The Difference Between Home Health and Home Care in Pennsylvania

Home health and home care are two different things. They sound interchangeable — and most families use them that way — but they’re funded differently, they provide different services, and they serve different needs. Understanding the distinction matters because it determines what your family qualifies for, who pays for it, and what kind of help actually shows up at your door.

Home Health Care: Medical Services at Home

Home health care is a medical service. It’s prescribed by a doctor and typically provided after a hospitalization, surgery, or acute medical event. Home health includes skilled nursing (wound care, IV therapy, injections, medication management), physical therapy, occupational therapy, speech therapy, and medical social work.

Home health is covered by Medicare (for eligible individuals) and sometimes by Medicaid or private insurance. It requires a physician’s order, and the services are time-limited — they continue until the patient recovers, stabilizes, or reaches their care goals. Home health agencies employ licensed nurses and therapists.

If your loved one just came home from the hospital after a hip replacement and needs a nurse to check the incision and a physical therapist to help them regain mobility, that’s home health.

Home Care: Daily Living Support at Home

Home care — sometimes called personal care or attendant care — is a non-medical service. It helps people with the daily activities that become difficult due to aging, disability, or chronic conditions. Home care includes help with bathing, dressing, and grooming, meal preparation, light housekeeping and laundry, medication reminders (not administration), mobility assistance and fall prevention, companionship and supervision, grocery shopping and errands, and transportation to appointments.

Home care is what most Philadelphia families are actually looking for when they say “my mom needs help at home.” It’s ongoing, not time-limited. And in Pennsylvania, it’s funded primarily through Medicaid — specifically through Community HealthChoices and the state’s waiver programs.

This is also where paid family caregiving lives. Through Participant-Directed Services under CHC, a family member can be hired and paid to provide home care services. That’s not available under home health — you can’t hire your daughter to be a skilled nurse. But you can absolutely hire her to help with bathing, meals, housekeeping, and daily support.

Why the Confusion Costs Families

The confusion between these two services creates real problems. Families who need ongoing daily support sometimes call asking for “home health” and get told their loved one doesn’t qualify — because they don’t need skilled nursing, they need personal care. They walk away thinking there’s no help available, when in reality the help they need just has a different name and a different funding source.

Other families get home health services after a hospitalization, those services end after a few weeks, and they assume that’s it — no more help. They don’t realize that a completely separate system (Medicaid home care through CHC) exists to provide the long-term daily support their loved one needs going forward.

And some families don’t realize that Medicare and Medicaid can work together. Your loved one might qualify for short-term home health through Medicare after a hospital stay AND ongoing home care through Medicaid for daily living support. These aren’t either/or — they’re different programs serving different needs.

Which One Does Your Family Need?

If your loved one needs skilled medical treatment at home — a nurse to manage a wound, a therapist to help them walk again — they need home health. Talk to their doctor about a referral.

If your loved one needs help with the daily basics — bathing, dressing, eating, keeping the house clean, taking medications on time, staying safe — they need home care. And if they’re on Medicaid (or eligible for it), Pennsylvania’s programs may cover it entirely, including paying a family member to provide the care.

Not sure which applies? CareChoice can help you sort it out. We work within the Medicaid home care system every day and can quickly help your family understand which services fit your situation.

Contact CareChoice → Philadelphia team

Related: Get Paid to Care for Family in PA → | Community HealthChoices in Philadelphia → | Can I Get Paid to Care for My Mom? →