirements in your state, or you can choose to buy private long-term care insurance. Who in the family pays is a different fight. Who Pays for Mom is the desk for that argument. This sheet only names the product.

Missouri’s three types, in the state’s words

DHSS describes three types of care in the home.

1. Home health. Major payer Medicare. Skilled nursing, therapy, medical social services, and a home health aide for personal care, not homemaker or companion care. Short-term, part-time or intermittent, physician order, homebound for Medicare, state home health license.
2. In-home care. Major payer Medicaid, which Missouri calls MO HealthNet. Homemaker and personal care, respite, and related services for people who meet nursing-home level of care and are eligible. Request services at the DSDS Call Center, 866-835-3505. Missouri DSS prints that this coverage is different than Medicare and can help with benefits not normally covered through that program, such as nursing home care and personal care services.
3. Private duty and private pay. Private funds or insurance. Care in shifts. No physician order needed for aide personal care, respite, or companion care. No license issued in Missouri for that type of company.

A company may have one or all of these types of programs, DHSS says. Ask which line you are buying. Write “VISITS” or “SHIFTS” next to the answer.

What does a non-medical caregiver actually do during a shift?

The National Institute on Aging’s list is the job: bathing, dressing, grooming, using the toilet, eating, and moving around, plus household chores, meals, companionship, check-ins, and transportation. A reminder that it is time to take the tablets in the person’s own labeled box is prompting. Deciding which tablets those should be is medicine. The two can run in the same house at the same time: a home health nurse at 10am, a non-medical caregiver at 2am. They are not substitutes for each other.

Can a caregiver drive my dad to doctor appointments?

Ask before you hire. NIA lists transportation services that drive people to and from medical appointments among the services for older adults living at home. Whether this caregiver may use your car, their car, or a company car, and what proof they need to show, is a company question or, if you hired privately, a question for your own insurer. Write the answer on the fridge sheet. Do not find out in the driveway on the morning of the appointment.

Sources opened 10 September 2026. Full list on the sources page.