Home Care: Non-Medical vs. Skilled Care, Costs & How to Choose the Right Provider

Learn the difference between non-medical home care and skilled home health care, typical costs, and how to choose a provider.

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What Is Home Care? Non-Medical vs Skilled Home Care Costs How to Choose Frequently Asked Questions

What Is Home Care?

Home care is supportive services delivered in a person's home to help maintain independence, safety, and quality of life. It is used by older adults, people recovering from surgery, and individuals managing chronic illness.

There are two major categories: non-medical home care (personal/custodial care) and skilled home health care (medical care provided by licensed clinicians).

Non-Medical Home Care vs. Skilled Home Health Care

Non-Medical Home Care includes help with daily living (bathing, dressing, meals), companionship, transportation, and respite care.

Skilled Home Health Care includes nursing care, wound care, IV therapy, and rehab therapies. It requires a physician's order and is typically intermittent.

Non-Medical Home CareSkilled Home Health Care
ProvidersHome health aides, companionsRNs, PTs, OTs, SLPs
Requires doctor's orderNoYes
Requires homebound statusNoYes (for Medicare coverage)
ServicesPersonal care, daily supportMedical treatment, therapy
DurationOngoing, long-termEpisodic, tied to recovery
Medicare coverageGenerally not coveredCovered if criteria met

Home Care Costs

Non-Medical Home Care is primarily private pay. Typical costs include $25–$35/hour for aides and $200–$350/day for live-in care. Long-term care insurance or Medicaid waiver programs may cover some services.

Skilled Home Health Care is often covered by Medicare or insurance when criteria are met. Without coverage, RN visits and therapy visits can be expensive.

Costs vary by region, hours needed, and provider type.

How to Choose the Right Home Care Provider

Clarify the type of care needed, verify licensing and accreditation, ask about caregiver screening, confirm availability, review costs and contracts, and check reviews or references.

Frequently Asked Questions

What's the difference between a home care agency and hiring a caregiver independently?

Agencies handle hiring, training, scheduling, and payroll taxes, and provide backup caregivers. Independent caregivers are less expensive but require more family management.

Does Medicare cover non-medical home care?

Generally, no. Medicare does not cover custodial or personal care unless it is part of a skilled home health episode.

How many hours of home care does someone typically need?

It varies widely. Some families need a few hours a week; others need full-time support.

Can home care be combined with hospice or palliative care?

Yes. Home care aides can supplement hospice or palliative teams with daily support and companionship.

What if my loved one refuses help at home?

Start with a small amount of help, frame it as assistance around the house, and involve the person in caregiver selection.

How do I know if someone needs home care vs. a facility?

Home care is appropriate when needs can be met safely at home; a facility may be needed for very intensive care.

Internal links

  • If your loved one's illness is advancing and curative treatment is no longer the goal, learn about Hospice Care — which includes in-home support.
  • For those managing serious illness while still pursuing treatment, Palliative Care can be combined with home care services.

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