Home Care vs. Home Health Care

In the last eleven years of us being in this business, we have come across countless situations where people mix up the term Home Care vs. Home Health Care. It sounds very similar and hence the confusion.

Let’s take the case of George. George is 95 years young and is in good shape physically. George lives by himself. He owns a beautiful home overlooking the canyon. He walks about 2 miles every day in the morning and then drives to the club to meet his friends for a game of poker. He stays long enough to have lunch at the club and then he comes home. Most times he even brings dinner with him.

George has been in the hospital for a knee replacement. The surgery went well and from there he went to a rehab center for a week. George was discharged to go home. Though George has been discharged to go home, he still needs help getting around the house.

Home Health Care

The doctor told George that he should be getting some physical therapy (PT) in his home. Also there was an infection around the sutures, which will require the wound dressing to be changed every couple days. This is where Home Health Care comes in. The physician prescribes the PT and wound dressing which are sent to a Home Health Agency of their choice. The physician decides how many days of PT in a week and how many weeks, etc. At the end of the initial prescription, the physician does an evaluation of the patient and decides if more PT is needed or not. The Home Health Agency sends a Physical Therapist as per the prescription and a nurse to do the wound dressing. These services are then billed to the respective insurance agency, be it the medical insurance or Medicare. In this situation, George does not have to pay for these services directly.

Home Care

George also needed someone to help him to the restroom, give him a shower, take him for a walk, etc. Let’s call these the activities of daily living (ADL). This is where Home Care comes in. George or his POA contacts a Home Care Agency who will then come out, do an assessment of George and in consultation with George, decide on how many hours a day and how many days a week he will need service. Once that decision is made and the service agreement is signed, the Home Care Agency will send a caregiver to provide the service. The services from the Home Care Agency are paid by the client. Exceptions to this are if the client has long term care insurance (LTCI). If George decides he needs more care, he can increase the level of care, or decrease it as needed.

So in a nutshell services prescribed by a physician and paid for by the health insurance/Medicare are provided by Home Health Care. Services that assists with ADL and such, where the client or LTCI pays for the service are provided by Home Care.