Start where you are
You landed here because someone you love needs more help at home than they used to — and you’re trying to figure out what that even means, who provides it, and what it costs. This is the map. Start wherever your question is most urgent; each link goes to the page that answers it in full.
First, the distinction that decides everything
Before anything else, one distinction sorts out most of the confusion: home health is skilled, doctor-ordered care (nursing, physical therapy) that Medicare usually pays for — and home care is help with daily life (bathing, meals, company) that is generally non-medical and paid by you. Confusing the two is the single most expensive mistake families make in the first week, because it decides who pays for what.
Home health vs. home care — how to tell which one you’re actually being offered →
Will Medicare pay for it?
For skilled home health care, often yes — when a doctor orders it and she’s homebound. For home care (help with bathing, meals, and daily tasks), almost never — that’s the part families don’t see coming. The full rules, and the narrow exceptions, are here.
Does Medicare pay for home care? The honest answer, and the exceptions →
What does it cost?
Home care is priced by the hour, and the hours add up faster than anyone expects — a few hours a day is one number, around-the-clock is a very different one. Knowing the real ranges before you call an agency changes every conversation you’ll have.
What in-home care actually costs — by the hour, month, and year — and what drives the price →
How do you hire someone — and someone good?
There are three ways to bring someone in — through an agency, through a registry, or hiring privately — and they differ in cost, control, and who carries the legal and tax burden. Then, whichever path you choose, there’s the question that keeps families up at night: how do you know you can trust this person in the home?
How to hire an in-home caregiver — three paths and the tax trap in the middle one →
How to vet and interview an aide before you trust them alone in the home →
What does a caregiver actually do?
“Caregiver” covers everything from a few hours of companionship to hands-on personal care — and there’s a legal line a non-medical caregiver can’t cross into skilled nursing work. What your caregiver does isn’t a fixed list; it’s set by what the person actually needs, written down as a plan.
What a caregiver does day to day — and what they legally can’t →
Start with the number nobody has given you
Every question on this page — home health or home care, what it costs, how many hours to hire — comes back to one thing you probably haven’t pinned down yet: how much help does she actually need, and with what. “She’s declining” isn’t something an agency can quote or a plan can be built on. A specific list of tasks and hours is.
The care needs checklist walks the same fourteen questions a visiting nurse walks, and ends with something concrete: which daily tasks need hands-on help, roughly how many hours a week, and which gaps are genuine safety issues.
Take the care needs checklist →Free. No email, nothing stored — it runs in your browser and the answers never reach me.
Questions families ask
What is home care?
Home care is non-medical help with the activities of daily life — bathing, dressing, meals, medication reminders, light housekeeping, and companionship — provided in a person’s own home. It differs from home health, which is skilled, doctor-ordered medical care such as nursing and physical therapy. Home care is generally paid out of pocket or through long-term care insurance or Medicaid, while home health is often covered by Medicare.
Does Medicare pay for home care?
Medicare generally does not pay for home care when it is only non-medical help with daily tasks such as bathing, dressing, and meals. It does pay for skilled home health care — nursing and therapy — when a doctor orders it and the person is homebound. The most common surprise for families is that personal care alone, without a skilled need, is not covered.
How much does home care cost?
Home care is typically billed by the hour, so the cost depends heavily on how many hours a week are needed, ranging from a few hundred dollars a week for a few daily visits to several thousand for around-the-clock care. Rates vary by region and by whether care is arranged through an agency or privately. The full breakdown by hour, month, and year is covered in the cost guide.
How do I find a good caregiver?
You can find a caregiver through an agency, through a registry, or by hiring privately, and each path differs in cost, control, and who carries the tax and legal responsibility. Whichever route you choose, vetting matters — checking references and background, and interviewing carefully before trusting someone alone in the home. The hiring and vetting guides walk through each step.
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Changelog
- 19 August 2026 — Linked the new guide on choosing a quality home health agency.
- 25 July 2026 — Published as the Home Care section hub.
Sources
- Medicare home health benefit rules — coverage of skilled care, the homebound requirement, and the exclusion of non-medical personal care
- CareScout / Genworth Cost of Care data — national ranges for in-home care by hour, month, and year
- Thirteen years of the author’s own observation inside home health and hospice referral, labeled as such throughout
Last verified: 19 August 2026 against Medicare home health coverage rules and current national cost-of-care data · Next review: February 2027, or immediately on a relevant change
This page is educational and is not medical, legal, or financial advice. Mark Duda is not a physician, a nurse, or an attorney. Coverage rules and costs vary by state and by individual circumstance — confirm details with her care team and the official sources. See our disclaimers.