If your parent is coming home from the hospital, someone has probably said “home health” to you. Someone else said “home care.” They sound like the same thing. They aren’t, and the difference decides who comes to the house, how often they come, and who pays.
What’s the difference between home care and home health?
Home health is medical care at home. Medicare describes it as care for an illness or injury that helps you get better, keep your current level of function, or slow decline. Typical services include wound care, injections, IV therapy, monitoring a serious illness, and physical, occupational, or speech therapy.
Home care, also called in-home care, is everyday help. A caregiver helps with bathing, dressing, toileting, moving around the house, meals, housekeeping, errands, and rides. The Oregon Health Authority licenses in-home care agencies and says plainly that they aren’t home health agencies, because they don’t provide home health services as Oregon law defines them.
- Who comes: home health sends nurses and therapists, sometimes with an aide. Home care sends a caregiver.
- What they do: home health handles skilled medical tasks, plus some part-time aide help while that skilled care lasts. Home care handles the tasks of daily living, for as many hours as you need.
- How often: home health visits are part-time or intermittent. Home care can run from a few hours a week to around the clock.
- Who starts it: home health needs a doctor or other allowed provider to order it. If you’re paying privately, your family can arrange home care directly. If Medicaid will pay, it starts with your local Aging and People with Disabilities or Area Agency on Aging office.
- Who pays: Medicare pays for covered home health. Medicare doesn’t pay for long-term care.
Does Medicare pay for home health in Oregon?
Yes, if your parent qualifies. Medicare is a federal program, so the rules are the same in Salem as anywhere else. With Original Medicare, your parent pays nothing for covered home health services. Medical equipment is different: after the Part B deductible, your parent pays 20 percent of the Medicare-approved amount.
To qualify, your parent needs all of these:
- A doctor or other allowed provider (a nurse practitioner, clinical nurse specialist, or physician assistant) who oversees a care plan and reviews it regularly
- A need for intermittent skilled nursing care (a blood draw alone doesn’t count), physical therapy, speech-language therapy, or continued occupational therapy
- Certification from that provider that your parent is homebound
- A face-to-face visit with the provider, related to the reason for home health care
- A home health agency that’s Medicare-certified
Homebound doesn’t mean your parent can never leave the house. It means they normally can’t leave, and leaving takes a major effort, usually with help like a walker, a wheelchair, special transportation, or another person. Medicare says your parent can still leave for medical treatment and for short, infrequent outings, like a trip to the barber or a family event. Going to adult day care or religious services doesn’t disqualify them either.
If your parent has a Medicare Advantage plan, call the plan before you choose an agency. Medicare says these plans may require you to use agencies they contract with.
What doesn’t Medicare cover at home?
Medicare won’t pay for:
- 24-hour care at home
- Home meal delivery
- Homemaker services like shopping and cleaning, when they aren’t part of the care plan
- Personal care, like help bathing, dressing, or using the bathroom, when that’s the only care your parent needs
Medicare also limits how much care counts as part-time or intermittent. Combined home health aide and skilled nursing time must stay under 8 hours a day and at or under 28 hours a week. In some limited cases, Medicare allows up to 35 hours a week. If your parent is expected to need full-time skilled nursing for a long stretch, they usually won’t qualify.
Most important, Medicare doesn’t pay for long-term care: the ongoing help with dressing, bathing, using the bathroom, and other daily tasks that many older adults need. Medicare points families to Medicaid, for people who meet their state’s rules, or to private long-term care insurance. Our guide to the cost of home care in Oregon walks through how families pay.
One protection to know about: if a home health agency thinks Medicare probably won’t pay for a service, it must give you a written notice called an Advance Beneficiary Notice of Noncoverage (ABN) before providing it.
Which one does your parent need?
Ask two questions. Does your parent need a nurse’s or therapist’s skills? And does your parent need help getting through the day?
- Home health fits when a doctor has ordered skilled care, like wound care, injections, or therapy, and your parent is homebound.
- Home care fits when your parent needs help bathing, dressing, eating, or getting around, or shouldn’t be alone, and no skilled care is ordered. It also fits after home health ends but daily needs haven’t.
- Both fit when your parent needs skilled visits and daily help at the same time.
Here’s how that looks in real life. Your mother comes home after hip surgery. A home health nurse checks the incision, a physical therapist works on walking, and Medicare may also cover a part-time aide to help her bathe. Between those visits, someone still has to make lunch, help her to the bathroom at night, and be there the rest of the day. That’s home care. Our page on recovery after surgery covers that stretch in more detail.
Can home care and home health work together?
Yes, and they often do. The home health team handles the skilled visits and reviews the care plan with your parent’s provider at least every 60 days. A home care caregiver covers the daily hours in between.
When home health ends, daily needs often don’t, and home care can keep going after the nurse and therapist stop coming. Our hospital discharge checklist can help you plan that stretch.
How do you get home health started?
- Talk to your parent’s doctor or the hospital discharge planner. Home health starts with a provider’s order.
- Choose an agency. Medicare says you have a say in which agency you use, and your provider or discharge planner should honor your choice. Medicare’s Care Compare tool at medicare.gov lists agencies that serve your area.
- Ask about coverage before care starts. Call 1-800-MEDICARE (1-800-633-4227), or, for Medicare Advantage, call the plan. Oregon’s SHIBA program also has trained counselors who help Oregonians with Medicare questions at 800-722-4134.
How Pasha can help
Pasha Health is an in-home care agency, not a home health agency. We provide the daily side of care: personal care, around-the-home help, nutrition and meal prep, transportation, companionship, respite, overnight and 24-hour care, and post-hospital recovery support for the weeks after a hospital stay. Your parent gets a written care plan and one assigned caregiver for regular visits. 24-hour care is covered by a small team. When a doctor orders it, our caregivers can also handle nurse-delegated tasks. We accept Medicaid.
Not sure which kind of help your parent needs? Schedule a 15-minute call or take the 2-minute assessment.
Questions families ask
Is home care the same as home health?
No. Home health is skilled medical care, like nursing and therapy, ordered by a doctor or other allowed provider. Home care is everyday help with things like bathing, dressing, meals, and getting around. In Oregon they’re separate kinds of agencies.
Does Medicare pay for home care?
Not on its own. Medicare doesn’t pay for help with bathing, dressing, or using the bathroom when that’s the only care your parent needs, and it doesn’t pay for long-term care. Medicaid may help if your parent qualifies.
How does my parent qualify for home health in Oregon?
The Medicare rules are the same nationwide. Your parent needs a provider-ordered care plan, a need for intermittent skilled nursing or therapy, a homebound certification, a related face-to-face visit with the provider, and a Medicare-certified agency.
What happens when home health ends?
The skilled visits stop, but daily needs may not. Many families add or continue home care so their parent still has help with bathing, meals, and getting around.
Sources: Medicare.gov (Home health services; Long-term care), Medicare & Home Health Care (CMS Product No. 10969, July 2025), Oregon Health Authority In-Home Care Agency Initial Licensure FAQ (updated August 1, 2025), Oregon Department of Human Services (Long-term care services), and Oregon SHIBA (shiba.oregon.gov).