As more older adults prefer to age in their own homes, in-home care provides support and services to do so. There are two types of in-home care: home care and home health care. It is important to note that terminology and regulations vary from state to state. Services, eligibility requirements, and payment options vary by provider.


Home Care

Home care is typically non-medical care for individuals who may need help with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and/or companionship. Care services can include dressing, assistance with toileting, housekeeping, meal preparation, or transportation. Home care is usually provided by private agencies or independent home care aides (employed by the individual needing care).

Home care services are typically privately paid, with an hourly fee being the most common. The hourly fee is usually based on the level of assistance needed. Medicare, Medi-Cal, and private health insurance generally do not pay for home care. Long-term care insurance may cover a portion of the cost, if certain requirements are met.

In California, home care agencies are licensed and regulated by the Department of Social Services. Independent home care aides may register with the Department of Social Services Home Care Aide Registry, but are not required to do so at this time.

Home Health Care

Home health care provides certain types of medical and nursing services, typically for individuals who have been discharged from a hospital or skilled nursing facility and are recovering from an illness or surgery. Home health care services can include occupational, physical, or speech therapy; medical tests; administration of shots or medications; wound care; and other nursing services. Care services are usually prescribed by the individual’s physician.

Home health care services may be paid for privately or covered by Medicare, Medi-Cal, private health insurance, or long-term care insurance. Hourly fees are the most common and are usually based on the level of assistance needed.

In California, home health care providers are licensed and regulated by the Department of Public Health. If the provider accepts Medicare and/or Medi-Cal, it will be certified by the Centers for Medicare and Medicaid Services.